The Messy Art of Diagnoses

Psychiatry is kind of a messy field of medicine. I heard that, in a study, when two different psychiatrists met the same patient & were given the same criteria for diagnosis, they came to the same conclusion about the patient less than 40% of the time, or something like that.

On the one hand, diagnoses can be very helpful. They explain our problems away with a “chemical imbalance” theory the absolves us of all personal blame. I’ll be the first to admit I’ve found this comforting before. A diagnosis also suggests the course of treatment – though with psychiatric issues, at least in my experience & my friends, it usually takes a long time to find the right cocktail of medications to minimize symptoms. Even my cocktail isn’t perfect yet & I’ve been a patient for quite some time, have tried so many different medications (as I pointed out in another post). I am not as functional as I could be. But there is that tricky human element.

Where exactly is the line between “mental illness” & normal human variation? I’ve heard it’s when something starts messing with your ability to live a “normal” life. But what does a normal life even look like for any given human? No one has a roadmap or guidebook, really. We’re all just making our way through.

Muse has a theory that, psychiatry still being a fairly young field, the diagnoses people are given will change a lot in the future. He went to a conference a while back where someone presented fMRI brain scans and argued that bipolar is actually much more closely related (brain connectivity-wise) to schizophrenia than depression – or something like that. He thinks that in the future the DSM will look very, very different than it does now.

So where does this leave me with my multiple diagnoses (bipolar, borderline & anxiety issues)? I guess, in a sense, the three do feel like separate things to me, separate illnesses. When I have a bipolar episode of depression or hypomania, it goes on for a lot longer than a high or low mood from my borderline does. I also think being anxiously attached (if you don’t know about attachment style theory in a adult relationships, google it – it’s so interesting & can explain a lot about your relationship if you are in one) has a lot to do with me fitting the borderline criteria. Or the other way around. My anxiety is my current beast – it’s been a while since I’ve had a bipolar episode (*knock on wood* & I hope I didn’t just jinx myself there). I deal the anxiety almost everyday – from mild anxiety all day long to intense anxiety or an anxiety attack for part of a day to not being able to leave the house for periods of time because of agoraphobia, it just depends.

But I can’t shake the feeling that all of my diagnoses are interrelated, connected somehow. I can’t help believing that when I make progress in one area of my illnesses, I am making progress in all areas. The brain is the most complicated & least understood organ in our bodies. And I believe we have souls too – something Muse and I affectionately disagree on. I know that my soul, itself, is not ill. My brain is. I try to reassure myself that I am not inherently bad or weak for struggling. I try to remember that there is a part of me that, as hard as I am working on becoming more so, is already whole.

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