The Daily Therapist: When a “thing” isn’t a “thing”

So I may annoy some folks in the next few days with what appears to be me obsessing over a new book that I just read, “Beyond ADHD” by Jeff Emmerson.  It’s a great book and I will be writing a more lengthy review of it in the next few days, just because.  But the book is definitely a reminder of things that I have thought and believed for years.  In psychology when we are trying to figure out what is going on with a patient and we’re going to assign a diagnosis, we’re supposed to engage in what is called differential diagnosis.  Which is otherwise known as “when a thing isn’t a thing.”

I engage in this process frequently, as I don’t want to operate on incorrect or incomplete information.  We psychology folks don’t prescribe medications, but depending on the patient and the treatment, we could possibly do something harmful, and we don’t want that.  Part of the premise of the aforementioned book is that the author has his own mental health journey and was misdiagnosed, more than once, and given the incorrect treatment, and even the incorrect medications.  The process of differential diagnosis is steeped in the scientific method and utilizes logic, which I’m bothered to say that many of my professional peers seem to be lacking in.  It’s very frustrating.

I’m a bit of an anti-diagnosis person anyway.  In mental health I often wonder how useful these diagnostic labels are.  Does it matter if we label one patient or another with Bipolar Disorder or Schizophrenia?  Some would argue that yes, we should do this.  It’s ethical and all that.  I just don’t know that I agree.  I don’t know that I ever have.  So let’s say I get a new patient that has a previous diagnosis from another professional.  Let’s say it’s Persistent Depressive Disorder.  All that really tells me is that another professional saw symptoms that they thought were consistent with that disorder.  Nothing More.  It doesn’t tell me history, it doesn’t tell me how severe the symptoms have been.  It also doesn’t tell me how to treat that person.

Believe it or not, there’s stigma and prejudice within the professional community.  Certain diagnostic labels generate prejudiced views from some, which add to the stigma that already exists.  You can hear it around the water cooler.  Someone throws out a label and someone will say “ya, we know how those patients can be.”  What does that even mean?  Why think that way? Going back to my original point, “when is a thing not a thing?”

It’s so important to be and stay objective, and to keep an open mind.  Just because it looks like ADHD doesn’t mean it is.  Just because it looks like Bipolar Disorder doesn’t mean that it is.  Just because some teenager looks lazy and defiant doesn’t mean they are.  ADHD can be trauma, Bipolar can be alcohol withdrawal, and a lazy defiant teen could have Vitamin D deficiency.  So whether you’re a patient, a layperson, or a professional, get objective and look beyond the labels.  You might just save someone’s life.

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