Posted on by khumbard87

Self-Diagnosis

There have been several times (more than I can count) over the past few years a client has come for an initial session and told me that they believe they have a specific diagnosis, without having input from a professional. Many times, when I ask why they believe this, they tell me that they saw something on a social media platform that really resonated with them and aligned with symptoms they are experiencing. A lot of these answers start with “I saw this video on TikTok…”

First off, I want to say that I think people talking about mental health on social media can be a really great thing. The more we share, the more “normalized” mental health concerns are, and this is decreasing the negative stigma related to mental health symptoms and diagnoses, counseling, psychiatry, etc. I think it’s awesome that individuals are finding videos that they can relate to and get to see that there are others out there going through the same (or similar) experience(s). This makes mental health concerns and diagnosis seem less scary and less isolating. This is normalizing, and I AM HERE FOR IT!

However, self-diagnosis can be so super tricky and complicated, and here’s why:

A set of symptoms alone does not equal a diagnosis.

What I mean here is that there are other diagnostic criteria to take into consideration. For most, if not all, diagnosable mental health disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5TR) there are criterion in addition to a set of symptoms that must be met. For example, let’s look at the diagnostic criteria for Generalized Anxiety Disorder. Yes, there is a list of symptoms, but you also have to meet the following criteria:

  • The anxiety and worry has to occur more days than not for at least 6 months and must be about a number of events or activities.
  • The individual must find “it difficult to control the worry.”
  • The anxiety, worry, or symptoms must cause clinically significant distress or impairment in social, occupational, or other settings.
  • The symptoms cannot be attributable to the effects of substance abuse, and lastly
  • The symptoms cannot be better explained by a different metal health disorder

We’ll talk about that last criteria next, but first notice that anxiety has to have occurred for the past 6 months or more. So if you are feeling anxious about something specific, and it has been going on for 2 months, you don’t meet diagnostic criteria for Generalized Anxiety Disorder (GAD). If you feel extreme anxiety only one day each week because of a specific activity you have to go to, you don’t meet diagnostic criteria for GAD. If you have worries that pop up about certain things, but are able to let those worries/thoughts go easily, you don’t meet the second diagnostic criteria, therefore cannot be diagnosed with Generalized Anxiety Disorder. These are things most of the TikTok videos don’t mention. And again, I’m not trying to “bash” social media videos. They are great at giving information and normalizing, but shouldn’t be used on their as a diagnostic tool. It’s unlikely that you’ll reach a correct diagnosis by watching a video about a set of symptoms.

There is a lot of overlap between separate diagnoses.

This can be really difficult to untangle, even for professionals. Under each diagnosis in the DSM-5TR, is a section called “Differential Diagnosis.” The experts who created and revised the diagnostic manual deemed this a necessary component because of the amount of overlap of symptoms between different diagnoses. Take a look at some informational Venn diagrams other sources have created that highlight how similar symptoms can be between two completely different diagnoses:

This one, from the NESCA website (https://nesca-newton.com/#), shows similarities in symptoms of ADHD and Anxiety.

And this one shows similarities between ADHD and Autism.

Most people will be able to relate to symptoms for several diagnoses over their lifetime.

I saved this point for last, because this is a point that has stuck with me from an introductory psychology course I took in college. Prior to beginning lessons into diagnosis, the professor warned the young students in class that we would likely see symptoms that we have experienced. He encouraged us not to begin worrying about having a diagnosable disorder just because we can related to 1 or 2 symptoms when looking at a disorder. Why? Because almost all of us have experienced symptoms of mental health. But that doesn’t mean we have a diagnosable mental health disorder.

If I look at the diagnostic criteria for Autism Spectrum Disorder, I can identify that I experience “Hyper- or hyporeactivity to sensory input…” I’m pretty sensitive to loud noises, bright lights, lots of movement, etc. I get stressed pretty easily when I’m in an environment with random, loud noises (helping at my daughter’s school), bright lights, or just a lot going on in general. Does this one symptom mean I might qualify for an Autism Spectrum diagnosis? Absolutely not.

To summarize, though this is not an exhaustive list of why diagnosis is complicated, hopefully it provides some insight into why self-diagnosis is really difficult to get right.

