Mental Health Diagnosis

Since the early days of my teaching career, I have had concerns with the medicalisation of distress. I noticed that some children were defined as behaviour problems and others were diagnosed with ADHD (that was the predominant mental health diagnosis for children then). It was hard to differentiate between the exhibited behaviours. Some of the ADHD children were medicated. My feeling was that this was an invisible straight jacket and it may have served the social context but it didn’t seem to serve the child. 

We have known, for years, that if we label children as ‘naughty’ they then live up to the label, and we will have effectively removed their opportunity to become their best selves. Now, children and adults are labelled with ‘medical conditions’ that are equally disempowering. If the problem is located in the person, we don’t have to look outside for the environmental and social factors that contribute to human distress. Unfortunately, support for mental suffering is often only accessible in this country following a formal diagnosis, so clearly people will jump through the required hoops - however, it is worth investigating the non-pathologising perspective if only to support a considered pause before accepting everything the medical profession has to say unchallenged. 

Drop the Disorder edited by Jo Watson and People not Pathology: Freeing therapy from the medical model edited by Pete Sanders and Janet Tolan draw on extensive research evidence to explain this current phenomenon and how harmful it is. 

Some important points are:

Diagnosis is down to interpretation and therefore opinion. There are no universal biological symptoms for psychiatric conditions as there are for physical ones, so no blood test to confirm ‘general anxiety disorder’ for example. ‘Conditions’ are defined by groups of ‘symptoms’ that are shared with a number of other ‘conditions’. Diagnosis only requires the ‘patient’ to be exhibiting a small number of those ‘symptoms’ to receive a diagnosis.

Therefore, different doctors could give a different diagnosis to the same person and the same doctor could give a different diagnosis to the same person on a different occasion.

Where do the lists of symptoms come from? The committee who compile the Diagnostic and Statistical Manual of Mental Disorders (DSM). Committee members have vested interests in this volume as a marketing tool for the pharmaceutical companies. 

The pharmaceutical companies are the main driver behind ubiquitous diagnosing. Their primary interest is to sell their products. The research around the benefits, lack of benefits and potential adverse effects of drugs for mental health conditions is well worth considering. 

Suffering is caused by things that happen to people directly on an individual level and indirectly through systems and structures that generally are born of political and economic ideologies that benefit only a fraction of society. Labelling pain as mental disorder has been presented as a sympathetic view of non-compliant, anti-social or different ways of being - society is being trained to normalise struggle and pain. I (and others who align with the campaigns Drop the Disorder and A Diagnosis for Everyone (AD4E)) believe medical labelling also sites blame within the individual - it has a suggestion that the fault is unconscious and biological rather than conscious with an element of choice, which was how labels like ‘naughty’ or ‘behaviour problem’ viewed the individual. 

The sympathetic style labelling is just as harmful to the individual. The medically diagnosed individual is assumed to be less capable in terms of making decisions and choices and assumed to have less capacity to realise their potential as independent human beings. Where others must learn that the diagnosed individual is ‘different’ and therefore subject to different expectations, the others’ struggles and differences are devalued and ignored. We are all unique/different from everyone else and what has happened to us is unique - we all grow up in a complex web of circumstances and for some people their circumstances are overwhelming and trauma loaded. We need to be normalising human responses to adverse environmental and social experiences. Depression and anxiety are just two perfectly normal responses to adversity. 

All these arguments and more are well evidenced and presented in collections of essays in the two books linked above. In addition, the Drop the Disorder Facebook page is a good place for finding stories from other sufferers, campaigners and for getting answers to questions or signposts to sources of support. 

As a counsellor, I can help those with a diagnosis to explore the circumstances that led to normal but not necessarily helpful responses. With knowledge and support to understand your reactions, and their derivation, you will feel less 'stuck' within the diagnosis and better able to find your inner resources to move forward with personal capability and control.

©Louise Knight

powered by WebHealer