Diagnosing mental illness with McMaster's Dr. Day
By: Palika Kohli
I recently had the opportunity to speak to McMaster’s own Dr. Day about the relevance and problems associated with labelling and diagnosing people with mental disorders. Dr. Day teaches Abnormal Psychology (amongst other psychology courses), and discussed the effect labelling has on students in particular.
Dr. Day introduces his Abnormal Psychology course every year with a precursor on the concept of diagnosing symptoms vs. diagnosing using an umbrella label. He discusses the problems associated with comorbidity (being diagnosed with more than one mental disorder) and professional specialization. He points to the impact medical school training has had regarding this issue.
“There is a biomedical bias from the start, which means [professionals are] looking for underlying reasons for symptomology, which of course may not exist at all. And they’re wedded to the DSM (Diagnostic and Statistical Manual of Mental Disorders) more than they ought to be… It’s like you have something, it’s a thing, like a diseased liver or kidney - which it’s not. It’s a set of symptoms. And I think that the whole problem of comorbidity in particular is that you can’t categorize that symptom. It is a whole person. It’s a real issue with the way we currently conceptualize mental illness.”
But there are some people that really need to know what, if anything, is wrong with them.
“There is a – or can be a – positive side to labelling. I’ve known a number of people or students who were relieved to hear the label being placed on their symptoms. Because now it seems like ‘Now I know what the problem is,’ instead of just a vague ‘I have a whole bunch of symptoms.’ Of course, it’s a two-edged sword. It does have some drawbacks, both for the professional treatment of the illness and for the everyday interaction the individual has with others who might know about the diagnostic label. But the label also helps them to give a name to their faceless adversary.”
What about celebrities? We learn all the time about different celebrities who suffer from different mental illness. Does it make it more acceptable for ‘regular people’ to be diagnosed with a mental disorder? And on the flip side, many celebrities use their diagnosis to explain away inappropriate behaviours, which perpetuates this same stereotype and increases the stigma associated with labelling.
“Yes, on the one hand, when people you know and admire and can even identify with (entertainment figures and so on) reveal that they have issues with this, it can make someone who has the same problems feel less isolated: ‘I’m not the only one.’ In fact, some very successful people have had to deal with these issues and apparently have dealt with them with some success, at least. But again, when you label it, you buy into the stereotype, too. ‘This is what bipolar disorder is like. This is what depression is like.’ But I will say in general, because there is has been much more attention paid in the media to various disorders, I think there is a growing acceptance on the part of many people, of mental disorder as something less than all-encompassing. And there is a greater willingness to seek professional help for these things.”
But there still is huge stigma associated with mental illness.
“There is great stigma associated with schizophrenia. People have a very dramatically distorted of what schizophrenia is and how it affects the individual. They think that’s a ‘real crazy’ person who is living in another world and doesn’t see people the way they are, and is dangerous… and nothing could be farther from the truth. But that’s the impression people have, because most people never come into contact with anyone (that they know of) that has more experience with schizophrenia.”
Why do you think stigma exists?
“I think the main reason is ignorance. People just don’t have enough contact or experience people who have these issues. We don’t really see them as people.”
