Monday, 20 February 2017

MH Monday: Should mental illnesses be labelled?

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Should mental illnesses have a label? Ie should 'depression' be labelled as 'depression', or should a patient be labelled as 'schizophrenic'?

This isn't really something I ever thought about until recently, when my psychologist housemates came home from a lecture discussing it a few days ago. For me, I just accepted that I had a label of 'depression' and that was the illness I was being treated for.

The argument is that giving someone a mental illness label may do more harm for them than good. Giving someone a label may instantly stigmatise them for a collection of behaviours and symptoms that they are experiencing, and that doctors have decided should be given a certain label. Public perception of illnesses like schizophrenia is generally negative, and it could actually worry the patient  and their family more if they are given a diagnosis such as this. The psychological labelling theory suggests that the patient is given a new identity, and it may take them a long time to come to terms with this (during which time the patient could become more unwell).

Psychiatric labels are also fluid and may change as time goes on. For example, someone may present with low mood and be labelled as having 'depression'. Later on, they develop symptoms of mania, and their diagnosis will change to 'bipolar disorder'. This change in label could be very distressing for the patient, as they are having to come to terms with a new diagnosis and a new stereotype and stigma around that diagnosis, as well as a completely new management plan.

Personally, when I was given my diagnosis of depression I actually felt relief. For years I had felt really low in mood and could not stop crying, and when I was given a label it all started to make sense. I was able to see that it was an illness, and not my fault. I was able to focus on the treatments that would make me feel better, and I felt like I just understood myself more. I also think it was a bit of a relief for my family, as they too were able to understand why I had been feeling so awful, and there was a light at the end of the tunnel through therapy and medication.

I also think that, from a doctor's point of view, labelling an illness makes it easier to treat. For example, when someone is given a diagnosis of depression, you know what you are working with and which anti-depressant to give them, as well as which therapy to refer them to. It also is easier to handover to colleagues, as the label can be stated, rather than having to run through the patient's symptoms and long history, which takes a lot of time that doctors don't often have. All physical illnesses have labels (eg breast cancer, leg fracture), so why shouldn't mental illnesses?

However, I also think that the diagnosis of depression or anxiety is very different to the labelling of a psychotic illness such as schizophrenia. Depression and anxiety are much more common and therefore seem to be more understood and accepted, especially in recent years, whereas schizophrenia still has a certain stigma around it. I think it would therefore be much harder to accept a diagnosis of schizophrenia than it would depression.

I guess my view is that the patient should decide. They should be given the option of whether they would like their mental illness to be labelled or not, and if they would like to know the doctor's opinion of what they are suffering from.

Whether someone is given a label or not, all mental illnesses are valid and should be treated with the same respect as a physical illness. Sometimes patients don't want to be told that they have cancer, and perhaps psychiatric patients should be given this choice too. Just something to think about, medic friends...
Some people are old at 18 and some are young at 90... time is a concept that humans created.
                      - Yoko Ono

1 comment:

  1. I think they should be labelled. That's part of the medical process. Would clinically obese people also be offended if a medical professional told them they're overweight? We should works towards erasing stigmas, not further deepening them, or staying in status quo.
    I think that people who gather courage to visit a doctor expect to be told the diagnosis. And those who come with unexplained symptoms that the doctor links to a psychical condition should also be relieved that there is an explanation, in my opinion.