The diagnosis of psychiatric disorders can be a complicated process for both patients and their therapists. The Diagnostic and Statistical Manual of Mental Disorders (DSM IV) is published by the American Psychiatric Association, and is the primary tool mental health professionals employ when assessing patients’ symptoms and determining an appropriate diagnosis and course of treatment.
The DSM uses a multidimensional approach to diagnosis so that other factors in a patient’s life that undoubtedly play a role in their mental health can also be examined, and a clearer picture of their problems and symptoms can emerge.
Overlapping Symptoms
There are several subtypes of mental disorders included in the DSM. There are, of course, personality disorders, such as Borderline Personality Disorder (BPD), Narcissistic Personality Disorder, and Avoidant Personality Disorder. There are also mood disorders, sexual disorders, sleep disorders, and anxiety disorders, just to name a few. Many disorders from different subtypes have overlapping symptoms that can make proper diagnosis tricky.
A symptom like depression, for instance, can merit a diagnosis all on its own if it appears to be the dominant problem. However, depression is also a symptom of several mood and personality disorders, and can be either the cause or the result of other problems.
People with personality disorders such as Borderline Personality Disorder can become depressed as a result of the problems their BPD symptoms cause. Likewise, someone with depression may have other problems resulting from the depression, such as insomnia or low appetite, each of which can also be symptoms of several other disorders.
Making an Accurate Diagnosis
In order to sort through the symptoms and causes of a person’s mental health issues, treatment professionals have to do the following, according to the multidimensional approach of the DSM:
- Determine the dominant symptoms
- Whether those symptoms have been pervasive for years
- How possible early developmental issues (such as Autism) factor into the picture
- Current health issues or diseases that may contribute to symptoms
- The stressors and day-to-day realities affecting the patient, such as a death in the family or loss of a job
- What their highest level of functioning is
Only when all of these factors have been assessed can an accurate diagnosis be made.
Diagnosing Personality Disorders
Ten percent to 15 percent of the population will suffer from a personality disorder. Of those, 67 percent will also have a co-occurring disorder, such as a mood or anxiety disorder. The most commonly diagnosed mental disorders, in fact, are not personality disorders, but anxiety and mood disorders.
Despite this, it is estimated that approximately 30 million Americans suffer from a personality disorder. The most commonly diagnosed personality disorders are Obsessive Compulsive Disorder, Avoidant Personality Disorder, and Schizoid Personality Disorder. Borderline Personality Disorder occurs in about 2 percent of the population.
While diagnosis can be a tricky process, the dominant symptoms of any given psychiatric disorder will generally be obvious enough to begin with to give mental health professionals a starting point. As patients continue to actively engage in therapy, further discoveries can be made regarding the causes, symptoms and manifestations of their illness, allowing for more precise diagnosis followed by appropriate treatment.
If you or someone you love is displaying signs of a mental health problem, seek professional assistance with diagnosis and treatment. Remember that the more forthcoming you are with your therapist about your symptoms, thought processes, and past experiences, the better chance you have of receiving a proper diagnosis and treatment.
