Can I Accurately Diagnose My Own Mental Health Issues?
As a mental health provider, I often encounter people who have gone online and read information about what they think is wrong with themselves or a loved one. They show up at my office declaring they have obsessive compulsive disorder, or that their boyfriend/girlfriend has narcissistic personality disorder. (These examples are for illustrative purposes only; you can replace them with any other disorders that exist.)
Self Diagnosis: Just Say No!
The short answer to the question of whether or not you should self-diagnose is "no." The long answer is that proper diagnosis depends on several factors, and even trained professionals sometimes have a hard time figuring out what exactly is wrong with someone. That's because proper diagnosis is not just about reading through a list of symptoms and seeing how many items you can check off the list, though that is often the starting point. You also need to factor in how severe the symptoms are: do they occur every day, several times a week, once a month, a few times a year? Plus, you need to consider how much the symptoms impact your daily functioning. Can you get out of bed each morning without much effort? Do you make it to work each day or do you call in sick frequently? Are you showering and taking care of you basic hygiene needs? Do you avoid certain places, people, or situations because of the symptoms you experience?
The reason symptom severity and impact on functioning need to be considered is because many of us exhibit some symptoms of different mental health issues at a variety of times throughout our lives. Often these symptoms are healthy responses to things going on around us, until the symptoms start to get out of control. Let's take anxiety, for example. We are supposed to feel anxious. It is the little voice in our head that lets us know that danger is near. It helps us prepare to either escape from a potentially dangerous situation or to stay and fight if necessary. When anxiety gets out of control, it tells us to be worried/concerned about everything, almost all the time. The anxiety becomes so big and strong that it can make it difficult to sleep at night or to concentrate on work because it wants us to focus on all the worries. In some cases, the anxiety will even prevent us from going places and doing activities. Now, the anxiety is no longer helpful. It has started to become a problem.
Excessive use of alcohol and/or other illicit substances, including marijuana and pain medications, can create mental health like symptoms. Use of some substances can cause you to see or hear things that are not really there. Your balance, coordination, and memory may become impaired when you are under the influence. Furthermore, different substances can impact your mood in different ways. Some make you feel happier while others cause depressive like symptoms. Stimulants boost your energy while other substances, such a marijuana, might make you feel more relaxed. Therefore, substance use becomes yet another factor to be considered when trying to accurately diagnosis any mental health condition.
To further complicate things, there are medical conditions that can impact mood, concentration, energy level, etc. For example, according to the American Thyroid Association, if you have issues with an underactive thyroid you might experience the following types of symptoms: energy loss, depression, and forgetfulness. Additionally, an underactive thyroid could cause weight gain. These four symptoms mentioned are identical to those listed as symptoms of depression. The only way to know for sure whether you have depression versus a thyroid problem is to have your primary care doctor check your thyroid.
Another example is that of cardiac arrhythmias (irregular heartbeats). Arrhythmias can cause a sensation that your heart is racing or fluttering in your chest. They can also lead to feelings of overall chest pain, light headedness, fainting, fatigue, or shortness of breath. All of these symptoms are similar to those experienced if you are having a panic attack. Again, the best chance of figuring out if the episode was an actual panic attack versus an underlying heart issue is to have testing performed by your primary care doctor or another specialist to rule out any heart conditions.
In summary, it is not a good decision to make a self-diagnosis. This is because accurate diagnosis is impacted by:
- severity of symptoms
- impact of symptoms on daily functioning
- substance use
- other medical conditions that may exist
If you are concerned that you may have a mental health condition, a good place to start is by speaking with your primary care doctor. He/she can provide you with a referral to someone in behavioral health or to another specialist who can help you obtain an accurate diagnosis.