What is a mental health diagnosis anyway? How do you know if you need a diagnosis? As someone living with a serious mental health condition for the past seventeen years, I hope I may be able to shed some...
In an effort to return to writing and blogging, I found this post in my drafts from the summer of 2020 and decided it’s time to follow through with publishing the keys to my Mental Health Mindset in hopes that they can help someone out there.
The first key to building a Mental Health Mindset is to obtain a proper diagnosis.
Photo by Alicia Bruce
Sounds simple enough, right? I wish it were that easy. On average, it takes a person ten years to receive the proper diagnosis for their mental health condition. TEN years. Can you imagine it taking your doctor ten years to properly diagnose your cancer? Me either.
What is a mental health diagnosis anyway? How do you know if you need a diagnosis? As someone living with a serious mental health condition for the past seventeen years, I hope I may be able to shed some light on this for you, and explain why receiving a proper diagnosis is the first step to my mental health mindset.
DSM-5
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is in it’s 5th edition and is the handbook used by mental health professionals to guide the diagnosis of mental disorders. It’s not perfect, as the National Institute of Mental Health withdrew support for the manual in 2013, but it’s all we have for being able to put a name to the symptoms we’re dealing with to have a starting point for treatment. The two main criticisms of the DSM-5 are that that pharmaceutical industry has an unhealthy influence on the revisions to the manual and that it has an increasing tendency to “medicalise” patterns of mood and behavior that aren’t considered particularly extreme.
Even given the controversy over the DSM-5, I’m still grateful it exists. If it didn’t, where would we start when trying to figure out what is going on in our brains? It baffles me that we know so little about what is the most important organ in our bodies. It’s my hope that in time more research can lead to better treatments for mental illness, but until then we have to work with what we have.
My Diagnosis Story
I was lucky when it came to being properly diagnosed. My mental illness emerged when I was 26 years old and came in the form of a psychotic break. I had been under a tremendous amount of stress at work - year-end numbers, setting goals for the new year, long hours, pressure to perform at very high levels, etc. - and it manifested in insomnia.
I couldn’t sleep for a week and that lead to unclear thinking, rapid speech (pressured speech is the symptomatic term), and excessive energy. This is classic mania but we didn’t know it at the time. Left untreated, mania often leads to psychosis. My husband tried to calm my mania by getting me to sleep, but it didn’t work. My mania turned into psychosis and I experienced hallucinations, both auditory and visual. It was extremely traumatic for my family. My husband had to call 911 to have an ambulance come and take me to the hospital. Once at the hospital, I was held overnight until they could admit me to the psychiatric floor. I spent two nights in the psych ward and then was released.
We thought it was a fluke incident, brought on by severe lack of sleep. The psychiatrist who evaluated me after I left the hospital agreed, and admitted I didn’t need to take the anti-psychotic medication the in-patient doctor had prescribed. Sadly, that wasn’t good advice. Two weeks later my illness came roaring back to life when I became manic December 23 and had to be admitted to the hospital on Christmas Day in 2005.
While I was in the hospital that second time for mania and psychosis, my husband and parents were able to find me a good psychiatrist who correctly diagnosed me with Type 1 Bipolar Disorder. He prescribed an anti-psychotic that was able to relieve my manic symptoms. I attempted to return to work after several weeks off for the hospitalization and to find a doctor who could start me on the proper medicine. I was seeing a psychiatrist and a therapist and was soon given a second diagnosis: Generalized Anxiety Disorder. Even though I wanted desperately to be able to get back to work, my anxiety was interfering with my ability to successfully manage a full desk. I got behind on my work and overwhelmed easily. I cried most nights on my drive home from work because I was so distraught. It was only a few weeks before I decided to resign from the job I loved in order to focus on my mental health.
Even though we had a diagnosis, my mental illness didn’t magically become easy to manage. In fact, it was quite the opposite. Quitting my job spiraled me into clinical depression. My career had become my identity, so much of myself was wrapped up in my work and my success that I felt worthless without the job title, salary and accolades. My depression took over my persona and sleep became my new best friend. The confidence that had catapulted me to the top of my company had crumbled into a pile of shiny anxious pieces at my feet and I had no idea if I’d ever be able to glue them back together. Sleeping away as many hours in a day became my new way of coping.
With the bipolar diagnosis though, we had a starting point and it guided us through researching various medicines for my condition. In my next post I’ll cover my Mental Health Mindset Key #2 - Ideal Medicine.