Since the Spring of 2020, with the advent of the Coronavirus Pandemic, many have noticed an increase in their own feelings of depression, anxiety, and fear. Many individuals have reached out to therapists and counselors across the world to work on their mental health.
One of the “silver linings” of this whole pandemic is the normalization and destigmatization of therapy, along with the recognition of the necessity of taking care of your mental health. Reaching out for help has emerged as a regular and necessary part of life in the past year and a half, but for many, it can be difficult to know where to even start.
Approaches to Getting an Accurate Mental Health Diagnosis
To get an accurate mental health diagnosis, let me walk through a few different approaches that you might explore.
Primary CareA simple trip to the family doctor is one of the most common points of entry for individuals’ mental health journeys. While talking to a primary care physician, many individuals will first encounter questions about what they have been feeling lately, and sometimes the prospect of taking medication is first brought up.
Due to the nature of primary care, doctors don’t usually provide regular ongoing mental health check-ups (such as on a weekly to monthly basis), but many primary care providers may feel comfortable prescribing a common antidepressant or antianxiety medication.
They might diagnose with a vague sense of depression or anxiety and often would encourage you to see a specialist (psychiatrist/therapist/counselor) for a more specific diagnosis. Note, for many professionals the diagnosis is more about appeasing an insurance company than for clinical treatment, so there might not be much need/desire on the doctor’s part to tease out the more accurate mental health diagnosis.
Psychiatrists To stay within the field of physicians, a psychiatrist is a medical doctor with a specialization in mental health diagnoses. Psychiatrists are very well versed in the diagnostic criteria of the Diagnostic and Statistical Manual (DSM-5) in which all mental health disorders and diagnoses are outlined.
An advantage of seeing a psychiatrist is they will have a more in-depth knowledge of potential psychotropic medications in which to prescribe beyond the “common” ones that many primary care doctors are comfortable with. For many, the common medications will work fine, but when individuals are not responding to those, it can be helpful to see a specialist who has a greater understanding of how to utilize different, and combinations of, psychotropic medications.
Sometimes it can be also helpful to see a psychiatric nurse practitioner (ARNP) who can also prescribe medication. In some instances, this can be a slightly cheaper option, and in my professional career, I have always seen helpful ARNP’s who are just as good at navigating mental health issues with their patients.
However, with psychiatrists, the drawback can be reduced availability. The route to becoming a psychiatrist is exceptionally long, and as such, there are simply fewer out there than we need. Getting in can take a long time, which is another reason starting on medication with a primary care physician can be a good starting point.
Additionally, as they are so full and booked, many psychiatrists do not provide ongoing frequent therapy in the traditional sense. Further, if they do it’s often only thirty-minute sessions. (However, some psychiatrists do provide ongoing psychotherapy so feel free to inquire with whomever you reach out to!).
Therapists and Counselors
The final major area in which an accurate mental health diagnosis can be obtained is through working with a therapist and counselor. Let me first clarify some of the nomenclature around our profession, which can be a little confusing. In general, I use the terms “therapist” and “counselor” (as well as “therapy” and “counseling”) interchangeably.There are some instances where someone may have a title of counselor, such as in an inpatient setting, but only have a bachelor’s in psychology/sociology/something else related. However, “therapist” is usually reserved for a master’s or higher level of education. What is important to look for is that the individual is licensed to provide therapy/counseling.
Here in Washington State, there are three major categories of licensure for therapists: Licensed Mental Health Counselor (LMHC), Clinical Social Workers (CSW), and Licensed Marriage and Family Therapists (LMFT). Further, each of these has an “associate” level (LMHCA, CSWA, LMFTA) which denotes a clinician more recently out of graduate school and still under supervision.
Note, this is not necessarily a sign of “second rate” clinicians. In fact, seeing an associate can be great since they are getting a second set of eyes on your case and actively working with their supervisor to bring you even better care! Each of the three disciplines outlined here is more similar than different, but in general, Mental Health Counselors are well versed in individual counseling, Clinical Social Workers in helping individuals in their context and systems, and Marriage and Family Therapists are trained to help individuals in their family context.
Many see “Marriage and Family Therapist” and assume these clinicians only work with couples and families, but they are also trained to work with individuals. MFT’s might be better labeled as “systems” therapists, meaning that they are trained to work with individuals as a part of a system, as well as working with an entire family system all at once.
The advantage of working with a therapist is that you can receive ongoing treatment. Beyond just finding an accurate mental health diagnosis, therapists will help you to identify tools to process and cope with any issues you might have. This typically looks like an hour session once a week to start.
Personally, I usually see people weekly for a couple of months then move to biweekly for a bit, eventually phasing out with monthly check-ins. In the post-pandemic world, this can be either in-person or via a telehealth platform. As such, it is now easier than ever to find a clinician who has availability as you can now look outside your immediate geographic region!
The Importance of an Accurate Diagnosis
One final thought is the importance of identifying an accurate mental health diagnosis. Different clinicians and practitioners will have varying opinions on this, but for me, diagnoses are only as important as they are important for the individual. For many, diagnoses can feel stigmatizing and constricting. By having a diagnosis, many feel that they are confined by what that diagnosis says.
For that reason, I make it a point to use “people first” language. This means that rather than calling someone a “depressed person,” I would call them “a person with depression.” This highlights the importance of the person over the diagnosis and reminds them that they are more than their diagnosis.
On the other hand, many feel that having the words to describe what can feel amorphous and difficult provides clarity and freedom. By labeling their “funk” as “Major Depressive Disorder,” it might provide direction and purpose to be able to properly handle it. No longer is it a monster in the shadow, it’s something right in front of you that can be addressed and tackled.
Regardless of where you are at, if you have been reading this then likely you or someone you love has been wrestling with a mental health issue. Please do not hesitate to reach out to me or one of the other professionals at Seattle Christian Counseling. Reach out soon and begin your journey of finding healing and improving your mental health.
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