Debunking Myths of the Mind

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The Dangers of Self Diagnosis

How self diagnosis can lead you down the wrong path.

In this day and age of limited time with doctors coupled with ample opportunity to google anything, the temptation for people to reach their own conclusions about their illness is strong. In this piece, I will describe when self-diagnosis is dangerous, and what you might know overtly about this danger. Here are a few truths to consider and how self-diagnosis affects this.

When you self-diagnose, you are essentially assuming that you know the subtleties that diagnosis constitutes. This can be very dangerous, as people who assume that they can surmise what is going on with themselves may miss the nuances of diagnosis. For example, people with mood swings often think that they have manic-depressive illness or bipolar disorder. However, mood swings are a symptom that can be a part of many different clinical scenarios: borderline personality disorder and major depression being two examples of other diagnoses. The clinician can help you discern whether you swing from normal to down or down to up, and by considering how long the mood swings last, the clinician can make the appropriate diagnosis. Here, the danger is that you may misdirect the clinician or even yourself.

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One of the greatest dangers of self diagnosis in psychological syndromes, is that you may miss a medical disease that masquerades as a psychiatric syndrome. Thus, if you have panic disorder, you may miss the diagnosis of hyperthyroidism or an irregular heart beat. Even more serious is the fact that some brain tumors may present with changes in personality or psychosis or even depression. If you assume you have depression and treat it with an over-the-counter preparation, you may completely miss a medical syndrome. Even if you do not want conventional treatment for depression, you may want conventional treatment for a brain tumor.

Self-diagnosis also undermines the role of the doctor-which is not the best way to start the relationship. While doctors are generally very enthusiastic about getting packaged information, it would help if you actually trusted your doctor. If your doctor is someone whom you cannot trust, then think again about why you see this doctor. Your doctor should respect your opinion, but the discussion should be an active one. If you doubt the doctor's diagnosis, tell him or her that you do and say why. This is much better than silently diagnosing your own syndrome.

Then there is the fact that we can know and see ourselves, but sometimes, we need a mirror to see ourselves more clearly. The doctor is that mirror. By self-diagnosing, you may be missing something that you cannot see. For example, you may be overwhelmed by anxiety and think that you have an anxiety disorder. The anxiety disorder may be covering up a major depressive disorder. Approximately 2/3 of people who present to outpatient clinics with anxiety have depression as well. In general, when two or more syndromes occur in the same person, we call this comorbidity. When people self-diagnose, they often miss the comorbidity that exists.

Another danger of self diagnosis is that you may think that there is more wrong with you than there actually is. For example, if you had insomnia, inattention and depression, you may believe that you have a sleep disorder, ADD and major depression. However, major depression can account for all of these symptoms. Thus, you may make things worse by worrying more as well.

Self-diagnosis is also a problem when you are in a state of denial about your symptoms. You may think that you have generalized body aches that started when your mood got worse, but a doctor may elect to do an EKG for chest pain that reveals possible coronary artery disease. You may have been trying to avoid the chest pain or you may have minimized this.

Lastly, there are certain syndromes that may not seem like problems to you even though they are very disruptive to your life. For example, with delusional disorder people do not think that they are delusional and because they are not overtly psychotic, they may not think to report paranoid symptoms that add up to delusional disorder. Also, many personality disorders are not spontaneously reported since they are usually problematic to other people.

Thus, self-diagnosis can have tremendous negative repercussions on the patient. For this reason, while reading is helpful and informative, it is always best to discuss your impressions with a doctor before you decide on the treatment you want.

Srini Pillay, M.D., is the author of the book: Life Unlocked: 7 Revolutionary Lessons to Overcome Fear. He is also an Assistant Clinical Professor at Harvard Medical School.

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