What Does it Take to Make a Diagnosis?

There are a couple of people who sometimes respond to my threads who don’t like it when I say we shouldn’t be calling people mentally ill just because we don’t like them or act in ways that we don’t like. I think it is time for me to outline what is required to make a diagnosis:

  • You have to be trained as a psychiatrist or a clinical psychologist. (Most “experts” or the “peanut crunching crowd” are not.)
  • You have to have actually examined the person. This goes beyond watching them on television or reading about them in magazines or newspapers.
  • You have to use proper diagnostic criteria.
  • You must be neutral. Most of the pseudo-diagnoses that I have seen fail magnificently on this score. In my experience, progressives are the worst, but this does not exonerate others including conservatives.
  • You must have the patient’s welfare in mind, not an opportunity to insult.
  • You must avoid stigmatizing people with mental illness who are not anything like the person you are diagnosing. E.g. By saying that terrorists are mentally ill, you are implying that people who are mentally ill are like terrorists. (Research shows that people with mental illness are less likely to be violent than the normal population.

A Response to Marya Hornbacher’s Research Project

Kitt O’Malley put me onto a research project by Marya Hornbacher who is writing a book that “will profile the lives of people who have a mental illness or who work in the field, and she’s trying to develop a deeper understanding of how the public views mental illness.” I couldn’t resist throwing in my own two cents. Because I have a long track record of never being included in such studies, I thought I would share my answers to her questionnaire here for your consideration and discussion:

Has mental illness affected you personally? If so, how?

Yes, I live with bipolar disorder, PTSD, and ADD. I lived in quiet torment for many years, occasionally bubbling over in rages that left my wife emotionally overwhelmed. This left me with feelings of deep guilt, but I didn’t do anything at first because I had been told that suffering was part of life and I should just buck up and endure it. When I finally did seek help, I was diagnosed with major depression and put on Prozac. Because I was “cured” the next day, I sought no further insights into my diagnosis until I came to the brink of committing suicide at age 47.
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