Dear Mesmerizing Meg: I’m embarrassed to say that I need to go over this on the internet with complete strangers, but I honestly don’t know what else to do. I recently just started getting help for severe mental health issues that I have had for my entire life. I’ve gone to therapy a few times over the years and always got some vague diagnosis like generalized anxiety or depression. But it always felt like something was missing or that I wasn’t explaining myself or being understood correctly. Because my symptoms change–sometimes I strongly relate to OCD symptoms and sometimes I don’t. I almost always have an extreme social phobia. But it never felt like my therapist “got” it. Last week, I was finally diagnosed with avoidant personality disorder, which gave way to social anxiety disorder, which gave way to OCD, all of which gave way to depression. For the first time ever, I felt understood and all these years of suffering and social isolation made sense. But now, I checked my patient portal and it only says I have OCD. And I again feel misunderstood and maybe cheated of that clarity. But the more I think about it, the more I worry that I only wanted that diagnosis for the sake of having the role of “sick person” or like I want attention or something. Maybe I am just lying to myself and all of this is just made up in my head. Is there a reason why a psychiatrist wouldn’t report a diagnosis? Am I crazy or attention seeking? Thank you for tolerating me.
Kind querent: You’re completely normal. I think, with the portal, psychiatrists often try to find one diagnosis that best encapsulates your symptoms. They list that as the primary diagnosis. I’m guessing your primary diagnosis is OCD. But this is all guesswork on my end. But, like, take me, for example. My diagnosis is schizoaffective disorder, bipolar type. This means I’m both schizophrenic and bipolar. That’s my official diagnosis, period, end of story. It even has its own code that you can use for disability paperwork.
But that diagnosis doesn’t take into account the fact that I also have PTSD, which I’ve never bothered to get diagnosed as having, because I know it’s there. That’s all I need, if that makes sense.
And it doesn’t take into account how dissociative I am. Nor does it take into account my obsessiveness (from OCD–I have obsessions but no compulsions).
So my theory is that doctors input one primary diagnosis, and they try to choose the one that best says it. This in no way, shape, or form invalidates any other diagnoses.
What you want is to have your feelings validated, and this is completely normal. We all love that “click” when we find a disorder or personality type online that we can totally relate to. Like, when I was in college, I read a book about highly sensitive people, and I was like, “Wow, the author gets me.” So don’t overthink whatever’s put in your health portal. Doctors are known for brevity.
I doubt you want to play the role of “sick person” as much as you just want to understand what’s going on inside your head. The beauty of diagnoses is that they gather together symptoms that many, many people share. It’s a type of normal, because it exists. For example, if you were the only avoidant person alive, then there wouldn’t be an avoidant personality disorder. These labels offer insight and understanding as to what makes us special and also to what connects us.
“I’m embarrassed to say that I need to go over this on the internet with complete strangers,” you said. Woo hoo!! Welcome to my blog!! ‘Cause that’s what we do here!