These statements seemed to strike a nerve with many mental health professionals, myself included. Having just spent the past three years earning my master of social work (MSW) degree, I have a profound new understanding of just how much not only goes into diagnosing a client, but their individual treatment as well.
Over the past few years, young people in particular have been turning to social media, namely TikTok, to try to get a better grasp on their mental health. Gen Z-ers have become increasingly aware of the importance of mental health care and have made it a big part of our collective dialogue. Unfortunately, that has led to a lot of self-diagnosing and all-around misunderstandings of very complex issues and terms. (Heck, here at Well+Good we realized pretty quickly that the widespread use and misuse of the term “gaslighting” was going to be downright damaging.)
I don’t point this out to shame or belittle anyone who has turned to the internet to try to figure out their health issues. After all, who among us hasn’t turned to WebMD in a moment of crisis (ahem, the common cold) and incorrectly concluded that our symptoms were something far graver?
This is especially pertinent when you consider that, as of 2020, during the COVID-19 crisis, a reported 31.6 million individuals in the United States had no health insurance. Even for those who are covered, finding the ever-elusive plans that cover mental health services, let alone being able to get an appointment with a provider you want to see, is its own hurdle. In 2019, NPR reported that “an office visit with a therapist is five times as likely to be out-of-network, and thus more expensive, than a primary care appointment.” It’s extremely tempting to turn to a free app that’s easy to get lost in for hours. But using it as a tool for something that requires deeper insights is a slippery slope.
I recognize this issue not only as someone who works in the mental health field, but as a person with my own complex mental health history. Before I found the right therapist and right kind of therapy for me, I was absolutely guilty of not only self-diagnosing myself, but perhaps even more damagingly, other people.
In the wake of back-to-back unhealthy relationships, I was desperate to find closure and clarity. It wasn’t just that there was something inherently wrong or unlovable about myself, right? I read every book and blog there was and came to the conclusion, on my own, that I had dated sociopaths or narcissists or a combination of both. Giving them these titles not only made me feel better about my pain, but it took some of their power away. It was the first thing to give me some sense of relief.
It wasn’t until I found my amazing therapist (whom I’ve been working with for over five years now) and going through the rigors of grad school to become an MSW that I discovered I hadn’t been properly equipped to actually get to the root of my partners’ problems. The people that I dated had their own complex backgrounds and traumas and genetics and risks and environments, and while I knew about some of it, it was not my place to diagnose them or even myself. My own initial diagnoses might have given me a sense of relief, but having a clear insight was what actually brought me lasting peace in the end.
For instance, look at narcissistic personality disorder (NPD), which the DSM-5-TR defines as a “pattern of grandiosity, need for admiration, and lack of empathy.” Okay, so that certainly fits the bill for my exes. But for a person to be diagnosed with NPD, they have to fit five or more of the diagnostic criteria, which have their own set of culture-related diagnostic issues, sex-and-gender related diagnostic issues, as well as comorbidities, including depressive disorders and substance use disorders.
It can be easy to look at a person’s behavior and see the broad strokes as their defining characteristic, but any mental health professional can tell you it’s far more complex than that. Moreover, when you misdiagnose someone else or yourself, you’re making the healing process ultimately more difficult for yourself. For instance, it wasn’t until my therapist clarified for me that I was actually dealing with someone with borderline personality disorder (BPD) that I could better understand them and really start to understand the dynamic of our relationship. When dealing with a narcissist, you let them know what you need from them and let them make that decision, but with someone with BPD, it’s better to set clear boundaries.
When you misdiagnose someone else or yourself, you're making the healing process ultimately more difficult for yourself.
The urge to self-diagnose was something I saw time and time again as I worked with individuals and families in recovery during my social work internships. I didn’t judge these clients when they were adamant that they behaved a certain way for a certain reason, or their loved one was estranged because they believed they had an undiagnosed disorder. In fact, I understood that instinct all too well. We want to have more control over situations and feelings and thoughts that feel thoroughly out of control. Putting a name to the pain you face can take away so much confusion.
However, until you get an accurate diagnosis from a mental health professional, you may just wind up lost on a misguided path. You can spend all your energy on TikTik “hacks” that don’t truly get at the root of whatever issue you’re actually struggling with.
While I think it’s great that the internet and social media can be a place to feel less alone and bring more awareness to mental health overall, it’s imperative that people get the proper care they not only need, but deserve. You can definitely get some great insights on social media to open your horizons about mental health, but it’s best to make a therapist your main resource on the subject at hand.
Trust me when I tell you, your pain is very real and there are so many amazing mental health experts out there who want to help get you on the right track towards diagnosis and treatment. They’re just not in between reels of Bill Hader dancing.
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