I was 14 when I was first diagnosed with Seasonal Affective Disorder, aptly abbreviated SAD. SAD is also known as seasonal depression, so termed because of its tendency to start and end roughly in sync with the changing of the seasons. For me, my season of darkness was— and continues to be— winter. The following year I was diagnosed with Chronic Depression and Generalized Anxiety Disorder. Though I have taken steps to combat the symptoms of these diagnoses, I continue to struggle with them to this day. Mental illnesses are not something that you can wish or will away. You rarely grow out of them. And working through their consequences is a long, exhausting process.
The reality of mental illness makes it fairly easy to understand why it would be frustrating to see why someone flippantly self-diagnosing themselves with whatever disorder they think fits them best. Particularly in an era fueled by social media and set ablaze by WebMD, it’s easy for Teenager Y to arbitrarily decide that they have borderline personality disorder and then crow it to their 1,900 Instagram followers, complete with a black and white selfie.
In addition to being annoying, careless self-diagnosis can be dangerous. Though in some ways attitudes toward mental health have improved during the past decade or two, in many ways there is still a profound stigma that surrounds both the discussion and the reality of mental illnesses. When someone who really doesn’t have anything wrong with them aside from a case of Teenage Angst (TM), it can be extremely problematic for them to pretend that something more is going on. It trivializes and undermines the experiences of people who are truly struggling to cope with mental illness, and makes it that much more difficult for us to gain the recognition and support that we often desperately need.
But here’s the thing: many people get so wrapped up in the idea of self-diagnosis and its potential flaws that they fail to see its many benefits, and sometimes even the necessity of it.
To clarify, I am not referring to people who do a forty second Google search and read four symptoms that they sort of had last Wednesday. We have already covered those people, and noted how they can be problematic. Instead, I am referring to individuals who have done extensive research on symptoms that have been plaguing them for a long time. The Internet does provide access to some legitimate diagnostic tools, as well as case studies and support groups for diagnosed cases of various mental illnesses. And there does come a point where a person can, with a reasonable degree of confidence, accurately identify a diagnosis for themselves.
Many people argue that, if people really do have a mental illness, then they shouldn’t have any problems getting it diagnosed by a professional. That manner of thinking is a big, big problem. Firstly, some people do not have access to professional psychiatric help at all. Clinical diagnoses also take time which some people simply cannot afford to devote to sitting in an office for a few hours a week. Being able to see a professional psychologist or psychiatrist is a privilege. Remember that when you suggest it to someone.
Secondly, some people who are grappling with mental disorders may have a great deal of difficulty discussing their symptoms or the experiences that may have brought them on, even with a professional. This is particularly true with patients who have experienced a trauma, such as individuals suffering from Post Traumatic Stress Disorder (PTSD). For others, it can be nearly impossible to actively seek help, especially with conditions such as schizophrenia and dissociative identity disorder.
Finally, relying solely on diagnosis by a psychiatric professional assumes the infallibility of doctors. Don’t get me wrong, I respect and appreciate doctors, and the majority of the time I’m eager to trust their judgment. But psychiatry is an incredibly tricky field, and the human mind is remarkably difficult to figure out, even for people who have been studying it for years. Sometimes patients are unwilling or unable to be completely transparent, making it nearly impossible to definitively diagnose them. Unfortunately, there is also a history of intentional misdiagnosis or under-diagnosis in the mental health field, especially among marginalized populations.
Chances are that you know best what’s going on in your own head, even if you don’t have a way to organize or categorize your thoughts, feelings, and experiences. A good mental health professional recognizes that fact, and does what they can to help you make sense of it.
Discouraging self-diagnosis also effectively creates a negative feedback loop, essentially encouraging inaction in a potentially mentally ill person. Most professional diagnoses, after all, begin with at least a tentative self-diagnosis— most people don’t start seeing a psychologist for no reason. After all, a diagnosis is ultimately just a label used to make sense of a set of symptoms that a person is experiencing. You will likely continue to experience those symptoms whether or not you find someone to stick a name on them.
From there, self-diagnosis can enable people to seek help, professional or otherwise. For those who cannot go to a mental health professional, or who choose not to, there are support groups in person and online that can be useful. People who have gone through similar experiences can help provide support and guidance. It can also make talking about your experiences in general easier. It will always be hard to explain why you began to cry suddenly and inexplicably in the middle of a social gathering. Being familiar with language to help you explain what’s going on can make it marginally easier.
Roughly two years after I was professionally diagnosed with depression and anxiety, I self-diagnosed with PTSD following the treatment I had endured in an abusive relationship. I began doing research in my freshman year of college, after I was playing a game of keep-away with a friend. In an effort to take the object out of my hands, he grabbed both of my wrists and pulled my arms above my head. The gesture was not malicious or violent in any way. I was not hurt, and at first I did not even understand why I was bothered. Nonetheless, the gesture caused me to dissociate, sinking to the floor and sitting, blank and non-responsive, for several minutes before my friends were able to rouse me.
Following this seemingly small event, I began to do research. I met all of the criteria— my symptoms had been going on for more than 3 months, they caused me intense emotional distress, and they were disrupting my life, particularly my ability to engage in intimacy of any kind. Experiences that I had attributed to weird quirks of my anxiety began to make more sense. All of the symptoms that I had been experiencing for almost a year began to slip into place.
PTSD is something that I rarely talk about, partly because it is a difficult subject, but also partly because I am afraid that people will invalidate the condition due to my self-diagnosis. I had access to a psychologist during this period of my life, but I was extremely uncomfortable discussing the circumstances surrounding my condition, and I actively avoided any discussion of them. However, after recognizing that my symptoms fit the bill for PTSD, I was better able to help myself. I found resources to help me cope, and I have been making progress slowly but surely over the last two years. Diagnosing myself and seeking targeted help for the symptoms that I was experiencing helped me to accomplish that.
Ultimately, self-diagnosis can serve a useful purpose. First of all, it provides people experiencing some kind of mental disorder with a sense of balance. No, the fact that you had an out of body experience in math class does not make you a bad student; you may have been dissociating. The fact that you had a panic attack at work and needed to step out is not shameful. The way that you are feeling is valid, and real, and although it may totally suck, it does not make you crazy. And remember: absolutely no one has the right to delegitimize what’s going on in your own head. Don’t let them.
