If you receive a mental health diagnosis from your treatment team, it means you have enough related symptoms to place you in the grouping of people with similar symptoms and the related diagnosis. It is not a definition of you as an individual. This is simply a categorization that allows providers to group effective individualized intervention tools based on the symptoms you present. It also supports a way for you and your team to communicate, especially when discussing medications.
Where Does a Diagnosis Come From?
Mental health disorders are diagnosed according to the DSM, a manual of the American Psychiatric Association that stands for Diagnostic and Statistical Manual of Mental Disorders. A diagnosis is based on a system called multi-axial, which has five parts. Each axis, or part, tells you different information about the diagnosis.
- Axis I lists mental health and substance use disorders for which symptoms of mind functioning are clinical and generally improvable through corrective measures.
- Axis II lists personality disorders; these symptoms of the mind and brain functioning are generally improvable through learning and developing new skills.
- Axis III lists general medical conditions, such as the condition and functioning of
the body and brain.
- Axis IV lists psychosocial and environmental problems, such as situational or environmental concerns.
- Axis V is the Global Assessment of Functioning (GAF), reporting numerically with a score of 0-100 of how you, generally, might be functioning in life.
Mental health disorders are varied, and they present in different ways. When looking at symptoms, experiences or functioning, you and your team will consider many different areas that will help reveal the whole picture.
It Starts With an Assessment
To accurately diagnose someone, a wide range of information is gathered and reviewed by experienced medical and treatment professionals. The most common areas for assessment of mental health include your physical appearance, attitude or rapport, behavior, mood and affect, speech, thought processes and content, perceptions, cognition, insight, judgment, your history and socioeconomic stressors.
Looking at one area of assessment alone may yield no clues or present an incomplete or incorrect diagnosis. However, looking at a combination can help to clarify the diagnosis and assist you and your team in understanding the best course of action to support health and recovery.
Here are some areas that may be assessed during an interview or mental health appointment:
- Physical appearance: Your apparent age, height, weight, manner of dress and grooming.
- Attitude/rapport: Your approach and interactions in the assessment process. For example, are you perceived as cooperative, uncooperative, angry, guarded, defensive or hesitant to be honest?
- Behavior: Your level of activity and excitement, eye contact, posture and gait. Abnormal movements, such as tremors, tics, repetitive or fidgety movements, or lack of movement of body, eyes, or other body parts may indicate a neurological illness or symptoms.
- Mood: Your overall feelings and how you perceive them. For example, you might be angry, anxious, sad, depressed, happy, uninterested, overwhelmed or in control. Or you may lack the ability to express your mood.
- Affect: How you express your mood or what shows on the outside. Differences between mood and affect can be symptoms in themselves. For example: How intense is the mood, or does it relate to the situation?
- Speech: The loudness, tone, clarity, and flow of your speech, as well as how fast or how slow you speak, word choice, repetitiveness and intensity all assist in providing further information.
- Thought process: The quantity, speed and logical awareness of thought, largely reported by you, and also observed in your speech patterns. Thought process can also be observed in behavior and within your level of focus or distraction.
- Thought content: The value you place on ideas, obsessions, phobias, preoccupations, convictions, control of self and others, and thoughts relative to mood or environment. Are thoughts intrusive or commanding? Do they seem rational? Are they observable beliefs?
Your perceptions, cognition, insight, judgment and history will also likely factor in to a diagnosis.
Receiving a diagnosis can be difficult for many people, but remember that it doesn’t define you. A diagnosis is merely a tool – one that can positively impact your health if you use it properly.