Beyond Labels: How Your Mental Health Journey May Transcend Diagnoses

Introduction: Understanding the Role of Diagnoses in Mental Health

Why Did I Decide to Write This Article?

Many patients come to me initially seeking a diagnosis or with the question of whether they have been misdiagnosed in the past. Because this topic arises fairly frequently, both one-on-one in my clinical work and in the broader culture of discussing and understanding mental health, and in my opinion, not often in a nuanced way, I'd like to explore this topic in general and share some of my viewpoints on it.

The Purpose Behind Psychiatric Diagnoses

When you or someone you care about steps into the world of mental health care, diagnoses can come up early. Labels, like “depression” or “anxiety,” can help clinicians see patterns and choose treatments that have been shown to work. They can facilitate easier communication of needs, progress, and care plans among different professionals. Diagnoses are also an integral part of the healthcare system in the United States, and they can open the door to various resources, including access to therapy, medication, and insurance coverage.

Looking at the Benefits and Drawbacks

While these labels can help point us in the right direction, it’s important to understand both sides of the coin. On one hand, having a diagnosis can be validating. It could tell you that what you're struggling with has a name and you’re not alone. It could offer a roadmap for treatment and recovery that might look different if you had a different diagnosis.

Conversely, a diagnosis doesn't encompass all aspects of who you are. It reveals a portion of your story but not its entirety. In the haste to diagnose, clinicians may overlook deeper issues. For example, while low concentration is a symptom of ADHD, it can also be associated with depression, trauma, and anxiety. Often, individuals seek an ADHD evaluation, only to find that profound unhappiness is the primary issue affecting their concentration and various other areas of their life.

Each person’s struggles are shaped by their unique life, values, and history. Putting too much focus on the label can sometimes make people feel boxed in, limiting their view of what healing and growth can look like. It’s easy to get tangled up in the label and miss seeing your resilience and strengths.

Setting the Stage for a Broader View

As we explore your mental health journey, it’s helpful to acknowledge both the help and the hurdles that diagnoses can bring. This article isn’t about tossing out labels altogether, or making the case they are universally harmful or helpful. Instead, I hope to widen the lens—recognizing that while diagnoses have their place, your mental health journey may or may not be helped in the way you think by receiving a diagnosis or diagnoses.

The first thing to recognize is that diagnoses are not fixed categories. The Diagnostic and Statistical Manual of Mental Disorders 5th Edition, DSM-V, is the manual used by American psychiatric clinicians for diagnosis, and has undergone numerous changes, edits, and deletions. (If diagnoses were permanent, there would only be one edition, rather than five, with more to come in the future!) The steering committee of the American Psychiatric Association (APA), who are human, determine what is included or excluded, primarily based on their individual clinical insights, which then is opened up to public opinion. After this period, the steering committee makes its own determination, hopefully taking into account both evidence and public opinion in what they choose to move forward with in print. In practice, this means that there are always alternative voices, diverse perspectives, and valid points that may not be reflected in the current approach to categorizing or understanding mental health.

Evolution of Mental Health Diagnoses

You may or may not know that at one point, being gay was classified as a mental disorder under "homosexuality" in the DSM. This diagnosis was not removed until 1973, reflecting a significant shift in societal understanding and acceptance of sexual orientations outside of the heterosexual.

Throughout the history of mental health diagnosis, several categories have undergone significant changes or have been removed altogether. Here are a few examples:

• Gender Identity Disorder: Previously classified as a disorder, this category has evolved into "Gender Dysphoria" in the DSM-5, emphasizing the distress that may accompany gender incongruence rather than labeling the identity itself as disordered. Many trans activists contend that labeling gender dysphoria as a mental disorder pathologizes gender diversity and upholds the binary gender framework.

• Hysteria: Once considered a common diagnosis predominantly for women, hysteria as a category was introduced in 1968 and removed from the DSM in 1980. (Note: Although many psychoanalysts still use the term "hysteric" as a category in their framework of understanding patients, this is something different than how it was used and understood historically in the DSM. It's an interesting topic for a future article!)

