[Ad Intra]

I'm in this boat right now.

I have the symptoms of PTSD but do not have the diagnosis. I am currently in therapy and I was diagnosed with depression years ago. Now my doctor and therapist always says "How is the depression?" or "How depressed are you?". They never asked about the trauma symptoms or the anxiety (even though this is why I'm in treatment in the first place). I keep saying the depression is not the problem, the trauma is. I feel like if I had the label of PTSD they would focus more on that.

My last two therapist did not diagnos, and the others I don't know about. It was never shared with me.

I really appreciated my last therapist, because they worked with what was bothering me that I wanted to change in my life. And I've had much success.

[ruh roh]

Can you change therapists? My therapist won't diagnose if the person is dealing with the effects of abuse or assault, because once the symptoms from that are addressed and resolved, you can't know what else is going on (if anything), so I guess that's a diagnosis of sorts, although I think ptsd is way overused these days. If I were you, I would find someone else to explore a non-biological cause of your depression.

[stopdog]

No - I don't have one and don't need one.
Could you see a different therapist and not release records to the new one?

[NowhereUSA]

I prefer not to have one. My T puts in a diagnosis for the sake of insurance - I think on paper it's MDD and GAD - but both he and my pdoc are more person oriented than diagnosis oriented. I think a diagnosis can help in a limited way, but honestly, I don't need it.

Have you considered having an outside psychological assessment done? That's always an option.

[Salmon77]

I have one, but my T said it was a placeholder for the insurance company more than anything. I've thought about asking if there was any other, but I don't know what difference it would really make. And I wonder if he'd be obligated to put it in my records and if that could be a problem down the road (a pre-existing condition or something).

[magno11789]

For insurance purposes I need a diagnosis, and she made sure I agreed with the diagnosis, which is bulimia. That's is why I went to therapy in the first place so it was easy to agree on the diagnosis, but she treats the person first.

Ad Intra, if you got the label PTSD, that would mean an increase in benefits and the government does not want people to get increases at all. I understand. I have been through a life of trauma, but they won't diagnose me only depressed. It takes a lot and once you are diagnosed or labeled PTSD, it is very difficult to get rid of it, you have it for life. Be grateful you have the therapy you do. Some employers when they see PTSD, they think you are mentally unstable and are unhireable. There is a big stigma that comes with it. tc

I don't have an official diagnosis. I know T has to put something for insurance purposes, but I don't know what it is. I'm sure it's probably anxiety and depression.

[ilikecats]

I'm not sure if I have an official diagnoses or not. I haven't asked. I would like to know if I have one though, and I would like to know what it is. If I do have one from my T, I think it would probably be anxiety and maybe depression too. But I think it should be definitely depression, anxiety, OCD, and maybe some other stuff.

[BudFox]

Originally Posted by NowhereUSA

I prefer not to have one. My T puts in a diagnosis for the sake of insurance - I think on paper it's MDD and GAD - but both he and my pdoc are more person oriented than diagnosis oriented. I think a diagnosis can help in a limited way, but honestly, I don't need it.

Same here. I've had T's who intentionally chose the most generic and least meaningful diagnosis code because they did not believe it their job to assign me some label, which can be stigmatizing and counter-productive. Plus many of the labels are baseless and rather absurd.

[Petra5ed]

I don't think it really matters unless you're wanting a specific drug. I probably wished a little for ADHD, but asside from that I haven't cared. Funny, I think I am misdiagnosed, but I just don't care. Diagnosis is mdd, gad, but I think PTSD is a better fit too. Not a big deal to me I guess

[Miswimmy1]

Originally Posted by BudFox

Same here. I've had T's who intentionally chose the most generic and least meaningful diagnosis code because they did not believe it their job to assign me some label, which can be stigmatizing and counter-productive.

I have mostly seen therapists who choose to conduct their practices in a similar way. In my opinion, as long as the treatment is beneficial, it doesn't really matter what you call the problem.

My T is person centred and won't diagnose - that frustrates the hell out of me. I really want a diagnosis. Im seeing him privately, and so a diagnosis wouldn't go on my medical records or employment or anything. Eventually after about 15 months he said he would be willing to say I have PTSD. Thats pretty easy for me to agree with. He will make reference to my 'dissociated states' but he won't acknowledge or say I have cPTSD or DID. I want him to say that out loud for several reasons - one of the biggest being the bits of me on the inside want acknowledging, and until he does, it feels like Im faking this, Im a fraud. I know he knows they're there, so I don't understand why he won't say so out loud.

I would also like something to concrete to go back to my family with. They just think Im being awkward, difficult, the black sheep, with unfair expectations. If I could turn round to them and say - look, I have DID, which was in a large (but not wholly) way was brought on by your behaviour to me. Either you get help (like I am) to change your behaviour towards me, or I continue to have an arms length relationship with you for my own safety. They all have experience working in the mental health field, and would respect a diagnosis from someone else more than they respect my feelings.

[Merecat]

Cassy, I see you're in the UK - I know from my own experience that therapists in the UK aren't trained or qualified to give a formal diagnosis. That needs to come from a GP, psychiatrist or clinical psychologist. Your T may well be able to see the signs of PTSD or DID but can't give you a diagnosis - if it's really important to you, would your GP not be able to help or is that you want it not on your medical records?

Originally Posted by Merecat

Cassy, I see you're in the UK - I know from my own experience that therapists in the UK aren't trained or qualified to give a formal diagnosis. That needs to come from a GP, psychiatrist or clinical psychologist. Your T may well be able to see the signs of PTSD or DID but can't give you a diagnosis - if it's really important to you, would your GP not be able to help or is that you want it not on your medical records?

