We as a society have made tremendous strides when it comes to mental health. It was not uncommon for asylum patients in the 1900s to face neglect in a prison-like institution, abuse by their caregivers, or subjection as guinea pigs for inhumane therapy in an attempt to cure them. In the past century, ignorance surrounding disorders has been mostly dispelled by raising awareness, advocating for reform, gaining knowledge, and developing proactive treatment. Unfortunately even now, treatment, therapy, and even sympathy seems to only be reserved for doctor-endorsed sufferers. The notion that someone’s condition is only legitimate if someone else ratifies it is problematic because it dismisses the existence of a mental illness unless it can be ‘proven’. For this reason, a diagnosis should not be the determinant of validity.

     Granted, allowing people to self-label can be problematic in some cases, it will be freeing in others since simply broadening the exclusivity of the mental health community does not devalue those who have been diagnosed. In a cyber-era that cannot help making everything trendy at some point, a dig at the inclusivity of what classifies someone as battling a mental illness is not an attempt to justify romanticizing serious and sometimes ugly disorders. Social news companies like Buzzfeed produce quizzes and articles that can tell you what mental illness you are based on your favorite pizza topping or exaggerate how OCD spring-cleaning makes us every April. Public displays of behavior like this consequently make that annoying girl from high school think it is okay to update you and 1,042 of her other Facebook friends about how she’s so bipolar when it comes to her feelings about her on-again-off-again boyfriend, or your little brother who is failing classes into thinking he can get away with telling your mom it is because he is depressed. Though having a mental illness can be a reason why someone would act out of character, it should not be used as a humblebrag to be trendy or an excuse to conceal irresponsibility. Incidents like these reckless misuses of labels are what convince people genuinely struggling that their symptoms are superficial, hence making it harder to come forward and be believed, and make clinicians crack down on what constitutes a diagnosis.

     Often times we forget that medical professionals are not experts - they are just practicing a science, one that is constantly evolving at that. Throw in the fact that it is not even as stagnant as physical health and the lines get even blurrier! Physical health practitioners can rely on blood tests and scans to back up the existence of an ailment, tangible proof that either qualifies or disqualifies people with no grey area. With mental health, the determining factor is someone's opinion. Grant J Everett describes to Panorama Online Magazine how psychiatrists diagnose mental health as ‘based on how somebody answers a series of questions, but in addition to listening to your answers, they’ll also observe your actions and other physical signs that may indicate your thoughts, feelings and so forth’ (“What Can You Do If You Disagree With Your Mental Health Diagnosis”). Using this system means that the likelihood of a discrepancy between psychiatrists is high and inevitable since no two will think alike. The screenings will undoubtedly yield different results based on the education they possess, controversies they indulge, and biases they hold thus rendering any collective conclusion unreliable.

     Another major oversight at stake is failure to penetrate a facade. This method only takes into account easy-to-read subjects, or say easier to read than others; it could dismiss people who are either too self-aware that can express their state of mind so precisely it almost seems too calculated to be authentic, or so high-functioning that their emotions come across as run-of-the-mill fleeting feelings that will fade. Just like how physical health doctors can be guilty of belittling patient worries, so can mental health doctors. This phenomenon of medical professionals making you question the credibility of how strongly you feel can be referred to as healthcare gaslighting. An article on Vocal Media detailing the experiences of women who fell victim to this type of manipulation offered the best advice as a concluding sentence: do not let anyone profile your symptoms, invalidate your concerns, or brush off your issues. You are the best advocate for your body, and your body is the highest authority on itself (“Medical Gaslighting”).

     It is not just the doctors however, who are to blame for the lack of trust undiagnosed sufferers have to put up with on top of their illness; society is just as responsible. "The fact that we require people to be labeled with a disorder to be worthy of care is an indictment of our collective moral community[...]" says Hanna Pickard, a Philosophy of Psychology professor at the University of Birmingham, “The need for diagnosis of mental disorders before showing compassion shames us all.” Not only is it diminishing to assume someone’s suspicion is invalid because a clinician did not cosign it, but it denies him or her the benefit of the doubt if they were misdiagnosed or have yet to be screened.

     In these instances, what is to be made of those who are truly depressed, traumatized, or obsessive prior to it? Alcoholics do not wake up one day suddenly exhibiting the qualities of a textbook addict; the indicators were present beforehand too. So, to believe someone’s anxiety is illegitimate before it is recognized is to believe that it manifested randomly, as if they were not already dealing with the ramifications before their theory was confirmed. Of course, this is assuming screenings are even available. People without insurance or people who simply just cannot spare the money should also be taken into consideration when it is assumed their mental illness is not viable without a diagnosis. According to the United States National Library of Medicine, the initial evaluation alone could cost upwards $200, and the Good Therapy blog mentions that sessions could put clients out another $100 per session or even per hour!

     American slam poet Neil Hilborn touches on how situations like this force people to carry on without treatment. In one of his poems named simply Joey after a childhood friend who this was a reality for, he paints the picture of how therapy is not a luxury afforded to everyone. “When I wanted to open myself up and see if there really were bees rattling around in there, my parents got me a therapist. I can pinpoint the session that brought me back to the world, that session cost seventy-five dollars. Seventy-five dollars is two weeks of groceries, it’s a month of bus fare, it’s not even a school year’s worth of new shoes, it took weeks of seventy-five dollars to get to the one that saved my life. We both had parents that believed us when we said that we weren’t okay but mine could afford to do something about it” (lines 40-41).

     He goes on to wonder how many kids like Joey had parents who believed them but also had to pay rent, and how lucky he felt not only to have parents who could do both but to also not be describing his friend’s funeral. Sure Joey could not bear the expense of a psychoanalysis, but treatment reflexively doubles as the way the world treats you upon realizing. It costs nothing to show compassion to people battling mental health issues. People should help people in need simply because they are in need, without strings attached. They should be compassionate when they first display signs, when mild symptoms increase in severity and frequency, when they come and go, when it becomes too much to carry alone or in shame because they feel embarrassed to admit their concerns for fear of being shunned. That is when validity begins - when it feels valid, not when it is proven.

Works Cited

Committee on Psychological Testing, Including Validity Testing, for Social Security Administration Disability Determinations; Board on the Health of Select Populations; Institute of Medicine. Psychological Testing in the Service of Disability Determination. Washington (DC): National Academies Press (US); 2015 Jun 29. 6, Economic Considerations. https://www.ncbi.nlm.nih.gov/books/NBK305231/

Cpoetrymsu. “Poem of the Week: ‘Joey’ by Neil Hilborn.” The RCAH Center for Poetry at MSU, 21 Mar. 2017, centerforpoetry.wordpress.com/2017/03/21/poem-of-the-week-joey-by-neil-hilborn/.

Everett, Grant J. “What Can You Do If You Disagree with Your Mental Health Diagnosis?” Panorama Online Magazine, 20 July 2016, panoramaonlinemagazine.com/2016/07/20/what-can-you-do-if-you-disagree-with-your-mental-health-diagnosis/.

FAQs, Therapy. “How Much Does Therapy Cost?” GoodTherapy.org Therapy Blog, 21 Mar. 2019, www.goodtherapy.org/blog/faq/how-much-does-therapy-cost.

Minx, Cheeky. “Medical Gaslighting.” Vocal Media, vocal.media/longevity/medical-gaslighting.

Pickard, Hanna. “Why Do We Need A Diagnosis to See Mental Disorders As Real?” IAI TV - Changing How the World Thinks, 18 Oct. 2019, iai.tv/articles/why-do-we-need-a-diagnosis-to-see-mental-disorders-as-real-auid-1067.

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