How do doctors diagnose mental illness

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Anonymous #1
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I know they take blood tests to rule things out but if they find nothing, do they just ask you how you feel and diagnose you from there? cause if someone wants a diagnosis and so lies that they are experiencing anxiety or depression symptoms like stress, panic attacks, low mood etc. A doctor wouldn't know they're lying and so would give an inaccurate diagnosis. idk it just doesn't make sense how they know if someone has the mental illness or not.
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Anonymous #1
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Does anyone know?
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black tea
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By asking you questions and watching how you act. I'm sure people do lie, but it seems like a weird thing to lie about.
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Nerol
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(Original post by Anonymous)
Does anyone know?
Hi!
GPs will diagnose things like low mood (depression) and anxiety generally by asking questions and using scales like PHQ-9 and GAD-7. They are self-report measures, so yes, in theory a person could lie about their symptoms and end up being given medication/treatment for problems they don't have. Mental health problems are generally diagnosed through clinical diagnosis, meaning diagnosis is based on reported symptoms rather than medical/diagnostic tests.

For more severe mental health conditions (schizophrenia, for example), assessments will be carried out by a mental health specialist, who will refer to criteria in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) and give a suitable diagnosis. Many mental health disorders have similar symptoms and are therefore difficult to diagnose. It may be a case of trialing treatments and medication to find out what works best.

Generally speaking, it is rarely the case a person will be diagnosed straight away and that diagnosis be rigidly stuck to.

Edit: Just to add that psychologists tend to use formulation rather than diagnosis. This involves making an evidence-based hypothesis of what the problem is, where it has come from and what kind of treatment might be effective. This is then tested over time.
Last edited by Nerol; 3 weeks ago
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kyungsoo
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they slap ur head like a melon. im joking. first go to ur doctor with a list of all the symptoms you have, they will then refer you to a psychiatrist.
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Joleee
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GPs don't diagnose mental health issues if that's what your asking and there is no blood test. all that happens at your appointment is that you explain what you've been experiencing and they might offer a prescription for antidepressants and/or refer you to counselling. even in counselling tho you may not get a formal diagnosis for anxiety or depression; it's just a space to talk about your feelings and perhaps learn techniques on how to manage your anxiety or depression. i suppose someone could lie about experiencing mh issue if they wanted to but there's no real point given you don't get anything out of it except antidepressants that don't do anything for you and a 6 month wait to see a counsellor.
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PastelColours
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not sure if this is accurate but I remember when I was doing a level psychology and my teacher said psychiatrists basically use this massive book called the DSM(diagnostic and statistical manual for mental disorders) which has symptoms for each mental illness.
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CosmicApathy1
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A lot of psychiatrists don’t care about you so they don’t actually do anything and just string you along
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Cancelled Alice
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At any point, mental health professionals and health professionals (even if they aren’t qualified to) may assess you for a personality disorder.
If 5 or more of the following 9 criteria apply they will shove you in the PD bin:

(1) Female
(2) Clinician experiences feelings of personal disdain
(3) Trauma
(4) History of being treated badly by clinicians and complaining about said mistreatment
(5) Surviving a suicide attempt
(6) Self harm
(7) Using crisis services once too many times
(8) Autistic Spectrum Traits
(9) Frictious relationships between clinicians and they are in need of a scapegoat
Last edited by Cancelled Alice; 3 weeks ago
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Nerol
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(Original post by CosmicApathy1)
A lot of psychiatrists don’t care about you so they don’t actually do anything and just string you along
It would not be in the interest of either the psychiatrist or the patient to do this. Psychiatrists will not 'string you along' for no reason. If you feel you have experienced this, or are currently experiencing this, do make sure the service you are involved with is informed of this. Services need to know if they are not providing adequate care.
(Original post by Cancelled Alice)
At any point, mental health professionals and health professionals (even if they aren’t qualified to) may assess you for a personality disorder.
If 5 or more of the following 9 criteria apply they will shove you in the PD bin:

(1) Female
(2) Clinician experiences feelings of personal disdain
(3) Trauma
(4) History of being treated badly by clinicians and complaining about said mistreatment
(5) Surviving a suicide attempt
(6) Self harm
(7) Using crisis services once too many times
(8) Autistic Spectrum Traits
(9) Frictious relationships between clinicians and they are in need of a scapegoat
PD diagnoses are not given easily. They are also frequently misdiagnosed due to overlap in symptoms between a variety of mental health disorders. I do think there is definitely much more stigma attached to personality disorders than, say, schizophrenia.

