Advice to hypochondriacs
In my personal experiences and also in my professional experiences in social work, I have learned the importance and usage of diagnosis and how it can affect people’s perceptions of their self image and of others. The importance of a diagnosis, at least in terms of mental health, is to help professional mental health experts treat their clients. In many cases one person doesn’t exactly fit one diagnosis in the DSM. Instead, you often find overlap of similar symptoms but not they may not be severe enough to qualify for a full diagnosis. When reading over patient charts, it isn’t uncommon to see an unspecified diagnosis. For example someone who has clear symptoms of anxiety but may not have clear explanations or clear examples of whether or not it can qualify for generalized anxiety disorder, the doctor will simply put unspecified anxiety. So one of the things that is not always explained to clients is that a mental health diagnosis is not the same as a physical health diagnosis.
In mental health there is more room for subjectivity. Our ideas of what a mental health illness is actually comes from social norms and social constructs. While working as a mental health professional, I would often find that my clients closely identify with their diagnosis. There are some benefits to this, such as helping explain their behaviors to others which can help advocate for them in social situations. However it is a double edged sword, as people may not view them as “normal” anymore. In some sense this is true because mental health diagnosis stem from an area of psychology called abnormal psychology. But the stigma that is placed on people with a mental health diagnosis is not helpful or even accurate. If you go back and look at where abnormal psychology essentially originated from, it was from observations made from people noting that a specific individual has strange behaviors that did not fit within social or cultural boundaries. When women did not have as many rights as they do today, you’d find them admitted, locked up and drugged, solely based on the family or husbands opinion. There is a dark history in the world of psychology and psychiatry that modern day professionals have to work hard to regain trust in society.
The reason for these “abnormal” people’s behavior is vary. One may often hear the argument between nature versus nurture. Any person who has studied psychology you would ultimately say upbringing and genetics both play key roles in psychology. For example the homeless population often have untreated mental health illnesses. It’s not uncommon to see a person who is homeless have erratic behaviors or symptoms of mania or psychosis. Sometimes these behaviors could even be attributed to substance abuse. So the question that arises, how did this person end up in this place, did they end up here because they got addicted to drugs, or did they get addicted to drugs as some way to try and self-medicate their mental health illness? Does this mental health illness stem from a predisposition genetically or was the onset triggered by the use of substances? These are questions we simply would not have the answer to. I use this as an example to help explain the differences between a mental health diagnosis and a physical health diagnosis.
If you’re wondering how this can connect to hypochondria, think about some experiences where you might feel sick but you’re not entirely sure what it might be or whether or not you should seek out medical help. Following your uncertainty, you decide to check out WebMD. Next thing you know you have fully convinced yourself that you have a rare illness and that you are dying. It’s pretty safe to assume that the vast majority of the time you are completely wrong about your self diagnosis. This happens in the world of mental health as well. Occasionally people who have a mental health illness may feel that their symptoms are more extreme than they really are (although it is often seen in the opposite occurrence as well). Typically, humans do not seek out information on our health unless we feel as though something is very wrong. So from that behavior it shouldn’t be all that surprising that someone who has anxiety, all of a sudden is convinced that they have schizophrenia or another mental health illness.
The ease of access to information is a blessing and a curse, diagnosticians can make mistakes in their perceptions even after years of schooling. In the field of mental health the diagnostician typically relies on self-report data and data provided from those who are close to the client. The more consistent findings are typically diagnosed by a clinical psychologist who has various forms of assessments in which there are standardized recordings of symptoms. However clinical psychologist are far fewer in the field and so you’ll often find licensed therapists or psychiatrist who are doing the diagnosing primarily based off of professional experiences, trial and error, and off of self reporting information. That is not to say that a psychiatrist or a licensed therapist would not have the knowledge or capability to successfully diagnose a mental health illness, but there is more room for error because perceptions and communication between people inherently have more room for error.
I can easily share a personal experience from my adolescence in which my hypochondriac behaviors led to a misdiagnosis of my mental health. Due to Childhood trauma and environmental instability, and possibly a genetic predisposition, I had an onset of severe anxiety and chronic depression. When my anxiety was at a high point I would try and figure out “what is wrong with me” . My coping skills for my anxiety could easily be confused with symptoms of OCD or with mania. One example is that when my anxiety would get really bad, I would try and regain some self-control by reorganizing and redecorating my living space. Sometimes it would be so extreme and I would be reorganizing all rooms in my house in the late hours into the early morning hours for extended periods of time without not getting any sleep. So when I would try and figure out why I had these compulsions to reorganize I would essentially scare myself into thinking that there was something severely wrong with me. When in reality, I just needed to learn some healthier coping skills such as sitting and focus on taking deep breaths. Instead, I self diagnosed myself with bipolar mood disorder.
From this point I went to a doctor and essentially spewed out everything that I read online about bipolar mood disorder and next thing I know I was taking a medication for the mental health illness, which I later found out was not recommended for adolescents. The side effects were extremely uncomfortable, I was consistently exhausted and always hungry. I was not educated on the risks of withdrawal, and in my life I have experienced 2 extreme cases of withdrawal, and to this day I do not think I have ever experienced anything as painful as that. Cold sweats and body aches in combination with the thoughts that I would certainly not pull through, were terrifying experiences, and it wasn’t until later that I learned it was from the sudden stop of taking these medications. Over the next five years I had taken a combination a various medications and anti-psychotics. It was not until I was admitted into an outpatient program that I was more correctly diagnosed and treated for my anxiety and depression.
Now the doctors that incorrectly diagnosed and treated me when I was an adolescent, followed standard procedure. It was simply a problem that stemmed from a self-fulfilling prophecy and an error in self-report data. So this idea of either self-diagnosing, or professional diagnosing, can affect a person’s self image end behaviors is sometimes debilitating and problematic. I worked with clients who’s guardians closely identified the children with the diagnosis. It was not clear if some of the child’s behaviors were in part due to a self fulfilling prophecy. I had one client in particular who would state, “I didn’t even know I had depression until they told me I did”. So it was a challenge to explain to people that one should not closely identify with their diagnosis. The diagnosis is more helpful to the experts in deciding a treatment.
I am sure to be biased about this topic because of my own experiences. Working in the mental health field is no easy task. Client’s emotions run high, and often times only hear a small portion of what you are trying to educate them on. In the end, this topic of mental health diagnostics really goes back to the idea of how labels affect people’s behaviors, and also how labels can also be beneficial or harmful. I personally cannot come up with a better system when I think about it. Because of the dark history in the field, transparency is essential to keep the trust of clients, and it would be immoral to hide a diagnosis from the client. The best way to counter the negative effects of diagnostics, in my opinion, is to simply try and give an education to clients about what a diagnosis is used for and what it really means. I must state that just because I did not learn this until college and after, that there are not professionals out there who do not do this. Nevertheless, I feel it is an important topic to discuss.
-Thoughts of a Writing Freak