In recent years parents, teachers, coaches, pediatricians, behavioral health providers and others have increasingly faced the challenge of teens who announce that they have a self-diagnosed mental health disorder. This can be a problem as over reliance of a youth’s self-diagnosis can short-circuit the process of more fully understanding what’s really going on behind the label they have chosen to define their problem.
There are a number of reasons why a self-diagnosis can be attractive for youth who are experiencing challenges in their life:
1) Such a label can provide a seemingly objective and normalizing narrative for a teen’s very personal pain.
2) It can also offer a sense of connection to others (online or in-person) struggling with similar conflicts and challenges.
3) For others it may also offer a non-judgmental singular explanation (e.g., my disorder is biological, etc.) and not a consequence of more complex psychological and/or interpersonal challenges.
4) For some it may offer a short-cut to getting medication to fix the problem while avoiding the more difficult process of self-examination and psychological growth
There used to be enormous stigma attached to being diagnosed with a psychiatric disorder. No longer, particularly as on-line platforms, stories in the media, advertisements for the latest medication, input from their peers, and messages from influencers of all stripes and styles, often promote self-diagnosis as a way to “understand” their pain.
It is indeed sad but true that many teens experience significant emotional challenges. Roughly 5% of youth experience serious and sometimes lifelong disorders, many amenable to meaningful interventions to reduce their impact on the person and their families. Another 10-20% of the youth population experience mild to moderate clinical difficulties that cause heartache for them, their parents and others.
In both situations, parents, in concert with involved pediatricians, psychiatrists and/or other mental health and substance use providers, will be tasked with defining a suitable treatment plan to address the youth’s troubling symptoms and environmental challenges. In the ideal situation, this process leads to a multidimensional assessment of the individual’s problems, along with an accounting of their internal and environmental resources to ameliorate these issues. Such an assessment, done well, should comprehensively explore the biological, psychological, familial and sociocultural factors that define the person’s situation and needs. Such a bio-psycho-social assessment will, of course, incorporate a delineation of diagnostic concerns but is much broader in scope than simply coming up with a label.
This process can be complicated. Even if a youth is correct about their diagnosis, over dependence on the label can preclude appreciation for the multiple stressors they may be struggling to manage, and, perhaps more importantly, minimize a focus on their strengths and the positive contexts of their life situation, thus limiting consideration of the various interventions that can help them and their families move beyond current symptoms and difficulties. If the youth’s self-diagnosis is not correct and treatment interventions are reflexively implemented, the outcomes will more likely be ineffective and/or actually harmful to some degree.
The bottom line for parents and providers is to respond supportively to the teen’s “self-diagnosis” while empathically broadening the conversation to be a more comprehensive inquiry of the youth’s presenting difficulties and strengths, and then defining a path toward greater understanding and growth promoting intervention.
Reference: “How to Navigate Therapy-Speak”, Suzanne Garfinkle-Crowell, M.D., New York Times Opinion, August 25
AUTHOR:
Mark Chenven MD, DFAACAP
Vista Hill Foundation