What's In a Label?
The pros and cons of diagnosis.
Posted Sep 05, 2011
Fifteen years ago this month, my father died. It was very sudden, I was 26, and I didn't know what had hit me. Three weeks later I was back at work, and it soon became obvious to me and my then boss that I wasn't coping, so I went to see my doctor. When he agreed to sign me off work for a few weeks, he cited 'debility' as the cause, to make sure that the word 'depression' didn't appear on my record. Was this the right thing to have done? Certainly there is a stigma attached to psychiatric diagnoses, but does this mean that when you receive one, it can only be bad news?
When my diagnosis of OCD was confirmed in 2004 it was a great relief. It was like being handed a labelled box into which I could stuff all kinds of things that I had always found distressing and frustrating about myself. I couldn't throw them away, but I could begin to find a way of keeping them in their place. As Jeffrey Schwartz puts in his book Brain Lock, I could 're-label' and 're-attribute' my symptoms, a process one of his patients encapsulated in the phrase 'It's not me: it's my OCD.' Fighting a named enemy still takes it out of you, but it's nothing like as enervating as trying to fight yourself.
A diagnosis from a professional is also the means to getting the right kind of help. It is an official acknowledgement that your problems are real; on a practical level, it provides you with the words you need to fill in the forms that will entitle you to claim treatment and the wherewithal to pay to for it. Receiving my diagnosis enabled me to get more effective treatment for my problems, and my life improved as a result.
So when I wrote my memoir The Woman Who Thought Too Much, it would have been easy to structure the narrative as a kind of heroic quest, with the diagnosis of OCD as the triumphant end point, but I didn't want to do that. The label 'OCD' was helpful to me in all the ways I've described, but it didn't sort everything. It didn't explain every problem I've ever had or still have; it didn't explain all my faults or excuse every instance of bad behaviour, much as I would've liked it to; even the things it did explain didn't disappear just because I was able to stick a label on them. A diagnosis can be useful - even liberating, if you let it be - but it's not a magic charm.
It's not a curse either. If that doctor back in 1996 had written 'depression' on my letter, I don't believe that in the very act of doing so he would have made my life any worse. And while the diagnoses I've received since may have pushed my life insurance premiums up a little, but that aside, I don't believe that they I've suffered anything worse as a direct result of having these labels attached to certain difficulties that I have with life. I'm quite certain that I would have continued to have them whether they were so labelled or not.
And, as for the stigma the doctor was so rightly worried about, it helps a great deal to remember that these labels we call diagnoses are properly attached to conditions, not persons.