“You have depression.”
“I think it may be bipolar disorder.”
“Borderline Personality is most likely.”
“Have you ever heard of Posttraumatic Stress Disorder?”
You’ve been feeling down lately and you decide to see your doctor. They might refer you to a psychiatrist, or choose to diagnose you themselves. You might do this several times over your lifetime, and each time, you get a different answer. You go, “what the fuck?”
It’s a common conundrum.
In psychiatry, we do not have the luxury of many of the tests and tools used by other fields of medicine. In other words, we don’t have the luxury of x-rays and blood tests to aid in the diagnosis of the vast majority of illnesses we work with. What does that mean? As psychiatrists, we rely primarily on our clinical expertise, the histories provided by individuals and their families, mental status exams, and whatever collateral information is available to come to our conclusions.
After we have gathered all of the available information we arrive at a hypothesis, or best guess – don’t worry. We’re usually right! Psychiatric diagnosis is a finicky thing, because I’d be lying to you if I said I, or any other physician, had the ability to understand perfectly the inner workings of your mind and your own personal experience in an hour-long conversation. The point is, people are complicated, and what may appear as depression one day may come to reveal itself as posttraumatic stress disorder on another.
So what’s the point of seeing somebody, if their diagnosis may be fluid? We can help. Working with a mental health professional at times of difficulty can be an important resource, especially when in a publicly funded healthcare system such as Canada’s. Even if your diagnosis may evolve over time, our treatments are often (and usually) pointed in the right direction. The treatment for depression and anxiety are often the same, and the same is true for bipolar disorder and schizophrenia. Most importantly, regularly seeing a physician can be a rock during times of turbulence, and I would recommend that to anyone, regardless of diagnosis.
Dr. Travis Barron is a resident physician in the Department of Psychiatry at the University of Toronto in Toronto, Canada.