DEBATING THE DSM –
MAY 19, 2022 – It was the reason for my distressing thoughts, overwhelming emotions, and undesirable behaviors. All other aspects of my life were secondary. If a mental disorder was me and the reason for my thoughts, feelings, and behaviors, it must hold the key to my mental health. But none did.
In some ways, each diagnosis was a self-fulfilling prophecy. I identified so strongly with it that I came to embody it. (It didn’t help that I was told I was anorexic and bipolar, not that I had them.) With the depression diagnosis, I saw myself as a depressed person. The anxiety diagnosis made me even more anxious. With the ADHD diagnosis came the belief that I was simply someone who was easily distracted and had trouble paying attention. The OCD diagnosis made me pay greater attention to my obsessions, which intensified my compulsive behaviors. As someone with bipolar disorder, I believed my surges of energy and periods of inertia were manic highs and depressive lows.
I sat in my new psychiatrist’s office. When our session ended, I waited for him to proclaim my new diagnosis or validate my current one (bipolar disorder) as if from on high. He didn’t; he just sat there as if deep in thought. Finally, I asked him what he thought I had. He glanced at the ceiling and then back at me and shrugged. “I don’t know what you have.”
I don’t know? No clinician had ever said those words to me. They’d doled out their assessments quickly and with aplomb. Most had come during a 15-minute annual visit. By the time I reached the corner and waited for the walk sign to cross Michigan Avenue, my mind started to spin—in a healthful, inquisitive way: Where did mental health diagnoses come from? What were they? Who discovered them?
My first diagnosis came at age 12. I hadn’t been eating much for months, then nothing for four days… “Anorexia nervosa,” the doctor said. A diagnosis can bring relief and even feel like a lifeline. But for me, it wasn’t that straightforward…- Sarah Fay, author of Pathological: The True Story of 6 Misdiagnoses