Getting support for your mental health concerns can be daunting and the idea that someone is going to give you a label after talking to you for just a few minutes can be unsettling. Especially with the stigma surrounding many diagnoses, and the inaccurate usage of them in the media & society. So why is your therapist/psychiatrist giving you one? Well, if you want to use your insurance to pay the bill, then a diagnosis is required. This diagnosis then helps create the treatment plan, and that is how your therapist shows you are doing the work so your insurance will continue to pay. Since therapy isn’t supposed to be all the time for your entire life, insurance wants to see a specific focus for treatment and the best way to do that is having your diagnosis and treatment plan match.
But what IS a diagnosis? A diagnosis is a name for a set of symptoms you are experiencing that are causing distress in your daily life. It comes from the DSM-5-TR or the ICD-11 (the two newest diagnostic manuals) including a code & a fancy name. There are lots of different ways people approach providing a diagnosis and there isn’t a truly right or wrong way.
Now, your diagnosis can change throughout your life, especially during the course of therapy. Say you come in because you are dealing with the loss of a loved one and are feeling depressed, then you can receive a diagnosis relating to depression. But then you could come in at a different point feeling anxious about driving after having gotten in a really bad car accident; your diagnosis can reflect trauma or anxiety. This doesn’t mean one of your providers diagnosed you wrong, but rather that the focus of treatment was different since you were getting treatment at different points in your life. If you aren’t sure the diagnosis matches what you are experiencing, ask your provider to explain and they will be able to help clarify. Since a diagnosis can change, your diagnosis could also be updated throughout your treatment once more information arises.
Many providers will give you the label with the least stigma first (e.g.. Adjustment Disorder with Depression & Anxiety) before giving you a “heavier” diagnosis (e.g.. Major Depressive Disorder or Generalized Anxiety Disorder), as “heavier” diagnoses require very specific, and significantly more, symptoms. This is why it is so important that you are honest with your clinician since we want to make sure you get the most accurate diagnosis. Labels can be a powerful tool, but they aren’t the be-all and end-all of treatment.
Additionally, the same diagnosis can present differently between people. It is possible to have two people who are both diagnosed with ADHD and it could look completely different for each person. The DSM-5-TR gives clinicians specific requirements that a patient/client needs to meet in order to be diagnosed with a disorder, but how that plays out in life looks different for each person. Social media is a great resource to learn about how symptoms play out for different people, but you are not them, so don’t diagnose yourself based on other people’s presentations. Bring your thoughts to your clinician and we will work with you to identify what the symptoms you relate to mean for you.
So how do we determine what diagnosis is the correct one? This is once again where I implore you to be honest with your clinician. The DSM & ICD just provide labels for sets of symptoms, and sometimes there are a lot of options that could match. It can end up being a case of which came first, the chicken or the egg, and while it is important to know the answer, sometimes it is more important to treat the symptoms as they are appearing now. You can have more than one diagnosis, but many diagnoses require additional evaluation, so having a conversation with your clinician about your thoughts on your diagnosis can help them get you set up with appropriate referrals as well.
In the end, a diagnosis is what you need it to be. It lets you use insurance to cover costs, it can help a doctor provide you with the correct medications that can treat your symptoms, assist you with getting support in your community, and help you and your clinician make a plan for treatment that will best help you. It can give you a sense of understanding of yourself and connect you with a community. As long as you are honest and upfront with your clinician, we will do our best to provide you with a diagnosis that will be accurate and give you a sense of relief.
JoAnna Hubbard, LMHC, is a recent transplant to New Mexico from California, having grown up throughout Southern California. She moved to Las Cruces in 2021 to pursue her Master's in Clinical Mental Health Counseling at NMSU and is now a Licensed Mental Health Counselor. JoAnna's academic background in California includes a BA in Psychology with a minor in Sociology and a Juris Doctorate with an emphasis in Criminal Law. She has diverse professional experience, having worked in settings such as a long-term in-patient psychiatric hospital, as a high school counselor, and as a mediator in Small Claims Court. JoAnna has experience working with severe mental illness, trauma, and LGBTQIA+ identity processing. She strongly believes in examining the systems that influence our lives and how we adapt to them, utilizing multiple therapy modalities to meet clients' needs. JoAnna enjoys incorporating various forms of art and games into therapy, including therapeutic D&D and bibliotherapy.
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