The Diagnosis Trap
The Atlantic
|October 2022
Doctors have their stories to tell about mental illness. But what about the stories we tell ourselves?
Let me explain something about me: When I was 12, I started having panic attacks, brought on by fears that I couldn't shake, even though I knew they were irrational. I was terrified, for example, that I'd become depressed-but I'd never been depressed before, and didn't feel depressed. My junior high school devoted a series of assemblies to warning us budding teenagers that we were entering the most dangerous years of our lives, now ripe targets for cutting, suicide, eating disorders, overdoses, AIDS, and fatal car accidents. I would spend hours, even days, worrying that one of these things might be coming for me. My mind seemed to spin out of control couldn't stop fixating, I couldn't calm down, and I couldn't understand what was happening.
Finding language to describe suffering of any kind is hard, but eventually, fearing I was going irreversibly insane, I tried first for my mother, then for a doctor. Soon I was told there was a name for my particular distress: obsessive-compulsive disorder. Receiving this news at 13 was both relieving and shattering. (And surprising. There had been no assembly suggesting we watch out for anxiety disorders.) With the diagnosis came explanations and context for what I had not been able to interpret, as well as a body of scientific knowledge about treatment. Still, OCD can be an upsetting diagnosis, partly because according to current psychiatric understanding, it's a chronic illness. You don't typically get cured. You "learn to manage it" and, like most chronic conditions, it ebbs and flows based on a variety of factors. I felt horror at being indelibly marked and feared that I'd never get back to "my old self." Who was I now?
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