Different Cultures/ Different Diagnoses

It's also important to recognize that the DSM is not universally used. For instance, in Europe, the World Health Organization's International Classification of Diseases (ICD) is the widely adopted system, currently in its 11th iteration (ICD-11). One example of a difference between these two guides is in the diagnosis of depression. The DSM-5 has specific criteria for major depressive disorder, while the ICD-11 allows for a broader range of depressive disorders, including those that may not meet the DSM-5 criteria. This highlights the variability in how mental health is understood and categorized across different cultures and regions, and helps us see that there is possibility that a sense of "discovering the truth" about what your experiencing via receiving a diagnosis may be a more nuanced conversation than you previously considered.

Furthermore, there are entire syndromes and disorders that exist in other cultures that do not exist in the American context. The DSM does discuss these as "culture-bound syndromes," but another way to put it is simply what people in other cultures experience as real. These ways of describing psychological distress are often not easily translated into Western diagnostic terms.

• Taijin Kyofusho (Japan and Korea): This condition involves intense fear of offending others through one's appearance, odor, or expressions, emphasizing shame and social anxiety related to interdependence.

• Neurasthenia (China and Japan): This term, meaning "weak nerves," is a common way to describe a cluster of symptoms including fatigue, headaches, and worry, often linked to the belief that excessive thought can harm the body.

Highlighting these different examples may prompt reflections around what a different cultural perspective might be on what you are experiencing. It also shows that diagnoses (let alone approaches to treatment) are not universal the world over.

Understanding Mental Health Beyond Diagnosis

These examples illustrate some of the reasons why diagnosis is not the definitive measure of one's mental health. Imagine being "definitively diagnosed" with one of the above at another time, only to live to see this category completely abandoned at another. Many people have lived through exactly this, and suffered much as a consequence.

It is essential to understand that mental health is a complex and evolving field. The criteria for diagnoses can and do inevitably change, and what was once considered a disorder may no longer be viewed that way. This ongoing evolution serves as a reminder that improvement in mental health can occur outside the confines of traditional diagnoses. Emphasizing personal growth, well-being, and individual experiences is crucial in the journey toward mental health.

With this in mind, let’s dig deeper into how labels shape our experiences and what lies beyond them.

The Benefits and Limitations of Diagnostic Labels

Diagnoses as Tools for Clarity and Support

Getting a diagnosis in mental health can be a turning point. For many, having a name for what they feel brings relief. It can help unlock treatment options and open doors to support services. Professionals often rely on these labels to communicate clearly with one another. When doctors and therapists use the same language, working together on a game plan can be much easier. This shared understanding can quickly connect someone to resources they need, like therapy, medication, or accommodations at work and school.

Where Labels Can Hold Us Back

But a diagnosis is just one piece of the puzzle. Focusing too much on it can keep people from seeing their potential beyond the label. It’s like looking at a picture and only seeing one color—you miss the whole image. Sometimes, a diagnosis can become a box that people feel stuck inside. This can limit hope for change, as if things are fixed or can’t get better. It can also limit people's imaginations around what might work for them if it isn't typically seen as the "right" approach for their particular diagnosis.

Diagnoses can also shape how people view themselves. If someone starts to only see “anxiety” or “depression” as who they are, it becomes harder to notice the strengths and personal qualities that make them unique. The label risks becoming part of their identity, rather than just a tool to help.

Understanding the Link to Stigma

There’s another side to diagnostic labels: stigma. Although these labels can help, they sometimes lead to judgment or misunderstanding. Others might make assumptions or treat someone differently just because of a diagnosis. This can be isolating and discourage people from seeking help at all. There have been instances when a diagnosis has been used against a person in court or at work with difficult consequences. Taking all this together, it’s clear that while diagnoses are useful, they shouldn’t define the whole person. Staying open to each individual’s story is essential for real progress and meaningful connection.

The Stigma Surrounding Psychiatric Diagnoses

How Labels Become a Double-Edged Sword

Diagnostic labels can offer clarity and connection. But for many, they also carry unintended baggage—social stigma and the pain of being misunderstood. When someone receives a psychiatric diagnosis, the reaction from others isn’t always supportive. Instead, unhelpful assumptions or even overt discrimination can show up, sometimes right away.

