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Diagnosis vs. Self-Diagnosis

Mark Dombeck, Ph.D.

One major benefit of seeking professional health care (mental or otherwise) is that a professional is often in a better position to accurately diagnose your problem, and point you towards the best treatments available for helping you get better than you are. You may have heard the term "diagnosis" before. A diagnosis is a label given to a particular illness or issue that you might have. Diagnoses are identified by their symptoms, which are the complaints that people make when talking to their doctors. Mental health diagnoses have been organized in a book called the Diagnostic and Statistical Manual of Mental Disorders (or DSM, for short). In the DSM, each diagnosis falls into one of several possible categories, including, but not limited to mood disorders (such as depression and bipolar disorder); schizophrenia and other psychotic disorders; anxiety disorders (including panic attacks, phobias, post traumatic stress disorders and obsessive-compulsive disorders); dissociative disorders (including dissociative identity disorder (formerly known as multiple personality disorder) and amnesia); impulse control disorders (such as compulsive hair pulling, or fire-setting); personality disorders (such as borderline personality and narcissism); and substance related disorders (such as alcohol or methamphetamine addiction).

One of the first things that a mental health professional will do when you visit him or her is to diagnose you. He or she will listen to you describe your issues and complaints, and fit them into one or more of the known illness categories described in the DSM. Diagnosing your issues is important, because it helps professionals to know which interventions to suggest to you (from among thousands that are possible) that will have the best chance of helping you to get better. Professionals know which interventions to choose based on your diagnoses because they are familiar with the work that thousands of scientists and clinicians have previously done to match particular interventions with particular diagnoses.

For example, let's say that you visit a mental health professional and complain about the following symptoms: You're experiencing severe mood swings, are feeling overly energetic lately, can’t concentrate, are spending money recklessly, are increasingly irritable with other people, aren’t abusing drugs or alcohol and have gone through similar episodes before in your life. Your professional will listen to what you have to say, and will ask questions about your experience to clarify things or get you to talk about things that might be important but which you've not mentioned spontaneously. He or she will likely want to learn about your past history of similar problems and may request medical records from other doctors if any exist. He or she may want to order several medical tests be done to determine if there is a physical cause, such as drug abuse, brain damage, hyperthyroidism or similar problem, that can explain your symptoms If no physical cause can be determined, you would probably be diagnosed with a psychiatric disorder that most closely fits with your presentation (in this case, possibly bipolar disorder). Your professional will know that certain treatments are known to be helpful for bipolar disorder (particular medicines such as "mood stabilizers" and "antidepressants", in this case) and will help you obtain those treatments, along with proper instructions and monitoring for their use. Other treatments that are known to be less helpful for treating bipolar disorder will not be offered. Alternatively, If you go to a professional and say that your major symptom is anxiety, that professional might diagnose an anxiety disorder, and create a treatment plan for you that includes interventions that are known to be helpful for treating anxiety disorders, including cognitive therapy, relaxation techniques, exercise programs, and anti-anxiety medication.

Only a doctor or similar trained and experienced mental health professional is qualified to make a true diagnosis and therefore to make treatment recommendations. Diagnoses are complex and difficult to make correctly. It takes many years of concentrated study to learn how to accurately diagnose patients, and even then, different doctors will sometimes make different diagnoses for the same patient. For example, the family of psychotic disorders are characterized by a variety of symptoms, including delusions, hallucinations and regressed (or "primitive") odd behaviors. Psychoses occur across many different types of disorders, including substance abuse, severe depression; bipolar disorder as well as schizophrenia and related psychotic disorders. When diagnosing schizophrenia, for example, it is necessary to rule out (or exclude) the possibility that other disorders (like bipolar disorder) or drugs (like cocaine) might be causing the problem. To make matters even more complicated, the very definitions of the different diagnoses change across time, as the DSM gets revised and rewritten. For example, not so long ago, homosexuality was a diagnosable illness defined in the DSM. This diagnosis was removed from the DSM in the 1980s when it became clear that it had been included there more because of cultural prejudice than for scientific reasons. Today, evidence from the biological sciences suggests that most homosexuality is biologically determined and thus a normal variation of human sexuality and not a disorder at all. It is rare these days to find a professional mental health provider who believes homosexuality is a mental illness.