So what do you do if you see a social media video (or read an article, talk to a friend, etc.) that makes you suspect you have several symptoms of a specific diagnosis? Number one, do more research from legitimate sources. Some legitimate sources include (I am not affiliated with any of these sites):

Also, I’d recommend that you find and complete a questionnaire from a reputable site. However, keep in mind that, just as with videos on social media, these questionnaires cannot be used alone to make a diagnosis. Mental Health America has a set of questionnaires for several diagnoses (https://screening.mhanational.org/screening-tools/).

If you do more research, and are interested in a formal diagnosis for treatment or other purposes, I’d recommend talking to a professional who is qualified to diagnosis. In the meantime, it would be accurate for you to make comments such as “I experience some symptoms of anxiety,” or “I suspect I might have a depressive disorder.” These are ways for you to acknowledge and share your symptoms, if you have not been formally diagnosed by a professional.

Disclaimer: I am a licensed independent mental health practitioner and certified professional counselor, but I am not your therapist. The information in this article is for general informational purposes only. This article does not create a therapist-client relationship. If you need specific recommendations based on your individual circumstances, please consult with a mental health practitioner near you.

Posted on by khumbard87

Using a Diagnosis as a Crutch

It is incredibly easy to fall into the habit of making excuses for our children’s behavior (and our own)!  My daughter is only 11 months old and I already find myself doing it. I’ve said, “she’s teething, so she’s a little grumpy,” when she’s whiny at the grocery store.  I’ve said, “she didn’t sleep well last night,” when she has a cry-fest in the church nursery.  When we look at the root of it, I think parents make excuses because they don’t want to be judged for having a not-perfect child.  But guess what?  Nobody is perfect, especially children!

I can’t speak from experience, but I would think that this pressure is increased exponentially if you have a child who has a mental health diagnosis (think Autism Spectrum Disorder, ADHD, Oppositional Defiant Disorder, etc).  These are some of the children who are most likely to “act up,” leaving their parents with ample opportunity to feel judged by others.  So I’m sure it’s easy to throw out “he has Autism” or “she has ADHD” to justify a kiddo’s behavior.  Sometimes, that might be appropriate, so I’m not saying that you shouldn’t ever make excuses for your child.  However, I think it’s a slippery slope and consistently excusing behavior could turn into both parents and their children using a diagnosis as a crutch.

 

Yes, your child’s diagnosis might (depending on what it is) make it more difficult (and sometimes near impossible) for them to do certain things.  I’m not talking about holding a child with ADHD to the exact same standards as every other child in the classroom.  A child with ADHD will have more difficulty staying focused on a task and controlling impulses.  But that doesn’t mean they can’t meet certain expectations.  When you consistently use their diagnosis as an excuse, a few things can happen over time:

  • You might throw all expectations of reasonable behavior out the window and just let your child get away with everything.  This will likely create havoc in your home, the child’s classroom, and possibly your marriage/relationship.  Here’s the thing: I don’t think anyone just wakes up one morning and says to themselves, “I’m just going to have zero expectations and let my child do what they want.”  It happens slowly over time, but (again) it’s a slippery slope when you start excusing behaviors because of a mental health diagnosis.
  • Your child might pick up on what you’re doing and start using their diagnosis as an excuse to justify their own behavior.  They may start to think that they can get away with everything because they can blame it on their mental health.

I have a sister with a mental health diagnosis (well, actually, it’s more like 3 or 4 diagnoses) and she uses these diagnoses as a crutch.  It is incredibly frustrating because she uses her mental health as an excuse for many terrible behaviors, like being rude and disrespectful to family members.  Don’t get me wrong, I know that her diagnoses make it more difficult for her to regulate her emotions and more difficult for her to control her impulses, but at this point, it seems as if she has stopped trying and just blames everything on her mental health issues.

I have talked to numerous parents who let their child get away with negative behavior because of a diagnosis they have received.  With my own sister, I’ve seen how difficult it can be to determine where to draw the line… what is she capable of doing and what is she not capable of doing?  Even though it’s hard to know what the limit is, the worst thing would be to just stop trying and use her diagnoses as a crutch.  Sometimes it takes a little bit of trial and error to figure out what the expectations should be.  Sometimes you might need help from an unbiased party (teacher, school psychologist, therapist, pediatrician, etc.) to find out where to draw that line.  Sometimes the process of that trial and error can be incredibly frustrating.  But it’s necessary.  And it’s worth it.