Various Real-Life Impacts of Stigma to Consider

In clinical settings, a diagnosis of borderline personality disorder can be associated with discomfort and reduced empathy from future healthcare providers. If this diagnosis is incorrect, it can remain on a patient's permanent record indefinitely, potentially affecting clinician decisions and treatments for many years.

In certain fields, such as aviation, a depression diagnosis can mean losing a job or never being eligible for the position. Although broader issues exist (such as how this policy might discourage individuals from seeking necessary help, and how it is influenced by the fear of litigation, among other factors), this example illustrates how an official diagnosis can impact other areas of life. Generally, one approach to navigate this is to discuss concerns with your healthcare provider, who might be able to assist you without officially recording a diagnosis.

Sometimes a mental health diagnosis can be used against another person in a legal proceeding, like a child custody case. Although a mental health diagnosis, such as PTSD or depression for example, is not an automatic disqualification in these cases, it could be considered a detriment and possibly have consequences.

Stigma doesn't only originate externally; it can also be internalized. In the workplace, individuals diagnosed with depression or anxiety might encounter doubts about their ability to manage stress or assume leadership roles. These experiences can have lasting effects, leading to feelings of isolation or reluctance to pursue goals and ambitions. When individuals primarily identify with their diagnosis, they may feel confined, unable to recognize their strengths or potential for growth. This self-stigma can make it challenging to move past the label and embrace the path to recovery.

Wow, Diagnosis Sounds too Scary, I Guess I Should Not Seek Help?

No! If there's one thing you should remember from all this, it's that seeking the help and support you need doesn't have to involve getting an official diagnosis in your records. Clinicians have many valid strategies to assist you while aiming to minimize any potential impacts. For example, many individuals seek help during events or life changes that make them anxious or depressed. In such situations, a time-limited diagnosis (meaning it's not a permanent label) can be used to code your visits if you're looking for insurance reimbursement. These diagnoses generally carry much less or no stigma. If you're not seeking reimbursement, your practitioner can discuss your concerns and whether a diagnosis needs to be included in your records.

Last Words on Stigma

While the stigma surrounding mental health varies across communities, it has generally improved in the United States and Europe over the years. Many individuals feel comfortable including diagnoses such as depression, anxiety, PTSD, or others in their medical records, as they rightly believe there is nothing wrong with these diagnoses and feel assured after weighing the benefits and risks for themselves. Although it is crucial to be aware of potential negative social or professional consequences of these diagnoses, most people retain the choice to share or withhold their diagnoses based on their personal desires, needs, and values. Legal protections exist in many areas to shield individuals from bias and stereotyping due to mental health diagnoses. In the United States, the Health Insurance Portability and Accountability Act, or HIPAA, also plays a role in safeguarding your mental health information.

Beyond the Label: Embracing Individual Experiences

Seeing the Person, Not the Diagnosis

We've all seen the funny, tongue-in-cheek TikToks and Instagram reels of people who take every behavior of theirs or someone else's and attribute it to "my ADHD," "my anxiety," or some other diagnosis. Amusing as these can be (and sometimes enlightening) a mental health diagnosis can never and should never (a word I use very rarely!) define or encompass someone’s whole story or experience. For example, two people with anxiety may cope in different ways, have different symptoms, and draw on totally different strengths. Sometimes when we chalk the reason for our experience always to a diagnosis we miss opportunities for deeper and more nuanced understanding of ourselves, our motivations, and what is really happening at a deeper level.

The Power of Individual Stories

Every person has a narrative that goes far beyond diagnosis. Focusing on individual stories—including what brings someone joy, what they value, and what helps them feel resilient—opens up new possibilities. When therapists and clinicians listen closely to these stories, they can tailor care to better fit each person’s needs, possibly even without an official diagnosis. This approach can encourage some people to see themselves as more nuanced and multi-faceted, empowering them to set their own goals and celebrate progress in a way that feels meaningful to them.

When Diagnoses Are Helpful: A Balanced Perspective

Diagnoses as Tools for Treatment and Support

Sometimes, having a clear diagnosis is truly important. It acts as a roadmap for both professionals and the people seeking help. Diagnoses help doctors, therapists, and counselors choose treatment plans that may more closely fit a person’s needs, like picking a medication or therapy. Insurance companies often require a formal diagnosis before approving coverage for mental health care, making access to care much smoother for many.

