How is Mental Health Disorder Diagnosed?

You might have read elsewhere on this site that these days, Addiction is considered a mental problem, not a moral one.  Therefore knowing how mental disorders are diagnosed is relevant for anyone wanting to know more about addiction, as well as anyone wanting to know more about mental health in general.

Mental disorder is diagnosed in exactly the same way as any other illness, because it is no different than any other illness – it’s just an illness that affects the brain, and not an illness affecting the heart, or the kidneys etc.

This is the process

A health professional is presented with a person who has ‘something’ wrong with them (symptoms), and it’s the doctor’s job to work out what is causing these symptoms.  Because, if a cause of the symptoms can be found, an appropriate treatment can be given.

This process of diagnosis is the same whether the problem to be solved is a sore big toe, difficulty breathing, or a possible mental illness.  A range of methods are used, including physical examination, and talking to the person in order to assess and understand the reason for their current distress.  If a possible mental disorder is suspected, more weight will be given to the behavior and beliefs of the person, and that of their family, than if they want their sore big toe fixed…. although, behavior and beliefs might still be useful to know when trying to diagnose a sore big toe – like the man who finally told me he’d been injecting motor oil into his toe joint ‘to make it run more smoothly’.  However, after due consideration, I decided he did not have a diagnosable mental illness!

Gather Physical Evidence

Sometimes, investigations such as blood tests and brain scans might be used to gather further information, and get a complete picture of a person’s possible health problems.  This is an important part of trying to assess a mental disorder, because sometimes, clues can be found that might indicate that some other illness might be affecting how the brain is working.  If that is so, treating the other illness will probably help with the mental problem as well.

The process of diagnosing any health problem is very like detective work: evidence is searched for, and collected together.  These collected facts are then compared to the characteristics of known illnesses to find the best match, and therefore the most likely diagnosis, or label, for that person’s problems, can be identified.

But of course not everyone, always fits neatly under one medical label or another, especially in mental health. Many mental illnesses overlap the theoretical boundaries of one particular label, or diagnosis, and some people have symptoms that tick more than one box at a time.

It is important to realize that any diagnostic label refers to the disorder, not the person.

These complications and limitations of overlapping signs and symptoms, and related diagnoses, apply particularly to the diagnosis of mental health disorders.  Therefore, the professionals don’t always get a diagnosis exactly ‘right’.  This doesn’t mean they are necessarily ‘wrong’ – always assuming they are competent and have followed the approach recommended by their profession.

Mental Illness Diagnosis Is Not an Exact Science

Health professionals in the field of mental health are aware of this potential overlap, and that there are these areas of uncertainty, and therefore, that some diagnoses (labels) might change slightly over time, as more clues and evidence are found.

It may be because one particular person is showing signs that lie in the borderline areas between two or more, diagnostic labels.  Labels are artificial constructs being applied to complicated human feelings and relationships – and mental health diagnosis is not an exact science, unlike physics or maths, where the facts are hard facts, that can be proven with physical measurement and calculation.

A mental disorder diagnosis sometimes comes down to one or two people’s opinion, or the agreed opinion of a group. Thankfully, the diagnosis and treatment of mental illness is usually accurate, and therefore maximally helpful. Having an accurate diagnoses means that the best and most appropriate treatment can be given.

Symptoms – And Labels – Can Change Over Time

Also, symptoms will sometimes change over time, and a slightly different pattern can emerge.  This can mean that the original diagnosis, or ‘label’, might now be misleading.  Mental health professionals are always trying to match up any one individual person’s problems with a treatment plan that is most likely to help their specific needs.  To do this, they use labels that aren’t always perfect.

Good health professionals realize the slippery nature of accurately diagnosing mental disorders, and therefore accurately treating mental illness, so they constantly review their diagnoses (labels) and treatments over time, as their patients, and their patient’s symptoms change or evolve.

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