[Miswimmy1]

How does a therapist diagnose someone accurately? How do they know? I've been thinking about this a lot.

For instance, how do you differentiate ADD from say, being a right brained individual, or a kinesthetic learner? Just because you show symptoms and fit the criteria of the DSM doesn't always mean you have a problem.

Are professionals too quick these days to diagnose?

Some are which is why it is always good to be educated about these things, and whenever possible, get a 2nd and even a 3rd opinion.

There are no blood tests for these diagnoses, so there is definitely a fair amount of subjectivity to diagnosis.

What you hope for is an experienced professional who doesn't jump to a diagnosis too quickly, who is willing to look at the various possibilities and to investigate them with you.

I have most respect for the professionals who are willing to say "I feel this is probably what is going on here, but this is my second suspicion. Let's try this, but watch and see how things develop."

My pdoc initially diagnosed me with major depressive disorder, but over time and with getting to know me and my history in more depth, he changed his diagnosis to bipolar disorder. Even then, because he was having so much difficulty stabilizing me, he insisted I go for more comprehensive testing AND for a 2nd opinion. He was quite willing to hear what other professionals had to say about my diagnosis and treatment. As it was, everyone concurred with his diagnosis which helped clarify things not only in his mind but in mine also, and he got a few helpful suggestions along the way as well.

[googley]

The issue with diagnosis and why it is done so "quickly" is because of insurance companies. Insurance companies REQUIRE a diagnosis to pay for services. That means that the client who comes in for an intake session, the therapist has to have something to put down on the paperwork after the first session. Therapists know that the actual diagnosis might end up changing as they find out more information. They have to have at least one disorder that is the 'primary' diagnosis. After that there are secondary diagnosis that is anything that is not seen as the most influencing disorder. IE if someone has major depressive disorder that is significantly impacting their life and social phobia that keeps them from being able to give presentations in class, the depression would be considered the primary diagnosis and the social anxiety the secondary diagnosis.

There are also diagnosis that can be listed as 'Rule Outs'. This means that the therapist thinks that the diagnosis may fit but does not have enough information one way or the other. This may be because there was not enough time to fully investigate the diagnosis given time constraints, or because the client tells the therapist that they have had a prior diagnosis of X and the therapist is not able to confirm that at the time.

The thing with diagnosis is that there are a lot of symptoms that overlap between diagnosis and diagnosis that are often found together (ie anxiety and depression) so this makes it harder to diagnose. So some times it takes more than one or two sessions (or a lot more) to figure out an accurate diagnosis. The other issue for example is with bipolar disorder. For most people (not all) a depressive episode happens before a manic or hypomanic episode. Given this, there may be a first diagnosis of depression that then changes to bipolar disorder after there is evidence of a manic episode.

So there are a lot of complications and details when it comes to diagnosing people.

[critterlady]

My T, like a lot of others, shies away from formal diagnoses. He uses a general one for me for insurance purposes, but other than that, he doesn't think they're all that helpful. He tends to look more at the individual issues I have. Whether I'm diagnosed with A or B doesn't make much difference in how he treats me and helps me with those issues.

Originally Posted by critterlady

My T, like a lot of others, shies away from formal diagnoses. He uses a general one for me for insurance purposes, but other than that, he doesn't think they're all that helpful. He tends to look more at the individual issues I have. Whether I'm diagnosed with A or B doesn't make much difference in how he treats me and helps me with those issues.

That works if he isn't prescribing medicine, but diagnosis is vital once meds are needed as the wrong meds for the wrong condition can be disastrous.

Some disorders can be diagnosed with medical tests. PTSD is the best example. Google PTSD and brain scans and there are tons of links to read about the research on changes and damage in the brain and how it is being picked up on brain scans. It is amazing stuff!

Other conditions are harder to diagnose. The DSM provides "criteria" for a disorder, but it is really only a guide. I personally think that pdocs and therapists rely on their experience more than anything.

[retro_chic]

I think with a lot of disorders the symptoms are on a continuum. At one end would be functional and the other would be dis functional. If a persons symptoms are causing dis function then they could possibly meet the diagnoses for the particular disorder. Everyone experiences anxiety or depression at times but for most it doesn't cause significant impairment. That's how I look at it anyway

[The_little_didgee]

Quick diagnosing can easily lead to a misdiagnosis especially when the diagnosed condition resembles another condition. A responsible clinician will consider these and not make a diagnosis in 15 minutes.

The wrong treatment(s) may harm the client so it is important to get a correct diagnosis.

Sometimes, the correct diagnosis isn't discovered until years later. Usually, a clinician will consider a new diagnosis when a client does not respond to the treatment(s).

Originally Posted by 1914sierra

What you hope for is an experienced professional who doesn't jump to a diagnosis too quickly, who is willing to look at the various possibilities and to investigate them with you.

Working together can definitely reduce the chance of misdiagnosis. The "alliance" approach makes this possible because the clinician gets to know and understand what the client goes through outside the office where living takes place.

This approach helped me get an accurate diagnosis. It took 18 years but it was worth the wait, even though it did not feel like that at times.

[Willowleaf]

My son who is the same age as you has a diagnosis of autism but this was given after months of tests, reports from all people in his life and only after we were really sure it was that not something similar. Especially in children some things aere easily mistaken for others and it is only apparent when they become 'cured' in later life! At your age he was tempted to get an ADHD diagnosis as well but decided in the end there was more to life than collecting labels. He was lucky however as the initial diagnosis gives him the opportunity to sit his exams in a separate room and a little more time. He never takes up this extra time as the ADHD side of him means it is hard to stary still and concentrate for even the shortest time.
I hope you manage to get things sorted for you. I can understand your wish to get a diagnosis if it could help you in school but remember you are more than a collection of labels.

Originally Posted by Willowleaf

I can understand your wish to get a diagnosis if it could help you in school but remember you are more than a collection of labels.

SO important to remember . . .

[Perna]

Diagnoses are for the psychiatrists and therapists, to help orient them with what issues you appear to have and how to go about treating them. If you go to see them, you have a "problem" (or you wouldn't go to see them) and they are going to try to put your difficulties in their orientation.

You may/may not have multiple, overlapping difficulties and so, who you go to see if going to treat you in their orientation; a psychiatrist is a medical doctor and is going to see what medicines might help, an educational psychologist might look for learning disabilities or difficulties and treat them, a psychotherapist will try talk therapy, a social worker might focus more on your relationships, your interactions (social :-) with others.

There is no "right" diagnosis, it is who and what appears to help you learn to live your life better and/or deal with your problems. For me, it was better to concentrate on my T and what we were doing together, if it was helping me, rather than a diagnosis or what the T was doing as a T, etc.

I feel there are only so many "broad" illnesses; if you are depressed and anxious; you have to decide, which is worse and work on that one first? People are not simple so they do not have simple problems that fit neatly into a diagnoses but someone working with us has to start somewhere so they look to see if you are depressed or anxious or both or could be bipolar or have a personality disorder, etc. and then, as they work with you more, get to know you better, they can perhaps get a better idea of more specifics.

I differentiate medical illnesses as not being primarily about "living" your life like mental illnesses are. Yes, my medical illnesses influence how I live my life but not the bare bones living of it. If I have a broken leg, I get a cast and hobble around for awhile and it's a pain in the butt but not about my "life" per se. If I have depression, anxiety, or a mental illness though, my thinking/feeling is affected and that influences how I live my life. There's a huge range of overlap but my symptoms are pretty much going to help me decide if I want to look at medical or mental, see my primary care physician or my psychiatrist first?