Thanks for that Merecat - I knew he wasn't allowed to diagnose - I didn't realise it was all t's though! Im not sure how I feel about talking to a GP. They haven't been that great so far - when it comes to mental health their default response is to put you on anti depressants and a four month waiting list for 6 sessions of CBT. None of which are any use for me. There just seems to be a complete lack of interest in mental health. You asking me that question has made me realise that what I feel most strongly about, is him acknowledging the other bits of me. I don't need a GP for that - so thanks!

[Freefallphoenix]

I'm also in the UK and have just seen my gp who is making a mental health referral for me with a question of bpd. However since coming here and realising there is so much stigma attached to this label I'm a bit unsure whether I want an official diagnosis of this on my medical records. I've been thinking about what I would gain from another diagnosis (on top of depression and gad) and it would partly be for validation of my experience and the fact that since connecting with the description of bpd symptoms I'm finally starting to make sense to myself in a way that I never have before. I also want to be able to better explain my crazy-making experience to my husband (and maybe other family members). And finally I feel that at this stage in my healing process I would benefit greatly from group therapy and believe I may be able to access this through a BPD diagnosis.

However I am also training as a person-centred therapist and am very way of the long-term impact of such a diagnosis on me professionally. Though there are obvious risks of such a label working against me in terms of 'employability' and 'stability', I also see potential for working as a therapist who has inside experience of dealing with mental health problems and what is possible for a client to gain through good therapeutic relationships.

The jury is still out on that one...

But I feel, like you do, that a label is only part of the picture and what work I do in therapy is the most important thing.

Phx.

[Merecat]

In in training too freefallphoenix so I get the concern about diagnosis - the other thing for me is that BPD sits very closely with PTSD/complex PTSD in terms of symptoms etc both of which carry less stigma. I don't know if trauma has been an issue for you but if it is, it's possible you're actually experiencing a reaction to unresolved trauma. I have PTSD and have found long term work with an integrative therapist who is experienced in working with trauma has been invaluable. Stuff that I really didn't connect back to my trauma experience has really alleviated, including crazy making relationship stuff. She doesn't "treat" me for PTSD, she helps me unpick and understand things that I really struggle with - it's slow, painstaking work but she doesn't need diagnosis to help me.

[MiddayNap]

I don't wish for a diagnosis. I'm a bit different, I've had plenty of reminders of that, but I cause no one any harm and I don't believe I should have a title thrown upon me simply because other people think I should feel or think in the way they do.

[Lauliza]

I think a diagnosis is most useful when it applies to certain benefits, like ADHD or autism. Otherwise, I think the treatment is what's most important and not the label. However, if you don't think you are receiving the proper treatment I would seek out another T.

In the US, only insurance and medical providers you give permission to have access to mental health. Otherwise no one knows your diagnosis unless you choose to disclose it. If there is any concern about stigma I would not share this information.

[BudFox]

Originally Posted by Lauliza

In the US, only insurance and medical providers you give permission to have access to mental health. Otherwise no one knows your diagnosis unless you choose to disclose it. If there is any concern about stigma I would not share this information.

I am less concerned about the stigma associated with others knowing about a diagnosis, than how the label affects me. "Self-stigma" it has been called.

Seems to me a diagnosis of Mental Disorder XYZ can change one's internal chemistry, outlook, and self-image. The experience could be shaming and pathologizing. Once internalized, it could stay with you for life.

There's also the real possibility that a "mental disorder" is actually the symptom of an undiagnosed bodily disease, and labeling it as such potentially throws the patient onto the wrong path.

[AncientMelody]

I wish I had diagnosis for a physical health concern, but not my mental health. For mental health I have and agree with generalized anxiety disorder. not sure if depression is still hanging around on my chart, if so that's well remitted.

I wish I had a specific diagnosis for my excessive daytime sleepiness. This has been ongoing prior to my mental illness and I in fact think the cognitive stress of the fatigue contributed to my mental health symptoms. I have a sleep specialty eval next week.

[BudFox]

Originally Posted by AncientMelody

I wish I had diagnosis for a physical health concern, but not my mental health. For mental health I have and agree with generalized anxiety disorder. not sure if depression is still hanging around on my chart, if so that's well remitted.

I have pretty serious anxiety as well. But how is a label like GAD a diagnosis? A diagnosis involves determining the cause of a disease or disorder, using the concept of differential diagnosis to rule out other causes. If a therapist applies the label of GAD or MDD, then purports to "treat" these disorders based only on that label, then what precisely are they treating?

Like you I have physical symptoms (fatigue, cognitive problems, and more) as well. The point for me is that there is no separation between mental and physical, and the only legit healthcare is that which addresses it all holistically.

[Lauliza]

Originally Posted by BudFox

I am less concerned about the stigma associated with others knowing about a diagnosis, than how the label affects me. "Self-stigma" it has been called.

Seems to me a diagnosis of Mental Disorder XYZ can change one's internal chemistry, outlook, and self-image. The experience could be shaming and pathologizing. Once internalized, it could stay with you for life.

There's also the real possibility that a "mental disorder" is actually the symptom of an undiagnosed bodily disease, and labeling it as such potentially throws the patient onto the wrong path.

I agree that this is the case a lot of the time. I think a lot of Ts don't like to talk too much about diagnosis for this reason. If they do, stick to straight forward diagnoses like depression and GAD. I think in some cases it can be helpful in terms of treatment, but that's ultimately up to the client, not the T.

I think looking for a physical source of "mental disorders" is very important, especially in relation to depression. Ideally, a client would have ruled out possible physical causes before starting therapy.