Reader Comments

You don't always know - Blackcat - Nov 24th 2011

I have a comorbid diagnosis of major depression and general anxiety. 

When I am in the middle of panic attack and in the down zone afterwards, it is very hard to work out for yourself what happened and what needs to happen next. 

Be thankful that instead of self diagnosing, for someone else to make a decision in your best interests (sometimes hard to see).  This person can be anybody but you.  The individual nearly always acts in your best interests.  If you have previously developed a crisis plan outlining problem and preferred treatment, it will be so much easier for the person to the right thing by your mental health and in accordance with your wishes.

hair pulling - ahmed - Aug 18th 2009

i pull off my hair and eat the roots from about 7 years what are the risks? what may have caused this? idont have any other symtem also i tried very hard to stop but icant even when i cut off my hair i turn to my leg hair ....

help for my son - pam - Jun 5th 2009

I have a 20 year old son who I know has some mental disorder --such as a personality disorder or something.  however, he would never diagnose himself because he is in denial that anything is wrong.  He is fine, everyone else has a problem.  I think I noticed it when he was very young but because he was my only child at the time, I wasn't sure what was normal and I thought it would get better.  It hasn't.  he also abuses alcohol and I don't know what else he may be using.  he has always had poor socialization skills so I believe he started using alcohol to "fit in" better.  He seems severely depressed all the time and has anger management problems.  His room is a complete mess and there are holes all in  his wall, his truck is tore up on the inside and there are dents all over it from his fists.  He is jealous and controlling of his 16 year old girl friend and stays out late every night.  However, he has a good job that he goes to every day.  His boss speaks very highly of him and ppl really like Jake.  They don't all see his Dr. Jekyll/Mr. Hyde mood swings.  I don't think he is bi-polar because he never has the high highs --only the lows.  He refuses to talk to a counselor, therapist, psychologist, or anyone.  i am a nervous wreck all the time worried about when he might snap again. 

Self-Help - C - Dec 8th 2008

I love the material that you guys inlist. However, the material should be proofread. There are lots of errors. I am able to conclude the words you meant but it's not what you put. One sentence you put do but obviously meant to put true. There were at least three that I saw. I just don't want a person to read it and think you all don't know what your talking about because you misspelled a word.


Problem if delusional - Dot Andrew - Jun 11th 2008
Delusional disorder would never be self diagnosed. My husband has DD and no-one else would know but me. He certainly believes all the things he thinks I have done to him are real. He always has said he had no problems at all.

Be weary - - May 15th 2008

There are a lot of things that can cause similar symptoms to a whole range of mental illness.  Everyday factors such as diet can contribute to blood sugar levels which, if fluctuating a lot from a person eating too many sweets, can cause symptoms that mimic those of depression, for example.  Unless you are in danger of hurting yourself or someone else, it's always best to get a second opinion.  Try ruling out other causes of your symptoms before you start medicating yourself for something you might not have.

Farcical notion that someone else can better diagnose - - May 16th 2007

There is a rather pervasive belief that it takes a doctor to tell you what is wrong with you. This is wholly untrue. You know what is going on inside your head better than anyone. True it is helpful to have the information and learning of a doctor handy in diagnosing and treating a mental condition but it is also true that no doctor can see inside your brain. They don't know what you see or how you think and for the most part physiatrists will try randomly prescribing you numerous medications for perceived symptoms. This guess and check method of treatment is the first and most common method of diagnosis through treatment. The doctors give you a pill hoping it treats the symptoms they think you have and then they assign a specific diagnosis to fit the treatment they see as working.

Often this is when you have been chemically lobotomized. If you no longer show the symptoms they perceived you having they consider you treated even if the medication is now causing other though normally less severe symptoms.

Editor's Note: An overly harsh assessment just above. Symptom reduction via medication does not in any way equal a "chemical lobotomy".

