Diagnosis – What does it mean?

DiagnosisEvery profession develops its own vernacular. That means that every profession has its own vocabulary. Diagnostics is the process by which medical professionals arrive at the terminology relative to the symptoms being seen. The questions that need to be asked are:

1. What is the purpose of a diagnosis?
2. What does the diagnosis mean?

In my more cynical moods I tell people that a diagnosis is the key to a provider being paid. Insurance companies require that a diagnosis be given before they will pay for an evaluation. What that means to a mental health provider is that you have approximately one hour to differentially diagnose and assign the appropriate title to the symptoms. Because of the general misunderstanding about diagnoses and the process of arriving at a diagnosis, an individual has to be very aware of the label that is being attached to their healthcare. Some diagnoses will virtually guarantee that life insurance is either not attainable or extremely expensive. Other times a diagnosis will be used by a system, such as the legal system, to attempt to validate behavior or indict an individual. In these cases I believe that the diagnosis introduces extreme prejudice into a system that is not educated about diagnostics.

Too often an individual, or a profession, will misinterpret a diagnosis and use it as a description of an individual. One common area of that misuse of diagnoses currently has to do with emotional disorders that include symptoms of anxiety, depression or anger. I have had clients that did not engage in treatment because it was their belief that they were angry because they had PTSD, could not leave the house because they had anxiety or have lost interest in relationships because they had depression. They had used the diagnosis as a definition of themselves rather than a description of symptoms/behaviors.

Appropriately utilized, a diagnosis will be a description of a series of behaviors so that more effective treatment can be offered and improved communication between providers can be attained. If an individual deals with anger, the diagnosis is not nearly as important as dealing with the anger itself. If an individual is unable to go out in public their diagnosis is not nearly as important as dealing with the lack of socialization. If an individual has lost interest in relationships, or life in general, their symptoms are more important to address than their diagnosis.

Unfortunately it seems that diagnoses are more and more often being used for purposes other than treatment. Anger, anxiety, depression or other mood states should improve with treatment. The goal of treatment of PTSD, anxiety, depression or other mood issues should be to reduce symptoms not excuse behavior. Symptoms that are successfully treated may not return and yet often will be used against an individual later. Diagnoses that are given inappropriately or inaccurately can create lifelong difficulties. Even diagnoses of many physical illnesses are inaccurate and the underlying contributors to the diagnosis are often ignored.

Dr. Caroline Leaf, in her book “Who Switched off my Brain,” has estimated that around 90% of all physical illness is a result of how we think. Dr. Donald Colbert, in his book “Deadly Emotions” makes a compelling argument in support of Dr. Leaf’s conclusion.

In short, diagnoses should be used to describe behaviors that result in the diagnosis and should never be used as an excuse to continue bad or nonproductive behaviors.

Remember, life is built on choices, choose treatments or lifestyles that assist to improve life function, not perpetuate illness.