Diagnoses – Between Truth, Stigma, and Blind Spots
Introduction: Diagnoses as a Double-Edged Sword
Psychiatric diagnoses, including mental health diagnoses, can be helpful, but they can also be restrictive, stigmatizing, or misleading. They are necessary to enable treatments and support, yet they are often rigid labels that do not always do justice to individual reality. In this post, I want to name my diagnoses and share my journey through the labyrinth of psychiatric classifications. Later, I will delve deeper into specific topics in individual articles – true to the motto: “Dig deeper.”
My Journey to My Diagnoses
I have been in therapy since 2004, with some interruptions. In outpatient psychotherapy, specific diagnoses are often not discussed – probably to avoid stigma. My diagnoses were never explicitly communicated to me. I only know about them because I have always requested copies of my reports and medical assessments.
A pattern I recognized: Diagnoses are often snapshots in time, changing over the years. Some disappear from records, while others newly emerge. Only the overall picture tells the full story.
My Diagnoses Over Time
- 2004: “Emotionally Unstable Personality Disorder” – my first diagnosis from a day clinic. Over the years, it gradually disappeared from reports.
- Recurring: “Chronic Recurrent Depression” – a definite match, as I have had multiple mild to severe depressive episodes.
- 2019: “Avoidant Personality Disorder with Dependent Traits” – diagnosed in a forensic psychiatric report from the Canton of Solothurn.
- Generalized Anxiety Disorder – appeared at times, particularly during periods of social withdrawal.
- Chronic Post-Traumatic Stress Disorder – mentioned in medical reports but never officially diagnosed.
Additionally, there were periods in my life when I drank a lot of alcohol. However, addiction was never a topic, and I do not believe it was a true addiction – rather a coping mechanism.
What Fits Me – and What Doesn’t?
I have analyzed and evaluated every single trait of my diagnoses. What I have found: Some things fit, others not at all.
An example is the Borderline diagnosis. I have met many people with Borderline Personality Disorder, and almost all exhibited the typical black-and-white thinking, idealization, and devaluation. That is completely foreign to me. Black-and-white thinking would be an insult to my intellect. I do not see people as good or evil – they are both, and that is precisely what makes them unpredictable. And unpredictability is my greatest fear.
Interestingly, I recognize schizoid traits in myself, yet no therapist has ever considered this possibility. Probably because I communicate openly in therapy, whereas classic schizoid personalities tend to be more withdrawn and distant. Here, a blind spot in diagnostics becomes evident: Diagnoses are not only based on symptoms but also on how one presents in a therapeutic setting.
Why Do So Few People Question Their Diagnosis?
What repeatedly surprises – even shocks – me is that most people with mental illness hardly engage with their own diagnosis. I have met individuals who flaunt their Borderline diagnosis without even understanding what it actually implies. Diagnoses are often accepted uncritically – as an identity marker rather than a working hypothesis.
Psychiatric diagnoses are tools, not pigeonholes. Yet they are frequently viewed as an endpoint rather than a starting point. I wonder: Are there others out there who question their diagnoses as critically as I do?
Conclusion: My Path Forward
This post is just the beginning. In future articles, I will dig deeper into individual diagnoses and what they mean to me. Because diagnoses are more than just medical classifications – they shape how we see ourselves and how we are seen. But the final word on my identity will always be mine.
