By David Joel Miller.
Why do they keep changing my mental health diagnosis?
If you or someone you know has a mental health diagnosis you might be wondering why the information you get is so inconsistent. You read about your diagnoses somewhere and yes you have some of those symptoms some of the time but there may be other symptoms you do not think you have had ever.
Then you see another professional and they give you a new diagnosis. Keep getting treatment and the diagnosis may keep changing. What is wrong with this? Which of the things you have been told are your problem is the correct diagnosis and why? Are the other diagnoses wrong?
You can have more than one problem.
Could be several diagnoses are correct. You could have high blood pressure and still have diabetes. You may have Depression and Anxiety and still have Partner Relational Problems.
It could also be that none of the diagnoses are right on the money and that what you are being given is a “provisional” diagnosis. As more information comes in your diagnosis might get changed. I know this is frustrating for you, it bothers most professionals also, but the truth is that the correct diagnosis is not always that clear.
“Strict Criteria” leaves a lot of people out.
Mental health diagnoses, in practice, are a lot fuzzier than they look in the textbooks. When we read research reports these are based on “strict criteria.” This means that the research participants are fully screened by someone on the researcher’s team and then they, or their files, are often reviewed again. During this process lots of potential subjects are screened out. Anyone who has ever had a substance use disorder is not included.
So if you have bipolar disorder and have abused alcohol – no research for or about you. The result of these screening out process is that we know a lot about people who have exactly one and only one issue but not so much about anyone who has two or more problems or whose symptoms do not exactly match the “strict criteria.” The problem with getting a correct diagnosis does not end with strict criteria.
Mental illness as a brain disorder.
Mental illness, as currently understood, includes most all thinking, feeling and behaving disorders. This creates a conflict when we start talking about “brain disorders.”
You could be born with a brain problem that makes you at more risk for depression – but then being neglected, abused or other sad life experiences cold overload your system and result in depression. So environment can change the brain. Learning can alter your mood and if you learned to be depressed you can unlearn it.
Life experiences can and do change the wiring in your brain. As far as your brain is concerned every thought you have is an experience as the electrical impulses and the chemical messengers move through your brain.
Change your thinking and your feelings change. As your feelings change your behavior will change. New feelings, new behavior, and your diagnoses could change.
Changes in thinking are not the only way you can change your feelings.
This freeway in your brain and nervous system moves in both directions. Change your behavior and your feelings will start to change. As your feelings change your thinking will change.
You keep changing without trying.
As you add more years to your life experiences, I am avoiding saying that anyone is getting older, your brain undergoes changes. Some of this is the result of learning and the growing of nerve cells. Other parts of the changes include hormones, puberty, menopause and so on.
Some mental illnesses are first seen at certain times in people’s life. Schizophrenia symptoms are a lot more likely to first start or become pronounced enough to be recognized during the teen years or early twenty’s.
Bipolar Disorders do not get diagnosed until after you have had your first recognizable manic or hypomanic episode. The result is that most people first get a diagnosis of some kind of depression, with or without irritable mood and behavior, and then, later on, they may get a diagnosis of Bipolar Disorder.
As we age our symptoms may change and the diagnosis will change. The underlying person is still the same person, just the life problems they are working on have shifted.
If you do not feel that your current diagnosis is accurate, do not stress. You could try another provider or you could just wait and that diagnosis may change all on its own.
Diagnoses, like off the rack clothing rarely fit perfectly. What you need is a good enough fit that it assists you in developing a program of recovery. Sometimes that recovery program is primarily about managing your symptoms so you can stay out of the hospitals or institution. For other people recovery involves seeing how far they can take their life.
Personally, I am a believer in recovery. I have seen so many people with serious mental illnesses recover that I find it hard to believe there is anyone who can’t have some recovery in their life.
Recovery means different things to different people. Focus on what you can do, what you can improve and see where your recovery will take you. Don’t let that ill-fitting diagnoses deter you from making the recovery journey.
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books
- If you’re mentally ill can you work? What profession or job for the mentally ill? (counselorssoapbox.com)