As both a psychiatrist and a patient, I know how slippery a diagnosis can be | Rebecca Lawrence

Naming a mental illness can help, but we mustn’t lose sight of the individual experience behind the label

Learning to be a psychiatrist means learning the names of a lot of disorders. Without these names, what would we have? A welter of distress, a confusion of symptoms. It would be very hard to say to a colleague, when pressed for time, what was wrong with any particular patient: “Well, his mood is low every morning, he doesn’t eat, his sleep is poor, his wife says he’s lazy and neglecting their child” might only be the start. But if you say, “He has an episode of moderate to severe depression, not responding to an SSRI”, your average psychiatrist has a grasp of the problem and what they might need to do.

The problem is that the disorder, or the diagnosis, is attached to a standard group of symptoms and signs, which is fine if your patient fits them all neatly, but can be a problem if they don’t. As psychiatrists, we are so familiar with these disorders that we may doubt a patient’s story if they deviate from the pattern. We might think, for example, that someone can’t be hearing the voices they say they hear because it doesn’t fit with the rest of their presentation. We want patients to have the symptoms we expect, and that we may be able to cure.

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