Psychiatric Diagnoses – what are they and why do I get one if I see a therapist?

A reader asked this question: Why do I get a label just for going to talk over my problems with someone?  The answer is on two levels and I will address the concrete one first.

A diagnosis is a name commonly agreed upon by clinicians which describes a specific set of behaviors, moods and actions, based on specific criteria.  The purpose is to provide clear descriptions of that criteria to assist in communicating, and treating people with that set of criteria.  In other words, once I know what your issues are, I know how to treat you most effectively.  For example, there are many kinds of phobias.  They are diagnosed by, among other things, a rapid increase in heartbeat and a feeling of alarm.  However, there is one phobia that does just the opposite – people’s blood pressure drops and they faint!  So, knowing which kind of phobia a client has makes all the difference in the treatment plan!

A diagnosis is a description of what the client is experiencing.  It is not a judgment or a moral issue.

Secondly, the health insurance system is based on the illness model: you get sick and you go to the doctor to get well.  The doctor tells the insurance company that you need your gall bladder out or you have a broken rib or you have the measles. Health insurance companies know that it takes an average of X weeks or months for most people to heal from their condition. With mental health, things get much fuzzier.  There is no diagnosis for Mid-life Crisis or the after-effects of being raised by addicted parents so the insurance companies don’t know what to expect or how long it will take you to recover from these experiences.  So they began to categorize and name the clusters of symptoms together to be able to anticipate a time frame for the treatment plan.

Finally, and least important, each diagnosis has a number code that is used for billing and that is how insurance companies figure out how to pay the providers.

It is your right to discuss your diagnosis with your doctor or therapist.  It can be a very interesting discussion on how they are thinking about you.