Reliably, about once a month, I come across someone who believes that a person who’s been diagnosed with X, Y, or Z mental disorder has, in effect, a life-crippling disability. Somehow they got a hold of the diagnostic manual of mental disorders or read some symptoms or an article or two online, and suddenly they feel like they know everything about a condition. If a person has a disorder like depression, they believe that they know everything they need to know about that person.
When I was seeing patients back in graduate school, I sometimes looked at some of them that way too. But in the intervening 20+ years, I’ve learned a lot. And one of the biggest lessons I learned is this — a person is not defined by their disorder or diagnostic label.
Human beings are complicated and wonderfully complex organisms. So complicated, in fact, that our basic understanding of the brain’s functions is still at its earliest stages.
We think we might know a person once we hear a label. “Oh, she’s an accountant.” “He went to Harvard.” “Yeah, I know, she has schizophrenia.” As though that label neatly sums up everything there is to know about that individual.
But labels are simply our brain’s way of taking a cognitive shortcut. It helps us process important information, back from the days of fight-or-flight imprinting. Our brain needs to understand — is this new person or situation a risk, and if so, do we need to fight it or flee from it?
So there is a value there. But it’s one we overestimate and hold on to long after its initial usefulness has faded.
Mental Illness & Diagnostic Labels
It’s been my personal belief that diagnoses are important to help inform treatment options, but that a person shouldn’t read too much more into them beyond that. Diagnoses are not written in stone, especially when it comes to mental illness. And while their intent is to capture a constellation of symptoms that seem to be related, its done as much for research purposes and so that professionals can talk to one another with some very broad-stroke understanding of what it is they’re talking about.
For instance, how hard it would be to research the thing we call “depression” if everyone’s definition of it was idiosyncratic or different? Very. So we agree about these basic, broad symptoms to help communicate and be able to research what we believe to be are the same disorders.
For patients, however, I believe that while a diagnostic label can serve as an important identity touchstone, too many embrace it as their core identity. I guess that can be okay for some, but I think a person is so much more richer and complex than a simple diagnostic label. It is, of course, an individual’s choice.
Defined By A Label for Other’s Purposes
Sometimes, however, other people need a person to fit their understanding of a diagnostic label — like autism — in order to keep their own identity and belief system intact. In family systems theory, the person — usually a child — is the “identified patient.” The child is the one with the problem. The parents and siblings are simply the ones who have to deal with it.
But as family systems teaches us, a family environment and their way of interrelating with one another is a very complex thing unto itself. It’s not simply that a child is suffering from ADHD or some other disorder. It’s also that a parent or sibling — usually for secondary gains such as getting their emotional needs met or feeling valued — plays into the child continuing with the problematic behavior.
A friend of mine told me the story of their brother who had a child with Asperger’s syndrome — what is now called the mildest form of autism. For years, my friend’s brother, Max, denied his son, Joey, had a problem, and their relationship progressively worsened as he grew up. Finally when Max sought help for his son’s problems, it was half-hearted and years too late. It’s not that Max wanted his son to suffer, but rather, he thought the only solution to his son’s problems was Max himself (because he apparently had his own mental health concerns).
When the son turned 18, he wanted nothing to do with his father any longer. Now caught up in an ongoing argument about his college education (Max thought Joey would never be able to attend college) after completing his first year at the university, Max still turns to his mild autism diagnosis as an excuse and a reason to help justify his behaviors and attitudes toward Joey.
Clearly Joey has outgrown his father’s expectations — but he hasn’t reset and adjusted his own expectations of what his own son can achieve. All he sees is his son’s limitations, while all that others see in Joey is his potential.
Grow Beyond Labels
If a label works for you, by all means, continue to embrace it. For some, it’s become a part of the individual branding opportunity that has arisen thanks to social media. This is a good thing, as it brings the conversation to where people are and makes it both very real and very personal.
But for others, it may be a good time to think beyond the label. We are more than what others say we are. We are wonderfully complex, wonderfully emotional creatures that, in the end, are more than just the sum of our parts. We are not just a list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders.
Nor are we simply the sum of our labels.