Clients often come to me with questions about their diagnosis. They want to understand whether they are feeling nervous about an upcoming life change or meeting criteria for Generalized Anxiety Disorder. They worry that they aren’t just a little sadder than usual but dealing with Major Depressive Disorder. Let’s be honest, the Google vortex and Buzzfeed quizzes don’t help (and no I’m not talking about the “What kind of tomato are you and why” ones). There are so many legitimate questions about diagnosis, and hey, I get it. We want labels. We want to empower ourselves with knowledge. Mental illness is often isolating and confusing, so having a diagnosis means finally naming something so complex and life-altering.

Diagnosis is often hard to talk about because it is as multifaceted as the people we treat. Unlike treating a physical ailment like a broken leg, evaluating mental health symptoms is nuanced. How do you quantify a feeling? How do you describe multiple competing emotions? In fact, since we often rely on invisible qualities like “irritability” or “restlessness”, diagnosis is often an educated guessing game.

You might be thinking, so it’s basically an arbitrary process?

Not quite. It is indeed a puzzle, but it’s far from random. Here are some of the questions I ask to help me understand a client’s unique diagnosis.

Can your symptoms be explained by any major life events or medical changes?

Losing a loved one, going through a divorce, job loss—these are all significant life changes that can impact our mental health. Research also indicates that illnesses such as heart disease, diabetes, and chronic pain can be linked to depression. Certain medications may induce side effects resulting in mood changes. It’s therefore important to rule out these possibilities before diagnosing. 

What is your distress tolerance?

We respond to stress differently based on our upbringing, personality traits, and a host of other qualities. Two individuals can experience the same life event and respond in vastly different ways. Understanding your unique sensitivity to distress is an important part of diagnosing. 

How are your symptoms affecting your daily life?

This is probably the most important question to ask when diagnosing. Symptoms can present on a spectrum. We all feel worried at some point, but fewer people feel so nervous that they cannot leave their home. Everyone feels some form of depression when something sad happens, but some folks feel so depressed that they can’t get out of bed or shower regularly. If your symptoms prevent you from taking care of yourself, that’s an important indication that a diagnosis is needed.

If you’re curious about your mental health symptoms, therapists like me are here to help. Using a combination of clinical interviews, collateral information from supportive people in your life (think teachers, spouses, parents, etc.), and sometimes psychological assessments, I can help determine what diagnosis fits your presentation. Why is this so important? Knowing the diagnosis helps us plan the best course of treatment, from referrals for  medication management to specific therapeutic approaches. Diagnosis feels mysterious, but my job as a therapist is to offer transparency and collaborate with you.