The most common misdiagnosed or more accurately over-diagnosed illnesses are chronic depression, ADD and ADHD in children and the most common severe side effect of the medications that are used to treat those diseases in people that most likely don't need them are psychotic episodes often violent ones with unhappy endings for everyone but the doctor. Homeopathic medicine figures that if a substance causes a certain reaction in an otherwise healthy person the substance given to an ill person with the symptoms might cause an improvement of symptoms. This is also true with 'modern' medicine the only difference is that modern medicine uses more and more synthetic drugs that are not fully understood.


Editor's Note: Also exaggerated. The theories behind Homeopathy and Allopathy (e.g., conventional western medicine) are not the same. Psychiatric medications simply do not typically cause psychotic symptoms . There are side effects of course, but not generally in that form.

Here is what I first started harping on with the title of this comment; Though a doctor’s learned knowledge can be helpful you yourself with a bit of help can better diagnose yourself if the doctor is willing to allow discussion during your visit. Do not allow anyone to prescribe medication as a first resort to finding a cure for perceived illness. Spend some time talking to the physician before you consent to medication in fact you should fully discuss the medication and what side effects they might even remotely have.

And if you are not depressed especially in children and those with acute sensitivity to medications take anything to treat depression, ADD or ADHD until you are certain that you have the problem and no other methods (often other methods work much faster and last longer on fewer doses) have worked. And always get a second opinion if you are diagnosed with chronic depression; many cases of depression would likely have improved faster if not masked with drugs treating the symptoms.

Editor's Note: This is only reasonable advice if symptoms are not severe. It is not useful for a suicidal person to seek out a second opinion, for instance. In that sort of case, the problem is enough of an emergency that it needs to be treated immediately.

Several patients I have talked to have a asset of alternate nicknames for the medications that failed them and caused severe side effects instead of treating the condition the doctor may have mistakenly diagnosed at first. An example of this is Unwellbuttrest for the drug commonly known as Wellbutrin ™ because of the common side effect of causing sever paranoid psychotic homicidal and suicidal thoughts in otherwise mildly (and temporarily) depressed people. My wife tried to commit suicide when on Welbutrin and would have succeeded had it not been for some quick thinking and a most annoying cat that pulled her out of the mental state the drug put her in. I myself have taken only 3 doses of the drug and was most definitely feeling a need to kill others (I am not homicidal naturally). Having tried to inform my psychiatrist team that the medication was causing the effect They moved to put me on another medication that works lowering the brain chemicals that welbutrin increases and I quickly recovered only to have issues again when that medication pushed me the other way into lethargy and depression. After a while I realized that for myself it was better not to be medicated and have been stable since. I also found that my anxiety was situational and closely related to PTSD from military service. I still have the PTSD but am better at coping with a clear head rather than a foggy mess. My wife is also off all medication for depression and is learning to handle the fact that she had been over medicated since childhood because her situation caused her to show symptoms of chronic depression.


My wife’s case shows that if you are chronically depressed you should look closely at your surroundings and see if maybe you have valid reasons to be depressed. If you do have reason to be depressed you need to work to fix those reasons of depression not to mask the symptom that is the depression.

Editor's Note: it is also a good idea to explore non-medication treatments for mental problems such as cognitive behavioral therapy (CBT) for anxiety and depression. CBT works as well or better than medication treatments for mild to moderate depression, and tends to have a longer lasting effect as well. There are no side effects other than therapy homework.

AND ALWAYS BE PART OF YOUR DIAGNOSTIC TEAM don't let the degrees on the wall belittle you into inaction. Work with the doctor and tell him or her details and specifics don't paint in broad strokes give detail because broadstrokes can limit the doctors ability not to prescribe towards a diagnosis.
Finally if you are on medication that is making you have feelings of anger, fear, hatred, anxiety, or prolonged or sever depression let your doctor know right away don't wait till your blowing away your friends atschool or work. AND TALK TO YOUR FAMILY AND FRIENDS WHENEVER POSSIBLE they often know you better than you think and want to help. If your family aren't willing to help that could be a sign that they are part of the valid reasons to be depressed or not concentrating.