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  • Writer's pictureDr. Davis

Diagnosis: What's the Point?

Most first appointments are intake sessions, where you go over various symptoms you experience. After reviewing the material, your psychologist will have formulated a diagnosis that fits your symptoms in the current moment.

Why do we do this? Isn’t a diagnosis just a label? Does it really matter?

When you think about diagnosis in a doctor or nurses office, you know that figuring out your diagnosis is vital to providing you with the proper treatment. If you come in with a broken arm and your only treatment is an antibiotic, you’ll likely be confused. Antibiotics treat bacterial infections, not broken bones. If your doctor thinks you have a broken bone, they’ll likely use an x-ray to confirm it. After that they may send you to a specialist to either splint or cast the bone to ensure proper healing. Knowing your diagnosis leads to proper care, proper treatment, and faster healing.

The same can be said with anxiety disorders. Knowing your diagnosis will help us determine proper care and treatment, which will help you recover more quickly.

Let’s look at two disorders:

1) Panic Disorder with Agoraphobia

2) Specific Phobia: Elevators

Panic Disorder with Agoraphobia: indicates a person has had a panic attack (four or more symptoms of panic peaking in a 10 minute period) and they have a fear of having another panic attack in the future. Agoraphobia means fear of situations or spaces where escape might be difficult or where enduring the situation would be very challenging/distressing. Treatment of panic disorder involves getting people used to strong physical sensations, learning about the lack of danger in the sensations they’re feeling, and removing safety/avoidance behaviors when in the midst of panic.

Specific Phobia: involves an intense fear/worry about a specific object, item, or circumstance. In the case of fear of elevators a person would be afraid of elevators and either avoid them completely or endure riding an elevator with extreme difficulty. Treatment involves evaluating thoughts related to elevators, developing healthier and more logical cognition, and engaging in regular/repeated exposure to elevators.

This is where it gets tricky. Did you know that many people with Panic Disorder with Agoraphobia dislike elevators? The reason is that escape from an elevator is often difficult and enduring it may be embarrassing if they have a panic attack in an elevator. If a diagnostic interview isn’t done, a person with Panic Disorder may very well be treated for an elevator phobia. If you only treat the phobia as it relates to elevators you haven’t completed treatment. You may have decreased a person’s fear in elevators, but that doesn’t treat the overall Panic Disorder.

This is why diagnosis is valuable. It is not about labeling you so you’re stuck with a label for life. It’s about figuring out in this moment what symptom criteria meets your experience so we can treat it. Once the condition is treated we can reevaluate and see if the diagnosis fits any more. Often, after treatment, the label doesn’t fit anymore because through treatment you and your symptoms change.

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