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Before I go any further, I need to tell you what this blog is not.
This is not one more post about how diagnostic labels are evil. They aren't. Diagnostic labels serve a function. They are a tool. Namely, they were created so that medical institutions could treat them and so that insurance companies could pay for their treatment.
A broken bone (diagnostic label) requires a cast (treatment) and those all need special shortcut names and codes so they can be electronically entered and errors minimized. But no one seems to wear that label for long. And even if they do, it certainly doesn't become their identity. You are a person first. You have a broken bone.
But for some reason, this language changes in mental health. It seems far too easy for people to become identified with their labels. In part I blame us professionals. It is much easier to short-hand our conversations when calling a person by their label.
Also, in part I think this is because we don't truly see mental illness as "real illness" yet. We still create artificial division between the brain and body and we still have a stigma attached to mental health diagnoses. We see these labels as a sign of failing in a way that we do not see a broken bone. And so we wear them.
I don't believe wearing your labels serves you or your health. I also do not believe living in a label-less society is possible or even helpful. As someone who doesn't bill insurance directly, I thankfully do most of my work without diagnosing clients. But over years, I have had my fair share of clinical diagnostic work. Having walked on both sides of the line, I've gotten some perspective on how diagnostic labels function in the real world. And so, like most things, I prefer a middle road approach. To me, it comes down to this question: How does your label serve you? Because it should.
When Diagnostic Labels Help
- When they create community and support.
So often we suffer alone in our struggles. Knowing what is going on with you can be the first step to finding others and accessing the vast stores of knowledge that exist online around any given issue. If you don't know what you have, its very hard to find any help. This is honestly my favorite part of the right kind of labeling. For instance, moms who discover they have Postpartum Depression or Anxiety suddenly have access to huge community support programs, online groups, in person groups, books and effective treatment options. Before that moment of diagnosis, they were simply alone in pain.
- When it creates an "A-Ha" moment.
Often, when there is an unidentified mental illness going on, it can feel chaotic and confusing. If you or a loved one are deep in the suffering of a disorder and you don't know it- it is hard to find patterns, triggers, or any deeper understanding of what is happening. Each day stands alone. With a good diagnostic label, your experience can start to make sense. I've seen clients smile with relief when it finally "clicks" in this way.
- When it creates a more helpful plan.
If you don't know what you're working with, it's impossible to create an effective plan. You also deprive yourself of the knowledge acquired about what works for others in your shoes. By having an accurate label, you suddenly are able to create order, goals, measurements, and treatment plans for yourself.
When Diagnostic Labels Hurt
- When they create a sense of isolation.
This doesn't always happen, but I have seen people be isolated and ostracized for their labels. I think this goes back to our stigmatizing around mental illness. Truly, the person is the same the day before and after a label is given. Either they are a friend or they aren't. The label doesn't change that.
- When they create feelings of hopelessness.
A good label should fold into a good plan. Always. The label should be informational. A broken leg needs a cast. A psychiatric label needs treatment of its own. If a label feels heavy and depressing instead of directional and empowering- it isn't doing its job. Shed that label and quick! It should be a breath of relief and hope- a sense of "I am not alone and there are things to do about this." If that's not how its feeling... something is off.
- When they are seen as your identity.
You are not your labels. You are a person first, and you have a condition. It is not a fixed state of being. I said it before and I'll say it again. Your label should fold into a good plan. So you should feel empowered with a vision of a future where you are either cured or treated for your symptoms. Every professional you encounter should be able to see your identify as different from your label. They need to have a plan to help you be the best you. If they can't? It's time to move on and find one who does. This also means there is onus on the person with the label- not for perfection, but for striving. We are not meant to stay inert. You are so much more than any label could ever be.
I believe, like most things, the extreme perspective sells. Our mainstream (medical) model has meant that diagnostic labels are abundant. This has created an (understandable) backlash response. In my opinion, the highly-medical approach and the anti-medical approach are both missing part of the point. The truth is far more nuanced and gray. Sometimes labels help, sometimes they hurt. The answer is in how they serve the person and not anyone else.
Bottom line: a label should serve you. If it doesn't, then trash it!
I label you as good enough. Just FYI.