Thinking about (over)diagnosing mental health conditions

Ode to the diagnosis - the clinical measure of illness, the proof of a problem, the hope for a fix.

Lately I've been thinking about labelling theory. It's a theory that pays homage to the latent power dynamics built into the systems of language.

(Some argue) a label like depression has the potential to set into motion a self-fulfilling prophecy. Others see diagnosis as an opportunity.


Receiving a formal diagnosis for a mental health disorder has benefits.

In addition to raising awareness about your condition and its associated symptoms, a diagnosis plays roles in the following areas.

  • Validating your struggles & connecting you with peers.

  • Proving eligibility for social and community services.

  • Granting validity for insurance claims and employment.

  • Opening the conversation to treatments including psychopharmacological and talk therapy options.

While new labels can take some adjusting to on a personal level, the diagnosis nevertheless offers some explanation for the ways in which you've been feeling, and it signals you're not alone.

The World Health Organization reports that depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease.

But experts say there's no conclusive evidence or current technology that can pin-point depression and other mind disorders within the brain.

Diagnoses for invisible illnesses are typically based on patient surveys and doctor observations and perhaps partner or family member testimony in some cases. Ruling out of other medical issues is important, too. Social scientists argue that such disorders, including borderline personality disorder and schizophrenia, may be better understood when examined within social demographics like geographical locations and religious beliefs. After all, what could be seen as a healer or shaman in one culture could be deemed 'crazy,' in another. Quite easily, actually.

According to the second edition of A Concise Introduction to Mental Health in Canada authors,

"Tracing or detecting any significant biological difference between mentally 'healthy' and mentally 'ill' brains, isn't conclusive."

What we do have conclusive evidence for are the associations between the social determinants of health, ie) housing, education, early life, food security, and gender, and mental health outcomes. It isn't a simple intersecting recipe you can get right every time, but we do know that things like war, and poverty, and addiction, and social unrest are not positive indicators of health. We need to be careful not to be reductionist in our thinking. Mental health is about so many complex frameworks and approaches coming together to draw the closest conclusion with the greatest benefit and least harm.

A fine line between in & sane

We're drawing a line where none exists, said psychiatrist and philosopher Karl Jaspers (1883 - 1969).

Just some decades later, children are being labeled from an ever-growing list of subcategories of mental disorders and illnesses. The lines are actually getting blurry between who is - and who isn't - categorically mentally ill. Today, there are hundreds of diagnoses and endless combinations of symptoms and syndromes. The WHO says mental disorders currently affect 1 in 4 people. Have we been pathologizing everyday emotions and maladaptive reactions in an era of anxiety, instability, and crisis? Are we quick to self-diagnosis and spouse-diagnose and render every maladaptive behaviour as a clinical illness? And why not? We are looking for some explanations. Reasons. Answers. So we created ways for us to log some words into a search bar from pretty well anywhere on planet earth and find information to confirm our bias. Joel Paris, editor-in-chief at the Canadian Journal of Psychiatry, says,

"We do not have to diagnose the human condition."

Paris is responding to the still ever-evolving list of disorders and syndromes available to choose from in the field of psychiatry for clients. So what's next? Under the European /Western psychopharma lens, you have prescriptions for all kinds of human conditions: anti-this and anti-that. Anti-human pills and potions. These concoctions can - and do - save lives. But so does therapy, and housing, and food, and water, and health care... Question to consider: In what ways does diagnosing everything as a personal problem move us toward mentally healthy communities?

4 views0 comments