WHY CAN MENTAL ILLNESS BE SO HARD TO DIAGNOSE?
The process of diagnosing mental illness can be frustrating. Frequently, someone experiencing a mental health crisis is well aware that something is wrong. Naturally, he or she wants answers. However, mental illness can be hard to diagnose.
It can take months, and sometimes years, for doctors to accurately diagnose a mental illness.
Symptoms of mental illnesses often overlap. Psychotic features, for example, are a part of schizophrenia and other psychotic disorders as well as mood disorders, dissociative disorders, and personality disorders.
There are individual differences. While there are distinct criteria for and symptoms of every mental disorder (The DSM-5: The Encyclopedia of Mental Disorders), each person is unique. What depression is like for one person is a bit different for another.
With few exceptions, medical tests don’t yet exist. While brain imaging can show how mental illness affects the brain, it’s not used for diagnosis. Further, there are no blood or other lab tests to show a mental illness.
Receiving a diagnosis of mental illness can feel like nothing more than trial and error. While there is a degree of trial-and-error involved, it’s educated, methodical trial-and-error. Diagnosis can be a difficult and frustrating process, but the process does involve progress on the road to recovery.
The diagnostic system can not be perfectly constructed. Therefore, it should come as no surprise that the current DSM-5 (APA, 2013) diagnostic system for personality disorders has its fair share of problems. Researchers and clinicians have identified several, significant, diagnostic difficulties that can be summarized as follows:
1. The DSM-5 method for diagnosing personality disorders is called a categorical approach. However, an alternative method, called the dimensional approach, is also presented in DSM-5 for consideration and future research. There have been numerous problems with the categorical method that the dimensional approach attempts to resolve.
2. The DSM does not account for the relative importance of various symptoms, and the descriptions of symptom criteria are overly broad. This means that patients diagnosed with the same disorder may have very dissimilar clinical presentations.
3. There is a high degree of overlap or co-occurrence of personality disorders with each other, and other mental disorders.
HOW IS MENTAL ILLNESS DIAGNOSED?
There are no ‘tests’ as such, for mental illnesses. Mental health problems cannot be diagnosed by checking the blood or body fluids of the person experiencing symptoms, as would be the case with a physical health condition such as Heart Disease or Diabetes.
A diagnosis will usually be made by an experienced psychiatrist working with other health professionals after a period of observation of the individual to identify symptoms. A person’s medical history and recent life events will also be taken into consideration. Family and friends can play an important role by discussing changes they have noticed in an individual’s behaviours. A check of the person’s physical health will also be necessary to ‘rule out’ any symptoms that could be contributed to a physical condition.
This process of obtaining a diagnosis is not easy, and it is not uncommon to have difficulties in either getting an accurate diagnosis or getting access to the appropriate treatment and care. A period of time for careful assessment is necessary to ensure a correct and accurate diagnosis is made.