Beyond Labels

Diagnoses in the DSM-5, short for the latest Diagnostic and Statistical Manual of Mental Disorders, are constructed by clinical observations. In other words, mental health diagnoses are entirely based on what we can see on the outside, but they do not address what is happening inside. In this way, psychiatric diagnoses are agnostic to the internal mechanisms underlying a disorder. What are the psychological, biological, and social roots of a given mental illness? The DSM-5 offers no answer.

By nature, the DSM-5 is largely descriptive rather than prescriptive. Since the DSM-5 classifies mental health disorders as a collection of symptoms, many practitioners focus on eradicating symptoms rather than unveiling what may be festering beneath. And who can blame such specialists? The truth is there is no manual outlining the etiology, much less the treatment, of mental health conditions.

Diagnoses are essentially labels, and they can be helpful in grounding practitioners in a uniform language surrounding mental health difficulties. Useful as they may be, diagnostic classifications can also be damaging by reducing a person’s experience into a label. Attaching a label to a troubled individual subtlety separates us from this individual. “Oh Jimmy, he’s bipolar.” Employing such language subconsciously furthers us from Jimmy’s experience, which simultaneously pacifies us that we are different from him, and numbs us to his pain.

All the above is not to advocate we throw the baby out with the bathwater – perhaps we can recognize that though we use these diagnostic labels for practical purposes, diagnoses aren’t real in an absolute sense. Invisible and complex, mental illnesses are incomparable to a bacterial infection that can be removed. Further, it is the rule rather than the exception to be diagnosed with more than one mental illness. This begs the question, is the individual with multiple diagnoses really suffering from two discrete conditions, or are there shared mechanisms underlying all the symptoms?

Though mental health difficulties are very real, perhaps diagnoses are partially arbitrary. Recognizing this reality could inspire individuals to stand in solidarity alongside those struggling with mental illness. Abandoning labels may also unite people as they share in the disillusionment, pain, and fear tethered to the human experience.