A work related rant, mostly, but it comes up in RL enough that I feel that it must be said, lest I explode as a result of compressed rage.
I don't consider myself to be an "expert" in differential diagnosis of mental health disorders, but I do know a heck of a lot more about it then the average person. 8 years of training, and all that. So, here's my official take on people who see a Made For TV special on mental health or a commercial for Paxil and think that they can diagnose themselves with something.
I really wish that people who don’t have any training in mental health disorders would stop diagnosing themselves. Specifically, my clients. Don’t get me wrong, I’m thrilled that people now feel empowered enough to speak up and say “hey, I’ve got this emotional or mental thing going on that’s disrupting my life and I want some help!” People couldn’t have felt free to say that only a few decades ago, and I think it’s amazing.
However! Just because your average layperson knows the word “depression” does not mean that they have the ability to diagnose it in anyone, themselves included. If you (general “you”) want to think that you might have Depression, that’s all well and good, but only a trained professional can evaluate you and tell you if you actually have Depression. I capitalize that word on purpose, because Depression is a clinical diagnosis made by a professional, whereas depression with a small “d” is a word that laypeople tend to toss around because they think that being sad = Depression.
Many, many clients I work with will announce to me that they are depressed. When I ask them why they think so, they often give me a whole schpiel that basically amounts to the fact that they feel sad. Maybe something happened to make them sad or maybe not, but basically that’s their sole complaint. Now, I don’t mean to minimize sad feelings; they can be incredibly debilitating and severe, and I’m certainly not saying that a person’s feelings should be brushed off as “no big deal” if it’s effecting them enough to bother them. But what this person is describing, a feeling of sadness, is not Depression, it is a depressed mood. Depressed mood is but ONE symptom of Depression. In order to get a clinical diagnosis of Depression (or Major Depressive Disorder for the more medically inclined), a person must also have other symptoms, including significant changes in eating and sleeping habits (too much or too little), extreme fatigue, irritability, psychomotor retardation (meaning, you can’t convince yourself to move), a disinterest or loss of pleasure in activities that you once enjoyed, etc. If you are extremely sad, you *might* have Depression. You might also have Dysthymia, Cyclothymia, Bipolar Disorder, or no clinical diagnosis at all. Only a trained professional can tell the difference.
Same thing with ADHD (Attention Deficit Hyperactivity Disorder. And no, there is no more ADD diagnosis. There isn’t, really - it’s called ADHD Inattentive Type). Lately, many people I know, clients and in my life, seem to want to blame ADHD for anything that their kids do wrong. Kid’s getting bad grades? ADHD is to blame! Your son won’t clean his room? ADHD, obviously! And on and on. Teachers are sometimes guilty of this, too…labeling a kid who has some behavior problems as needing medication because they have 30 other kids in their class and can’t deal with the bad behavior. Yet, somehow, these same kids who are labeled as “ADHD” manage to play Xbox for seven hours on end. Wonder of wonders.
Again, I’m not saying that ADHD or inattention isn’t a huge problem for some kids. But kids, especially young ones, don’t always tell you what’s bothering them, and inattention and bad behavior can mean one of any number of things. Many kids who are under stress will present as looking like they have ADHD, when really they’re just anxious and they only way they know how to cope with their feelings is to act out. Likewise, ADHD is not responsible for a kid’s defiant behavior. The diagnostic criterion specifically says that if inattention is due to defiant behaviors rather than inability to concentrate, it is NOT ADHD…so Ritalin is not a cure for…anything, actually, but especially not for oppositional defiant behavior.
Last, and this comes up more often in my real life than in work, OCD, or Obsessive Compulsive Disorder. Neatness, even really, really anal-retentive neatness is NOT OCD. OCD is a disorder in which a person’s obsessive thoughts cause anxiety and in order to relieve the anxiety they have to act out a compulsion, repeatedly. Washing your hands 50 times a day for fear of germs, having to touch a doorknob 17 times in a specific way before you can open the door, needing to check 20 times to make sure the oven is off before leaving the house…these are all classic OCD symptoms. It has nothing to do with neatness, although OCD related to fear of contamination might also lead a person to be really really clean…however, this person won’t just put their books in order according to the Dewey Decimal system, they’ll scrub the house all day until their hands are bleeding, and then immediately start again.
Most people don’t know this, but there is a disorder called Obsessive Compulsive Personality Disorder. This is where your compulsive neatness comes in. But! Neatness does not automatically mean you have this OCPD, either. OCPD has, like everything else, a whole schlew of symptoms. People with OCPD are not just “neat.” They are incredibly rigid when it comes to everything - rules, schedules, work, everything. They are inflexible to the nth degree, and often see everything as black or white, right or wrong, with no gray area whatsoever. They are perfectionists and refuse to let anyone else do anything because “their way is the right way.” Neatness is but one piece of this complicated disorder. Chances are, if you know someone with OCPD, you loathe them, because these people are notoriously hard to get along with.
I could go on, but I think my point is made.
Now, an analogy. Would you, assuming you have no medical training, diagnose yourself with Diabetes, or a brain tumor? Of course not! You’d say “something seems off to me, I think I’ll go to the doctor’s and get checked out!” And that’s exactly what you should do. Same goes for mental health disorders. Walking into a mental health professional’s office and demanding that you receive some certain medication because it “worked for your friend” is ridiculous. Often times, mental health symptoms will heavily point toward a certain diagnosis, much like a bone protruding from your arm would be a pretty heavy indication that your arm is broken. However, even though you’re pretty certain that the arm is broken, you’d still go to the doctor’s, right? I certainly hope so. And you never know, the arm could be dislocated or something. That’s why we have doctors!
In conclusion, clients of mine, unless you are legally licensed to provide a differential diagnosis for mental health disorders, please trust the opinion of a competent professional over your own colloquial knowledge of mental health. Insisting that you are “right” and the evaluating professional is “wrong” is ludicrous, but if you insist that they are wrong, seek a second opinion rather than start demanding certain treatments. You are not qualified to diagnose or treat yourself. STOP IT.
Thanks for listening. I needed to say that, I really did.
And yes, I realize that there are plenty of incompetent, med-pushing doctors out there who give out Ritalin and Prozac like candy because it's the easy way. But that's another issue for another time. ^_^