A Diagnosis is a Label of Convenience, Not a Definition of Character

There is only one basic question that people coming for counseling have.  

Why?

Why do I feel this way? Why do I see these things? Why have I always been a little bit different?  Why can’t I stop drinking and hurting the people around me? Why do I always end up with the same kind of bad romantic partner?

The fundamental need of a person who seeks help from a mental health provider is to help them account for the strangeness and difference of their experience.  Few people come to talk therapy because they understand what’s going on.

One of the great steps forward in the past few decades has been the increased accessibility of knowledge and services to treat mental health and its associated issues.  We no longer speak of depression or alcoholism in hushed tones.  It’s possible to talk about schizophrenia, even in our family members, without universal stigma.  We now can now discuss things like trauma and abuse quite transparently and seek the help we need without shame.

Many more than ever before have taken the opportunity to seek out help for things they would have been scared to claim openly even a few decades ago.  Words like bipolar and OCD have entered our vocabulary.  A whole generation has grown up knowing that a mental health diagnosis might be part of their life, and they have found ways to manage, survive, and thrive.

However, no diagnosis can truly capture the complexity of a person or the individual character of their experience.  You are more than your depression or your anxiety.  Your diagnosis is not you, any more than you are your diabetes or asthma.  It’s a clinical label of consensus and convenience, and it can be wrong.

A diagnosis can never totally explain our choices or account for our mistakes.  It’s a description of one small part of you, not your name.  Many people begin to treat their diagnosis as a kind of wicked imaginary friend, responsible for all their failures and bad choices.  My depression made me stay home and miss that opportunity.  My anxiety is why I can’t talk to them ever again.  Worse still, some people almost become their mental illness and explain everything from its shadow: I am a depressed person so I can’t. 

If recovery is our goal, then diagnosis is our starting point, not our finish line.  Almost everyone is capable of some kind of forward progress in their lives.  Sometimes our real why can be challenging to confront, and by far the healthiest way to proceed is to acknowledge it, own it, and learn from it.  It has absolutely nothing to do with anything found in the diagnostic manuals and everything to do with what you do from this point forward, starting now.

The best question is the one after the why.

How?

How will I get that job?  How will I make myself happy again?  How will I learn to work and play in the world without failing?

How?