At Take This, a core part of our mission is education about mental health. In this effort, we’re embarking on an exciting series to educate you about psychological disorders! Authored by clinical experts in the field, we will give you a research-based summary of what the disorders are, how they show up in real life (not just in the pages of a clinical book), and where you might see them in the games we know and love. Each diagnostic summary will also give you resources for more information and typical treatment recommendations for each diagnosis. Keep your eyes peeled for the weekly release of diagnostic content, beginning soon!
Now, before we begin the series – there are a few things that will be helpful to cover. Let’s start with what diagnoses are. Mental health terms have become so common, that we use the titles of diagnoses to describe how we’re feeling in a casual manner… but what is the difference between feeling depressed and having depression? Being forgetful and having ADHD? Being picky and having OCD? There’s a big difference between experiencing challenges and actually qualifying for a diagnosis. The major commonality among every single psychological diagnosis is deceivingly simple: the problem must interfere with your ability to function beyond a “normal” level. The fancy term for this is clinical significance – how much a problem stops a person from living their life. One common reference tool for levels of difficulty can be found here.
When I say it interferes with functioning, I mean it has to create problems in major areas of life – at school or work, in relationships, or at home. When I say beyond the normal level, I mean that the problem is not due to what can be an expected reaction to life. For example, if Joe lost his job, it would make sense for him to feel low and struggle with self-esteem or motivation for a while – this does not mean Joe automatically has depression. If that continues for two years, Joe still hasn’t found a new job, and has lost friends since he stopped reaching out as much, we’d be looking at something more likely to be diagnosable. Joe’s symptoms go on longer than expected and they stop him from having a social life… they may even be stopping him from finding a job or earning money. This is why diagnoses are valued in the clinical world – they give clinicians guidance around potential treatment options and the best steps to take to help their clients feel better.
An important distinction that I want to make right away is the difference between neurological, or brain, differences and their role in diagnosing. Diagnoses like ADHD, autism, and traumatic brain injury (among others), technically fall within the same manual as mental illnesses. Dealing with the symptoms of brain differences can parallel dealing with the symptoms of mental illnesses, but there is a categorical difference between the two. Think of it like the difference between suffering from the flu versus having a broken bone. You may have pain from either medical problem, but the approach and causes are very different.
The Doctor Called Me What?!
When it comes to the words clinicians use to diagnose people, there are lots of key differences that you’ll want to know. Several terms and phrases that are used in clinical descriptions do not necessarily mean the same thing as they do in layman’s terms. You won’t need a medical dictionary to make it through the diagnostic series – by the end of this introduction, you’ll know the basics.
First up: when licensed clinicians give a diagnosis, they sometimes need to give an exact description of the problem. One element of this description is the severity – typically grouped into mild, moderate, severe, and sometimes even profound or extreme. Think of it this way: suffering from mental illness is kind of like having to carry a heavy backpack.
- A mild case of Depression is like having a backpack with several books; manageable, but gets in your way and will make your shoulders ache. It’s certainly not ideal but it doesn’t make life impossible.
- A moderate level of Depression is like having all your textbooks from a full day of school in the backpack, and you can only carry it on one shoulder. It tips your balance, it’s heavy, and you’re tired every time you carry it – this is a big inconvenience and can prevent you from going as far or doing as much as you’d have done if you didn’t have to carry so much. You’ll likely throw your back if you’re not careful, and you spend a lot of time managing it to prevent more injury.
- A severe case of Depression is like carrying the biggest backpack you can, full of your and two of your classmate’s textbooks, so heavy you have to bend forward to manage the weight. You definitely suffer from physical pain by carrying it, and you don’t want to move or go anywhere. Life is so unbearable by carrying this backpack that you stay home and avoid moving at all so you can just leave it on the floor. You may even wish you didn’t have to wake up in the morning, just so you don’t have to carry the darn thing anymore.
Basically, if there’s a mental illness present, there is suffering present. All disorders are significant and life-impacting. Just like medical diagnoses, any illness is a burden on the person who suffers from it. Even mild forms of psychological diagnoses are significant enough to greatly impact a person’s life.
The second important phrase that you’ll likely see in this series is differential diagnosis. This basically means how clinicians decide between similar conditions when diagnosing a client. The way disorders present, or manifest, can differ from person to person – even within one diagnosis.There can also be symptoms shared by multiple diagnoses. For example, attention and concentration can be affected by a lot of different diagnoses. Telling the difference between Depression and Bipolar, Anxiety or OCD, and other similar conditions requires training and education about the facets of mental illness. This is why only licensed providers are granted the responsibility of diagnosing.
But Where Do Diagnoses Come From??
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (commonly called the DSM-5) is the most current source for mental health providers to base their diagnostic conclusions. Think of it like the encyclopedia of mental illnesses, organized by focus of concern (such as neurological, personality, and the like). Please be aware – this is used in North America, and culture plays a major part in how dysfunction is understood. Cultural consideration is a whole different thing that we’ll address in a separate article as we continue the series.
So Now What?
In the coming weeks, you’ll see lots of articles giving you the lowdown on what several big-name diagnoses are. If there’s a diagnosis you think just has to be on the list, send us an email – firstname.lastname@example.org. If you’re a clinician or licensed mental health professional, and you want to write for Take This, here’s the link to our expert content page (and has the submission form at the bottom!): https://www.takethis.org/expert-content/