But, perhaps most importantly, diagnosis can provide some people with a sense of relief that what they are going through is real and deserves to be taken seriously.

Accessing Resources with a Diagnosis

A diagnosis can also open doors to resources and support systems that might not otherwise be available. In schools, children with a recognized mental health diagnosis can get extra support services or accommodations. Adults may use their diagnosis to access workplace adjustments or specific community programs. This recognition can bring a sense of relief—knowing help is available and within reach.

Connecting with Others

People can and do form connections based on their struggles and/ or diagnoses. It could just be sharing your day with a friend who struggles with similar issues as you and feeling seen and heard. It could look like joining a group for individuals living with depression or anxiety that can bring not only insights, but deeper understandings and possibly friendships. Parents might feel closer to children or feel they have a sense of shared experience.

The Need for a Broader View

While diagnoses are helpful, it’s important to remember they are only one piece of the mental health puzzle. Relying solely on labels can make us forget our complexities, our capacity to change, and even more importantly that we can always surprise ourselves. Mental health is influenced by relationships, experiences, culture, and strengths. Regardless of whether or not you have a diagnosis, I will always take your experiences seriously.

Taking a balanced perspective means using diagnoses when they’re necessary and helpful, but understanding how they are not always so. The best care plans look not only at symptoms and labels but also at dreams, values, and personal strengths. This comprehensive approach supports both healing and growth, giving everyone the space to thrive beyond any diagnosis. Focusing on people’s unique stories and resources creates space for new possibilities on the path to wellness.

Conclusion: Your Journey Beyond Clinical Diagnoses

Reflecting on the Bigger Picture

Your mental health journey is about so much more than a checkbox on a form or a diagnosis in your chart. While psychiatric labels can guide treatment and open doors to support, they’re only part of the picture. They may help professionals make sense of what’s going on, but they don’t define who you are and what may be possible.

Possible Questions for You to Reflect on Regarding Diagnosis:

• What do I hope to achieve by obtaining a diagnosis?

• Do I think it's possible to receive help and improve without having a "definitive" diagnosis? Why or why not?

• Could a diagnosis in an official record have a negative impact that I should consider for my profession or life?

• If I were informed that I could be assisted without a specific diagnosis, how would I feel? Is this something I could accept? Why or why not?

Staying Open: Recognizing You Beyond the Label

Diagnosis can absolutely offer clarity, connection, and validation among other things; I would never claim that it can't or it never does these things. That said, it’s important to really be honest about what you expect from a diagnosis as well as to notice when and where your personal story may offer something beyond traditional categories and current frameworks.

Keep in mind that you will always be more unique and specific than any label can contain, whether that is a mental health diagnosis, an identification with a certain gender identity, or a certain religion or ethnic group— to name a few. Growth comes from discovering what matters most to you— on your own terms, in your own words, in your own embodied, unique, and specific experience.

It can be easy to get caught up in seduction of "figuring it all out" with a diagnosis, and potentially letting that shape your sense of self. But even the idea that we need to "figure it all out" to live happy, fulfilling, personally meaningful lives is an idea to be questioned! (Maybe a future post?)

Your Ongoing Exploration

The journey towards your definition of well-being is not likely to be linear. At Modern Holistic Psychiatry, I strive to understand your goals around seeking a diagnosis to ensure your expectations align with what a diagnosis may or may not provide. After reflecting on these questions, if you decide a diagnosis would be beneficial, I am happy to use my clinical expertise to offer a diagnosis or diagnoses. As part of my intake, I offer a full-spectrum of validated clinical assessment tools to screen for and help us move toward diagnosis if that is what we ultimately decide to do. If not, the assessments can be there as a tool to help us understand your state of mind at the beginning of our work together, and track how it evolves over time. Win-win.

Regardless of your choice regarding diagnosis, I always hold the values of avoiding rigid interpretations and encouraging curiosity and compassion in your self-understanding. Each step you take with curiosity, allowing yourself space to "not know" the answers and to surprise yourself, whether big or small, contributes to a richer sense of self—diagnosis or not.