I often have clients that suffer from Post-Traumatic Stress Disorder after they receive a diagnosis. “I’m Bipolar? What? Wow! I must be worse than I thought.,” or “Borderline Personality Disorder? Oh geez. That just sounds terrible. There must be something really wrong with me if I have a Personality Disorder.” Thank you for that, society. Session one is often spent destigmatizing mental health and the various diagnoses. I often tell clients that this is just a way for health professionals to communicate your symptoms. It is your story that matters and every story is different. Your experience with Bipolar Disorder is very different than how client B is experiencing Bipolar Disorder. Mental health diagnoses are subjective. There is no blood test. It is based on the cluster of symptoms that the diagnostician put together, which is based on what you felt relevant to tell said diagnostician in that 1-2 hour period.
Let’s play a game. Client A comes in complaining of extreme stress for several months. She has a high stress job, recently got engaged, and has been juggling some financial hurdles. She often feels anxious, eager, and impatient. She had difficulty sleeping for a while but mostly just feels very tired. Her fiance teases her for going to bed so early and calls her an old lady. Work has not been very fulfilling. She continues to workout but less frequently and less intensely. Her regimen of healthy eating has often been disregarded. She has made less effort to go out with friends and would often rather crawl up on the couch with Netflix. However, she is in a great mood today, the first day of 70 degree weather in over 3 months. (Client A is purely fictional. Wink.).
Situational Depression? Stress? Mood Disorder NOS? PMS? Seasonal Affective Disorder? Sure. Maybe. Yes. Just depending on which you focus on, it could be any of those. It’s not really fair to tell clients, “Well, hmmmm, I don’t know,” or “It could be any one of these five things.” So we make our best assessment and treat accordingly. Usually the true troubles reveal themselves. Either way, we treat according to your symptoms: Continue stable diet, exercise, and sleep regimen, get outside, reconnect with friends even if disinterested, build mindfulness practices to help with anxiety. Maybe take medication. Maybe try an alternative approach like light therapy.
So maybe I have Seasonal Affective Disorder (SAD), or maybe I have PMS on the tail-end of a chaotic couple of months. Whatever you care to label it, the core components of healing are the same. I just may need to negotiate tropical vacations into my health and wellness budget every January.