A clinician's personal feelings towards a patient/client should never be a criterium for diagnosis, nor should patients complaining about treatment. PDs are difficult to diagnose, and there is ongoing debate around the sub-categories under the PD umbrella that currently exist.

I've heard this view of being 'thrown in the PD bin' from people I have worked with before, and it is clear that work is needed to improve support offered to people who display symptoms related to PDs. I always got the sense that often PD diagnoses were a 'last resort' when medication or other treatments hadn't worked. There is generally pressure on clinicians in the healthcare system to diagnose. Mental health treatment is still heavily medicalised, and this lends itself to a diagnostic approach.

Things are improving slowly, it seems. It is just such a shame so many people have felt let down by mental health services.
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Cancelled Alice
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(Original post by Nerol)
It would not be in the interest of either the psychiatrist or the patient to do this. Psychiatrists will not 'string you along' for no reason. If you feel you have experienced this, or are currently experiencing this, do make sure the service you are involved with is informed of this. Services need to know if they are not providing adequate care.

PD diagnoses are not given easily. They are also frequently misdiagnosed due to overlap in symptoms between a variety of mental health disorders. I do think there is definitely much more stigma attached to personality disorders than, say, schizophrenia.

A clinician's personal feelings towards a patient/client should never be a criterium for diagnosis, nor should patients complaining about treatment. PDs are difficult to diagnose, and there is ongoing debate around the sub-categories under the PD umbrella that currently exist.

I've heard this view of being 'thrown in the PD bin' from people I have worked with before, and it is clear that work is needed to improve support offered to people who display symptoms related to PDs. I always got the sense that often PD diagnoses were a 'last resort' when medication or other treatments hadn't worked. There is generally pressure on clinicians in the healthcare system to diagnose. Mental health treatment is still heavily medicalised, and this lends itself to a diagnostic approach.

Things are improving slowly, it seems. It is just such a shame so many people have felt let down by mental health services.
Are you aware of Joel Paris’s work, he is rather popular with Nice/ the NHS probably because his views are congruent with neo-liberalism. He feels that PDs can be diagnosed based on how the clinic feels about their patient/ ‘counter transference’, he also reports that the diagnosis can be made based on one interaction/ appointment.

It’s not a feeling, people are being let down by mental health services.

Sorry if I am coming across in an antagonistic/ rude way- it’s not personally directed at you at all.
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Nerol
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(Original post by Cancelled Alice)
Are you aware of Joel Paris’s work, he is rather popular with Nice/ the NHS probably because his views are congruent with neo-liberalism. He feels that PDs can be diagnosed based on how the clinic feels about their patient/ ‘counter transference’, he also reports that the diagnosis can be made based on one interaction/ appointment.

It’s not a feeling, people are being let down by mental health services.

Sorry if I am coming across in an antagonistic/ rude way- it’s not personally directed at you at all.
I think I have read at least one of his papers about reluctance to diagnose BPD.

You are not coming across as rude at all, I think you are absolutely right. A lot more money, time and work needs putting into mental health services as a whole. They are stretched thin and things do start to slip when clinicians start to look for quicker ways to do things.

The point about counter-transference is interesting. I've started working within a psychology team in a homeless outreach team that resides within a drug and alcohol service. One of the sections on our referral form is about counter-transference and the recovery workers' view of, feelings towards and relationship with the clients they are referring. I think it is an aspect that is largely overlooked in many services.

You were also right to point out my misuse of the word "felt". People are being let down. Seeing it happen is what made me want to go into this career in the first place. We need to do better.
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