Diagnoses—Between Truth, Stigma, and Blind Spots

Introduction: The double edge of diagnoses

Psychiatric diagnoses—classic mental-health labels included—can be helpful. They can open doors to treatment and support. But they can also restrict, stigmatize, or mislead.
They’re necessary—and yet often rigid tags that fail to capture a person’s lived reality.

In this piece I want to name my diagnoses and share my path through the labyrinth of psychiatric classifications. Later, I’ll unpack specific topics in separate posts—my motto: dig deeper.

How I learned about my diagnoses

I’ve been in therapy since 2004—with a few breaks. In outpatient therapy, diagnoses are rarely discussed, presumably to avoid stigma. No one ever told me mine outright.
I only know about them because I’ve always requested copies of every report and assessment.

One pattern became clear over the years: diagnoses are snapshots. They change. Some fade from the file, new ones appear. Only the full arc tells the story.

My diagnoses over time

• 2004: Emotionally Unstable (Borderline) Personality Disorder — my first diagnosis from a day clinic. It gradually disappeared from later records.
• Recurring: Chronic, recurrent depression — this fits; I’ve had multiple episodes from mild to severe.
• 2019: Avoidant Personality Disorder with dependent traits — per a forensic-psychiatric evaluation for the Canton of Solothurn.
• Generalized Anxiety Disorder — noted during periods of pronounced social withdrawal.
• Chronic PTSD (referenced) — appeared in medical letters but was never formally diagnosed.
• Alcohol as coping: There were phases when I drank a lot. No one labeled it a use disorder, and I don’t think it was true dependence—more an (imperfect) coping strategy.

What fits—and what doesn’t?

I’ve examined every single criterion for these diagnoses and rated how much it applies to me. Some fit. Others don’t at all.

Example: the Borderline label. I’ve met many people with BPD. Most showed that hallmark splitting—idealization and devaluation. That’s alien to me.
Black-and-white thinking would feel like an insult to my mind. I don’t see people as good or bad—they’re both. And that very duality makes people, to me, unpredictable.

Unpredictability is my greatest fear.

Interestingly, I often recognize schizoid traits in myself. No therapist has ever raised it. Probably because I’m very open and communicative in therapy—whereas “classic” schizoid presentations are more withdrawn and distant.
Here’s a diagnostic blind spot: labels depend not only on symptoms but also on how you present in the therapeutic setting.

Why do so few question their diagnosis?

It still surprises—sometimes shocks—me how little many people with mental-health labels engage with what those labels actually mean.
I’ve met folks who wear “Borderline” like a quirky badge without understanding the underlying assumptions.

Diagnoses are often accepted uncritically—not as working hypotheses, but as identity markers.

Yet psychiatric diagnoses are tools, not drawers. Too often they’re treated as an endpoint rather than a starting point.
I keep wondering: are there others out there who question their diagnoses as critically as I do?

Conclusion: My path continues

This post is only the beginning.
In future articles I’ll take individual diagnoses apart and explore what they mean for me. Because diagnoses are more than medical categories: they shape how we see ourselves—and how others see us.

But the final word on my identity will always be mine.