What a Mental Health Diagnosis Means (And Doesn’t Mean) About You

“Freddy Jones is a 58-year-old, African-American male carrying a diagnosis of bipolar disorder.”

This is how most mental health professionals talk about you.

“Freddy Jones is a 58-year-old male immigrant from Congo who has been diagnosed with bipolar disorder. He has discussed an inability to sleep due to constantly working on his album. He speaks rapidly, switching often between subjects of creating the music, advertising the record, and how to turn a profit.”

This is how I’ve been trained to talk about you.

What’s the difference? The first sentence dehumanizes Freddy and sounds as if he himself is an illness. The second sentence describes Freddy as a human being with a story and a point of view on a diagnosis that he received.

I am a therapist in Massachusetts with experience serving individuals who struggle with mental health issues. When I began graduate studies at Boston University Medical School, I was originally taught to speak to doctors. I felt well-equipped to head into hospitals and show everyone how well I could assess and treat patients with my fancy new medical jargon.

But then I began working at a human services agency that didn’t love my approach. “Stop using the medical terms,” they said. “Tell us what’s really going on with the person,” they said. At first, I didn’t understand. I was telling them what was going on. Didn’t they hear me? This patient has bipolar disorder. What else did they need to know?

But as it turns out, they needed to know a lot more, and so did I.

Let’s break this down. Traditionally, mental health professionals turn to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) when diagnosing an individual. To meet criteria for Bipolar Disorder I, for instance, a person has experienced at least one manic episode.

But what is a manic episode?

Manic episode can mean: impulsive decision-making; distracted, racing thoughts; overly talkative; loss of need for sleep; euphoria; increased energy; abnormally upbeat. That is already a lot of descriptors for one type of episode. To pare it down, Freddy most likely struggles with decreased need for sleep, talkativeness, and racing thoughts.

But what are racing thoughts?

Racing thoughts are unwanted, rapid-fire thoughts that cause a person distress. In some cases, it makes it very difficult for a person to sleep. In Freddy’s case, he has stopped sleeping, and his thoughts turn rapidly from making music, to advertising his album, to making money.

Why didn’t you just say that in the first place?

That’s the question, isn’t it? Why are mental health professionals not very specific when discussing the people they serve? Seems like it would make life much simpler. Well, for the most part, we are not trained to do this. As the mental health field progresses, it has become common practice to work under a “medical model” in which we use evidence-based practice to appraise, diagnose, and treat patients. This shift may have taken place as a way to break stigmas around mental health as a pseudo-science. If the evidence-based practice is good enough for medical doctors, it should be good enough for everyone, right? That would make sense if not for this little snag…

In modern medicine, a broken bone can be mended by wearing a cast. Bipolar disorder, PTSD, depression, anxiety, and a whole host of other diagnoses describe a person who feels broken. This cannot be treated by telling someone to do more self-care.

The point of this is not that doctors are doing their job wrong. In fact, there are tons of doctors and mental health professionals who use psychological terms, and their work is greatly appreciated by the people they serve. But the benefits of changing the way we speak about these individuals are numerous:

It humanizes the people seeking therapy, and that in itself changes the way mental health professionals relate to these individuals. An enormous part of building the therapeutic relationship is people knowing that their therapists understand them. I have no personal experience of what it is like to have bipolar disorder, but I absolutely can relate to Freddy’s experience of being kept up at night due to work anxiety.

It separates the individual from the diagnosis. “Freddy is bipolar” has a way more judgmental tone than “Freddy struggles with bipolar disorder.” An even more empathetic statement would be “Freddy struggles to sleep because he is constantly thinking about his album.” Not only does this take away the labels and stigma that are usually paired with a diagnosis, but it also empowers Freddy to know that his perspective on the situation matters.

It reduces the “teacher to student” dynamic that often occurs in therapy. The people I serve know that I cannot fix their problems. However, because they feel seen as human beings and feel empowered to work on their mental wellness, they often begin to do the work themselves. I can offer suggestions and guideposts here and there, but I don’t feel the pressure to say the right thing or give perfect advice. The people we serve are experts at their own lives if we only provide them with space to grow.

This is not only an issue for people working in healthcare, but also in our popular culture. Many of us tend to throw around mental health terms today. We say “Rachel must be depressed,” or “Rachel’s not doing enough self-care”. But what do these phrases mean? Is Rachel depressed because she is tired, slow, or sad? Would self-care look like taking a bath, going for a walk, or playing music?

Often when our loved ones are struggling with mental health issues it is hard to find the right words.

Sometimes we say the wrong thing because we don’t know what the right thing is. But it is completely within our power to find better language to use for mental health issues.

For example, rather than:

“Rachel, you’re just depressed.”

We can choose words that are specific, non-judgmental, and empathetic. Try:

“You seem sad, Rachel.”

When we are at a loss for what to say, we can be curious and ask more questions. Rather than:

“Rachel, why don’t you get out of bed already?”

Try:

“What can we do to help you, Rachel?”

These changes may seem small, but they make a world of difference in both healthcare and in our everyday lives. The words we choose often reveal our perspective, and words are such a powerful way to show someone you care. By changing our language, everyone can contribute to breaking the stigma and making a difference to those struggling with mental health and working toward recovery.

About the Author: Danielle Pinals is the creator of Real Talk with Danielle, a blog covering mental health, the arts, and travel. At baseline, Danielle is overwhelmed by all of the ideas in her head.

Blog: www.daniellepinals.com/blog

Facebook: Danielle Pinals

Instagram: @daniellepinals

Photo by Alekon pictures on Unsplash

The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in this article or linked to herein.