The biggest debate in the mental illness community is most definitely whether or not it is okay to “self diagnose”. The definition of a self diagnosis is someone who realizes that they are likely mentally ill in a specific way, and uses that label despite no formal doctor diagnosis of any kind. There are many individuals in the community that believe self diagnosis is an ultimate red flag. They claim (publicly) that self diagnosers are a bane to the community at large and should be frowned upon.
I fundamentally disagree with their statements.
Self Diagnosis as a Starting Point
Self diagnosis is not only okay, it is a crucial step in the process to receiving the necessary care. On average, even the people who are most on top of their health (which, stereotypically, is not people with mental illnesses) only go to the doctors once or twice a year. At these visits, they will receive routine care, be asked a series of questions that mostly revolve around physical health, and then be sent on their way. General Physicians do not work to find illnesses to diagnose you with. Their primary job at a physical is to make sure nothing looks obviously wrong and send you on your way.
As a result of this, in order to get mental health care you have to actively seek it out. In most cases, people with mental health disorders will pursue therapy, either through a psychologist or a therapist, in order to receive care. But how do you find a therapist? You search by their specialties which are… diagnoses.
In order to receive care, you are required to come up with a starting point for the issues and diagnoses that you believe you may have. Of course, for some people those might be wrong, and it’s important to be open to new possibilities, and even the lack of diagnosis entirely, when entering therapy. However, it is still impossible to underestimate the fact that prior to starting therapy, nearly everyone is required to have a theory of what their “problem” is so that they can receive adequate care.
For many people who seek care through therapy, their diagnoses end up being unofficial anyways. For example, I have been diagnosed with Attention Deficit Disorder (ADD) by two separate therapists, neither of which knew about the diagnosis of the other. However, neither of those diagnoses has ever gone on a record of any kind. It is just a statement made by a therapist who believed that to be true about me. I do not medicate, since I have thus far managed to handle it through self-medication, and so there is no need for me to undergo a formal process of diagnosis.
Do the people who complain about self diagnosers count this as a form of self diagnosis? How “formal” does the process have to be?
When it comes to mental health, it is hard to settle on a single concrete diagnosis in most cases. Many people get misdiagnosed for years. Others are never diagnosed at all, despite seeking help. By pushing for only formal diagnosis, it is perpetuating the idea that mental health is black and white. It is not, and many in-betweens exist.
Therapy is EXPENSIVE. If you don’t have adequate insurance or access to resource, the barrier to entry can be immense. As such, it is not possible for these people to get treatment or a diagnosis. That does not make their mental illness any less real, and they have just as much of a right to claim the community as people who are able to afford therapy. In fact, for people who are being gated from formal avenues of therapy, access to online mental health communities can be even more crucial, since they are one of the only ways for them to seek treatments and coping techniques.
Even if you can afford therapy, that doesn’t mean that the process will be smooth sailing. In the medical community, women, especially black women, as well as gender nonconforming people and other people of color, are far more likely to be disbelieved when they report feeling unwell. Their symptoms may be brushed off as “over-dramatic”, and they’ll be sent out the door without the help that they need. For these groups, self-diagnosing is crucial, not just so that they can access online communities, but so that they have the words to fight for the care that they need. It is a privilege to be able to walk into the doctors office and claim that you are feeling unwell in a particular way, whether that be having a stomach ache or panic attacks, and have doctors believe you and search for the root of the problem. For many people, the reality is that they would have to push for an ultrasound to actually find out what is wrong with them. Equally so, they would have to push for anxiety treatments or a diagnosis with another mental illness.
The Real Problem in the Community
As I was mulling over why TikTok and other mental health content creators appear to hate self diagnosis, it occurred to me that the real problem was not those that are genuinely self diagnosing, but those that use mental health as an excuse. When people see a video that says “I’m always late because I have ADHD” and then decided that they, too, must have ADHD because they are always late, this is a form of abuse of self-diagnosis. The people who do this are not those that actually are struggling with ADHD, it is the people who are struggling with being late despite not having ADHD, and decide to use it as an excuse.
However, this is less to do with self-diagnosis, and more to do with people who abuse mental illness in general. There are plenty of people who behave in harmful ways without remorse who are genuinely diagnosed with mental illness, just as there are plenty of people who use a fake mental illness as an excuse. On the same token, there are people who are always late, or some other symptom of mental illness, who are actually always late no matter how hard they try otherwise. It’s important to have grace for these circumstances, both with yourself and other people.
We are not at the point in the destigmatization of mental illness where we can afford to doubt people who claim to have a mental illness. If people are struggling with their mental health, they deserve to get the help that they need. On the same token, if you are struggling with mental health, you deserve to forgive yourself for the mistakes that come with combatting a mental illness. The people who falsely claim mental illness to get away with bad traits are hurting the community. On the flip side of the same token, the people who lash out at anyone who experiences mental illness symptoms are equally hurting the community.
People struggle, and for some, self-diagnosing is the only way for them to find community and get the help they deserve. It’s time for us to accept that, and accept self-diagnosis as a valid step on the mental health journey.