Lynette * recently consulted with me as she felt very confused and frustrated. She was experiencing all sorts of symptoms and was looking for answers. Before meeting with me, she had been on the rounds with GP’s and psychiatrists.
One psychiatrist gave her a diagnosis of bipolar disorder. A year later, a different psychiatrist decided that she was suffering from anxiety. A third even suggested she had features of a personality disorder. With each diagnosis, came a different prescription.
When Lynette began working with me, we met once a week. After a few months, I witnessed variations of her symptoms (which explains the differing diagnoses of each doctor). Some sessions she was clearly anxious but during other weeks, features of depression predominated. It soon became apparent that Lynette suffers from depression and anxiety.
This is not uncommon. Depression and anxiety can combine in patients in different ways. For example, sometimes anxiety is overriding and stays that way. Often, anxiety evolves into depression. Other times, anxiety symptoms and depressive symptoms co-exist. It is not unusual for a patient to feel very low and panicky at the same time.
It would be nice to be able to put people, their symptoms and diagnoses into a neat box. Lynette certainly would have preferred that as it would provide clarity and direction. She would also feel supported by her mental health team rather feeling like a ball being thrown between experts.
Unfortunately, neat little boxes rarely exist in psychiatry and psychology because people do not slot into boxes. Every individual comprises a complex set of thoughts and behaviours. Symptoms overlap and may evolve over time.
Personally, I think diagnoses are overrated. My preference is to focus on describing symptoms and teaching tools to manage them.
* not her real name