I see a lot of complaints about the DSM1. And honestly, a lot of them are valid. I get it. There are a lot of issues with it. I would not be uninterested in a discussion of alternative systems. But that’s not my topic today. No, today I want to explain why I am happy, for now, to be diagnosed according to the DSM. Because the reality of my situation is that, without it or something very much like it, I would likely not be particularly stable, from a mental/emotional standpoint. And as a result of that, probably not particularly stable in any other way.
A diagnosis can have a lot of positive effects, and some negative ones. For me, the pros outweigh the cons. And then there’s the insurance thing, okay. My understanding is that, in some places, it takes an official diagnosis to get insurance coverage for treatment. I hate this, and wish it were not true. But here are some real positives. For one, it says officially, that I am not just “losing my mind.”
For another, it points towards treatments that have worked for other people with the same diagnosis, really streamlining the process of finding something that might actually help. There are so many treatment options, and to be honest, we don’t know how or why all of them work. The more we can group people according to similarity of symptoms, the more of a chance we have at gauging how an individual will respond to any given treatment. It begins a process of narrowing-down.
In addition, a diagnosis can bring a sense of meaning, of peace. “Oh, this is an actual thing I’m experiencing!” It may seem less significant than finding a treatment plan, but I assure you, it can matter just as much to someone who has thought for years that there was just something wrong with them. Something that made them different than anyone else, and somehow extra-specially flawed. For me, a bipolar diagnosis was a sense of community without needing to meet anyone else, which, you know, my anxiety wouldn’t have enjoyed. But all this time later, when I do find out someone else is bipolar (and sometimes I do get a very strong feeling for no obvious reason before I learn this about them), some part of me attaches a little label to them that says something like “relate!” or maybe even “family.” And, of course, knowing that other people have travelled the road you’re on now offers hope. If they got through it, maybe I can too. Look at that person with the same diagnosis as me living a normal life!
I will admit that having a diagnosis can be a double-edged sword, as when it’s used to make assumptions about your behaviour and capabilities. Bipolar people, for example, are seen as erratic, promiscuous, selfish, easily angered, even violent. Not the kind of person you would want, for example, as a friend, or… say… getting custody of children2. But, of course, just because somebody can be something doesn’t mean they willbe. Especially if they’re appropriately treated, thanks to an appropriate diagnosis. I hate especially to see the sometimes well-intentioned but often ill-informed portrayals of various mental illnesses in fiction. This is probably something I’ll circle back to in a later post. I don’t always drop TV shows from my list for poor portrayals of mental illness, or the way they discuss it, but I have. It always catches me off-guard, and it always hurts.
Honestly, I think most of the negative effects of being openly diagnosed with a mental illness have to do with the assumptions people make when they hear you have a mental illness. Whether it be doctors who might dismiss your concerns or strangers who react with fear, people distorting your intentions through lack of education or through more deliberate manipulation, the worst of living with a diagnosis, to me, is the misuse of that diagnosis. That is one of the main reasons I write this blog; I want to start conversations and do what I can to break down stigma.
Some of the heroes (from my point of view) who have, sooner or later, been open about their diagnoses have included the incredible Carrie Fisher, Stephen Fry, Selena Gomez, Catherine Zeta-Jones, Mariah Carey, Lady Gaga, Jameela Jamil, Whoopi Goldberg, Wil Wheaton, Adele, Kristin Bell, Shawn Mendes, and Ryan Reynolds. There are some big names in that list, and there are plenty of others I didn’t get to. It might be tempting to think that with all of these celebrities doing their parts to normalize mental illness, the struggle must be over. It is not.
In case it comes up in a future post, I’m currently examining the possibilities regarding pursuing another diagnosis or, alternately, pursuing treatment without a diagnosis. I admit it has me sort of mixed-up inside.
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1 This would be the Diagnostic and Statistical Manual of Mental Disorders, a tool for diagnosing mental disorders typically used in Canada and the US. Currently on the fifth edition, DSM-5.
2 Just want to quickly add, in case it’s not completely clear, that I don’t support making such assumptions.
I hadn’t considered some of the positive implications of having an official diagnosis, being much more aware of the negatives of not having that diagnosis. Very interesting read and there are definitely some big names on your list of celebrities who have been open about their own diagnoses. It can be a big risk for public lives, but it’s inspiring and so beneficial when they are willing to be that open. It’s normalizing the open discussion, not the illness. Which I think can be so helpful.