Probably half the psych patients in the country are misdiagnosed. Forget diagnosis! What matters is what we know for sure. You know your friend is depressed. Whether it's bipolar, unipolar, tripolar . . . who cares? Psychiatrists will try out all of the same meds, regardless, to see what might help. They will use bipolar meds on persons who are not diagnosed with bipolar disorder . . . to see if they help. They will also try out antipsychotics on someone who is clearly not psychotic . . . to see if they help. They are not treating a diagnosis; they are treating the symptoms.

If you must have a diagnosis, let's say your friend has PD-NOS. That means "Personality Disorder, Not Otherwise Specified." It's probably one of the most common personality disorders. Lots of troubled people have a mish-mash of dysfunctional traits that don't line up perfectly with any one classically defined personality disorder. But it's clear they are not functioning normally. It's clear they have an approach to living that is "maladaptive." That's really all you need to know. Your friend has a personality disorder. Whether it's this one over here, or that one from column B, or sort of like this other one is all kind of beside the point. So just label it PD-NOS and move on. What can be done about it? THAT is the question.

No medication is going to "fix" your friend. Maybe some med will help. Let the psychiatrists knock themselves out ordering one after another, till something might seem to sort of help. They'll try anything. I went through that myself. I was on antidepressants, mood stabilizers, antipsychotics, tranquilizers, drugs for epilepsy, drugs for Parkinson's. Sooner or later, they try everything that has any effect on the brain. It's a big experiment. That's all it can be.

It's possible that your friend may have something wrong in the brain. Most likely, your friend also has something wrong in the mind. Brain problems and mind problems are not the exact same thing. Of course, one impacts the other, and both may need to be dealt with.

Ideas matter. What a person thinks matters. Your friend has some bad ideas rolling around in the brain. Your friend has some bad habits. Your friend probably has an inadequate amount of good relationships with other people. No drug fixes bad ideas, bad habits or the lack of good social connections.

So getting well is tough. Usually, a distressed person will need to try out stuff that doesn't help, before being willing to do what actually can help.

Being obsessed with selecting a diagnosis is what is trending these days. Everyone wants to get in on the act. So therapists, nowadays, are big on handing out diagnoses (that's plural for diagnosis.) A good, honest therapist would say: "I don't know what your diagnosis should be, and I don't care. Tell me what problems you are having. Then let's talk about how you can better manage those problems."

Your friend has serious, chronic problems. They can't be cured. They are chronic. But chronic problems can usually be made more manageable.

THAT (making problems more managable) does not happen by a doctor or therapist explaining a bunch of stuff to your friend . . . like how the amygdala does this and the hypocampus does that. Such discussions change nothing. Your friend has to make a daily plan of things to do and has to stick with the plan. A good therapist can assist with coming up with that plan of what to do on a daily basis. Trial and error leads to fine-tuning the plan. Your friend discovers what works and what doesn't work. This process can be followed, even if nobody is sure about the diagnosis.