The Positives and Negatives of Assigning ‘Labels’ to Mental Health

As a teenager, I found my doctor was hesitant to give my mental illness a name.

Perhaps he simply didn’t believe that it was serious enough to warrant a diagnosis. Maybe he felt that naming my condition could have increased the chances of reinforcing that condition in my mind. Perhaps he was reticent because of the stigmatizing impact of mental health labels. Recent research here in the UK found that 40% of those questioned said they wouldn’t disclose a mental health condition at work for fear that it would affect their employment prospects.

But the danger of not naming an illness is that we delegitimize it; not only through the eyes of those around us, but perhaps most importantly through our own.

Despite regularly seeking medical attention in the 20 years that followed, no amount of internal rationalizing stopped the incredulity I felt towards my mental health issues. In the end it took me two decades to change my thinking from “these are weaknesses that I should stop whinging to doctors about,” to “this is a chronic anxiety disorder that deserves serious attention.”

No doubt, the desire to avoid “pathologizing” my condition was a well-intentioned and perhaps, for some reading this, a refreshingly unusual approach. The charge I am more familiar with is that we can be too willing to treat issues of behaviors and moods experienced by young people as a medical problem.

But here I think we find something of a paradox. On the one hand, there is the argument that “medicalizing” mental health challenges is a sticking plaster solution that ignores the life circumstances, peer-pressures and socioeconomic factors that are causing it. Furthermore, behaviors that have the audacity to not fit societal “norms” risk becoming the target of a medical diagnosis, perhaps demonstrated most egregiously by the “treatment” of homosexuality as an “illness” as recently as the early 1970s.

But on the other hand, to what extent does a failure to label a mental health condition only worsen its combined impact with exacerbating life circumstances, especially when a diagnosis becomes a gateway to much-needed advice and support? And at what point does a negative “label,” prompting stigma and discrimination, become a positive “identity” which empowers us to self-advocate, increase our visibility and — in the case of mental health— seek our own solutions to the anguish we face?

When the “Mad Pride” movement began in the UK in the late 90s, its advocates claimed that it was about provocatively reclaiming a label, just as pioneers in the Gay Pride movement had trailblazed in the early 70s. For others, the comparison was fundamentally flawed. Yes, both communities face injustice and discrimination, but whereas the idea of being “treated” for being gay is in fact just a symptom of society’s prejudice and ignorance, there are undoubtedly millions of mentally ill people who would like nothing better than to be “cured.”

In my view, to simply disregard “Mad Pride” as a frivolous jolly that undermined the seriousness of mental health is to misunderstand it. I never went, but reading about it, Mad Pride seemed to be about increasing the visibility and celebrating the resilience of those behind a mental health diagnosis. It was about taking ownership of labels by repurposing them into identities, and using this as a springboard for self-advocacy.

Twenty years after I first went to a doctor, and as part of a course of cognitive behavioral therapy (CBT) therapy, I found a label for my condition: generalized anxiety disorder (GAD). Since then, this label has evolved into an identity.

For me, the importance of this isn’t just that it’s led me to seek treatments and interventions more proactively (though this may well be true). It’s that it has gifted me the belief that the reason I feel this way isn’t actually my fault; that it’s fine for my mental health issues to become “someone else’s problem” too; and that “no” — writing this article is not a “pathetic” act of melodramatic self-indulgence. In other words, my identity can be considered a positive one in that it has encouraged me to regard my mental health problems with the seriousness they deserve, which I believe in turn, has improved my mental health.

Self-diagnosis and misdiagnosis can carry equal risks as non-diagnosis. However, in my view, it is through patients and doctors working together to understand and take shared ownership of mental health problems that those who experience them can be empowered to both tackle them and, most importantly, acknowledge them for what they are.

You can follow me on Twitter @wsadlertweets.

In the UK, Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.