I recently saw an article about how millennials are diagnosing themselves with mental health disorders via information on social media, largely naming TikTok as the source. Seems hardly surprising, but it was interesting that a quick search shows that a few sources are naming this as an urgent and dangerous trend.
As a therapist, I have also noticed first-hand what seems to be a trend in younger populations to self-diagnose and I’m amazed that often, young clients know more about DSM criteria than I do. Is this simply being educated about mental health, or is it something else? The younger generation is blessedly woke to the reality of mental health problems, being exponentially more aware of the labels, symptoms, criteria, and medications in the realm of mental illness. And more and more of them are also taking their own mental health more seriously, taking responsibility and learning proactive measures. Which is excellent.
I want to note that in some of these cases, I have twenty-year-old clients come into the office with more awareness of their condition and more skill and education than any other generation. It’s a marvel, and it often greatly facilitates the difficult work ahead of us. Because of the utterly dismal, broken health-care system that we all live in, self-diagnosis can be an essential help in owning one’s challenges and pursuing proper paths of healing.
However, there is another side to this awareness, which is murky and unhelpful. What is the danger in self-diagnosing? Or in a diagnosis in general? What I see both in my office and online, is a high number of young people who have become identified with their diagnosis, and then hold it up as a shield to actually defend against change. There seems to be an attitude that ‘since I have a mental illness, and we all know it is a real illness, then it is not going to change, so not only do I not have to work on changing things, then you are offensive to me if you suggest that I should do anything more than cope with it and let it define me’.
I trust I’m clear in saying that this is not a majority of youth, but only that it seems to be prevalent. And when you add to this the possibility that someone would self-diagnose, you create another problematic layer. My concern is that in certain cultural subsets of young adults, it has become fashionable and an identity badge to wear a mental health diagnosis. But there are very important differences between experiencing bouts of sadness or anxiety, and being clinically depressed or anxious.
When a diagnosis becomes an identity, that person may actually defend it from change.
This is true for anything that a mind holds onto for identity. Identification is considered a healthy process of ego-maturation and individuation in a young person, but it has limits. If it is held too tightly, it becomes a hindrance and obstruction to growth and happiness. It is not hard to see that when the mind becomes identified with a pathological stance, rather than a more innocuous one, it gets doubly challenging.
And can I please make a point here to say that gender and sexual identities are a separate conversation, at least for the sake of this article, because I’m talking about diagnoses, and gender identities are not pathologies, of course. Rigid identification is problematic in any realm. But that is outside of what I’m talking about here.
So what is the answer to this necessary, but problematic rise of self-diagnosing? I would suggest that not only do we have to popularly educate each other as to the existence of mental health issues (as we have been successfully doing) but now, we need to educate ourselves in the ways and possibilities that these things can shift and change. Yes, we need to take mental health seriously, and not pass it off and dismiss it like we collectively had done in the past. However, just as importantly, we need to know a diagnosis is not a pronouncement on one’s soul, carved into the rock of your life. That stands not only for anxiety and depression, but also for things like personality disorders and OCD. We can change. And regardless of how much (and don’t get started on the word “completely”) the crucial thing is that beyond that, the diagnosis does not need to become a central aspect of our identity.
We must stop seeing the problem as the person.
We almost desperately need to have a better understanding of the fluidity and spectrum and mechanics of healing in mental health. Otherwise we are going to lose a lot of people who consciously or unconsciously declare to themselves that they cannot be helped, cannot change, and cannot heal.
Take for example, a young woman that I recently worked with that after spending some time in therapy, finally received an actual diagnosis from her doctor of clinical depression. She stated to me that basically, the diagnosis was a ‘relief’ and that it now gave her permission to relax her efforts at change, because, in her mind, “people with depression statistically don’t ever get better”. On one hand, it might be great that she can stop being so hard on herself. And I don’t want to minimize the fact that this diagnosis may help in various ways, by getting her medication and simply respect and allowance from family, job, friends. However as a therapist that watches ‘people with depression’ get steadily better all the time, it is saddening to see what feels like mis-applied misinformation. What are the statistics she is getting, and why are they absolute? Because while it may be factual that many – and perhaps even let’s say a statistically high average – of people diagnosed with depression continue to meet that diagnosis over a long period of time, why would a person decide that this means ‘all people, all the time’, or that it means that you cannot be one of the ones that gets so much better the diagnosis no longer applies? Because there are plenty like that too.
How you relate to your diagnosis may be more important than you think.
Let’s please remember that all our diagnoses are just human fabricated labels that we have decided to use to speak about clumps of symptoms, and that they have changed wildly over time, and no doubt will continue to do so. Diagnoses themselves are also spectrums, which is essential to remember. Diagnoses can be temporary. They can vary greatly. They can be just plain wrong. But most importantly, every person – regardless of diagnosis – can grow and change in meaningful, helpful ways. It doesn’t matter if you have a diagnosis of a personality disorder. You want to hold that card as defining you? you want to argue with me that the whole point of a PD is that it is intrinsic and therefore, ‘for life’? That’s fine. But guess what – you can also grow and change hugely and it is your choice whether you stay open to that.
Another example is a man that I know that is self-diagnosed as being on the ASD (autism spectrum disorders) and is also suffering from tremendous clinical depression. Neither have been officially diagnosed, but that isn’t even the point. This person holds the attitude that since his autism is a neuro-divergence in the way his brain is made, and is therefore unchangeable, that there is utterly nothing he can do to change things in his life. He does not go to therapy, he does not try medications, and he seems utterly resigned to his misery. Once again, our assumptions create so much suffering.
I take that in contrast to another person I know who is again likely on the ASD, and suffers brutal anxiety – but this person is actively engaged in therapy and has made exceptional strides in self-awareness. Is she still ASD? Of course. Is she still anxious? Yes. But less! But also, her relationships with others have dramatically improved, and her relationship to herself has lightened tremendously. In short – her diagnoses still remain, but the quality and richness in her life have improved dramatically. This would never have happened if she just assumed her diagnosis was her rigid identity for life.
A mental health diagnosis may be appropriately seen as a disability – but it is a unique category, because unlike being blind or missing a leg, this one can dramatically shift. If you were blind, but with work you could regain a large portion of your sight, would you not want to? Or would you be offended that I suggest that you do the work to that end? If you were missing a leg, would you stop eating healthy, or work on gaining strength in other areas of your life to offset that? Many do, and that’s a shame.
Recent research in neuroscience has told us exciting and optimistic things about the neuroplasticity of the brain, over the whole course of life. We are never, ever in a space where our minds cannot change. Not even when we’re 70. And we must not forget that mental illnesses are issues of not just brain chemistry, but thought, idea and belief. We can change. We do change.
Is a small improvement not obviously better than none? Is that not worth the work? We must be able to know and see not just our own potential to heal, but each other’s as well. Otherwise we face a dismal and hopeless future. To know, for ourselves and others, the perennial possibility of healing and change is not to be a dewy-eyed optimist, but a realist who will simply not bow under the weight of a louder pessimism.
How we see the world IS what we see, my friends. I see the change every day. I see it in places that surprise me and make me beyond grateful that I can help in this work. Don’t sell yourself short. You are much, much more than any one idea, behaviour, or pattern. Just know, there is so much possible in us, still.