So much about mental health diagnosis is interpreting symptoms as they present. Since so many symptoms overlap it is a process of watching the patterns. Typically they will start with a more vague diagnosis such as mood disorder or anxiety. Then as time progresses and the provider sees a pattern and gets to know a client they will fine tune and come up with a more definitive diagnosis. Frequently they will then change it. In some cases like with schizoaffective disorder they may want to make sure before they make the final diagnosis until the are sure because of the stigma and possible negative effects of the diagnosis.

Another issue is that severe depression can look like psychosis in some people. Also, for some people using some drugs including marijuana it can appear that a person is psychotic. Some people also mask some of their symptoms so the provider doesn't have a full picture

My pcp originally had mood disorder in the beginning because she needed something but needed to get a bigger picture.

T had me with a diagnosed of Major depression and Conplex PTSD. Over time she realized the Ptds was the major issue. When triggered my mood spirals and I have a hard time stopping it.

Psych np originally diagnosed me with Bipolar. T totally disagreed. She felt that because I often try to put on a happy face it my appear that it was bipolar. Sometimes when I was trying to appear in a much better place than I was I over compensated and appeared manic when really I was depressed. I agreed with T completely. After about a year or so I mentioned it to psych np and she agreed with T and stated she had known for a while and just never changed the paperwork so she did then.

When I started with EMDR T she used only PTSD because that was what I was going for. She also spoke with T a couple of times because I was seeing both of them. She agrees that PTSD is my primary diagnosis.