For the Love of Labels
Receiving a diagnosis, even when it’s not considered a “serious” problem and even when it feels like all the disjointed problems are finally explained is not always a relief. There’s something about a healthcare professional looking you in the eye and saying, “You have [xyz].”
From about age 14 on, I had terrible anxiety and panic. It got to the point where I almost fainted a few times from hyperventilating. So every day in high school, I’d walk through the halls wondering if something was going to set me off, and if it did, would one of the guys in class make fun of me? Would he say, “She’s such a drama queen” or, “Oh, are you going to faint?” and roll his eyes.
It took me about 14 years to accept that I really needed treatment. Even though I had a family history of anxiety and depression, an undergraduate degree in psychology, and a graduate degree in counseling, it still took me that long to even consider getting help. After a week of feeling sick even though I knew nothing was physically wrong with me (I visited the doctor’s office the way the devout visit church) I finally made an appointment to talk about the anxiety. I was tired of worrying about what awful thing was going to happen next or when I was going to have to lie down under my desk and hope none of my co-workers walked by and saw me. (Oh yes, that happened.)
So the day I walked into the doctor’s office, I knew what I had, but even at that, having someone tell me, “You have moderate anxiety and mild depression” made me burst into tears. It’s safe to say that I was especially fragile in that moment, but I also knew I’d crossed a point of no return. I could no longer kid myself into thinking maybe I’d just had too much coffee or that it would pass as soon as things settled down at work, or as soon as my husband got a better job. There was always something else it could be . . . until there wasn’t
Fast Forward to Today
Now, I have my own practice, and not surprisingly, a lot of people come in with anxiety as at least part of what they are coping with, and I have a lot of empathy for all of them. It’s hard to get up, get dressed and go on with life when you really do feel like you’re taking a risk getting out of bed in the morning. Also, we do live in times when there is a lot to be afraid of. Teens now have to go through lockdown drills the same way we used to do fire drills. It doesn’t help that at least once a year, we see news about real active shooter situations or bomb threats. Right around 9/11, even people outside of New York panicked every time they received mail in a brown envelope. Of course, the rational take on all of this is statistically, it is extremely unlikely that these things will happen. Also, worrying won’t prevent any of it from happening, but that doesn’t help for those of us who come pre-wired to worry.
What amazes me is the number of clients I’ve seen who don’t seem satisfied with just one diagnosis. I’ve had clients come in and just “throw it out there” that they wonder if they have OCD because they like to keep the bathroom clean or they are bipolar because people tell them they’re moody. If people in general weren’t worried about annihilating every microbe that poses a potential threat, PineSol wouldn’t exist. Also, for anyone who is out there wondering, if you really think you have OCD, of course you should ask someone about it, but know that it’s not the same thing as being “a neat freak.” As far as moods go: it’s not normal to be in the same mood every single minute of every single day. Moods go up and down, and most of the time, it’s fine. Just like being a little anxious before an interview isn’t a sign you have generalized anxiety disorder, and feeling sad when a friend moves away doesn’t mean you’re depressed.
The thing about a diagnosis is it can turn into an identity for some of us, and that’s problematic because diagnoses change. Since the latest version of the DSM finally got published, several disorders that have become part of popular culture are gone. (Not to worry—everything really is still in there, but the terminology has changed.) Many of my colleagues in the field have expressed concerns about these drastic changes. The opportunity I see is to reminder ourselves that when we talk about diagnoses, we are talking about an agreed upon vocabulary that usually describes a cluster of mental health symptoms in most people who have a particular illness. As far as my client is concerned, I just want them to have the best chance at recovery I can give them.
Empowering versus Overwhelming
Consumers definitely should be given as much access as possible to materials to help understand their psychological difficulties. I recommend publications by The National Institute of Mental Health. They are available for download and many can be ordered and sent to you for free. If you are prescribed medication, pick up a pill manual and learn about the side effects. Talk to your pharmacist about their thoughts on the meds you are taking and how people seem to tolerate it. Then, take a breath and let it go. You are not depression. You are not ADD. You are not bipolar. You are just you on your way to recovery.