Diagnosis Creep

You may have noticed that there’s an upswing in people identifying with mental health diagnoses lately. Here’s my take on this, I think there are 4 reasons.

The first is what I’m going to call diagnosis creep. People are using clinical terms much more broadly than was intended in the past.

You’ll see this when people say “I’m so OCD” or “I’m so ADD”. Or when you watch a video that talks about “High Functioning Depression” or “High Functioning Anxiety”. But, for a clinical diagnosis, with PTSD, Depression or Anxiety, the diagnostic requirements say “The symptoms cause clinically significant distress or impairment in… functioning.” Many people can experience traits of these diagnostic labels, but often not meet formal criteria for them when professionally evaluated.

In the past terms like depression, anxiety, ADHD, and trauma were used to describe a small percent of the population- maybe less than 5%, and it included the most severe forms that impaired functioning. But now people are casually using them to describe a much broader segment, maybe 30+% of people.

It’s easy to see diagnosis creep with the label of narcissism. My colleague Nevin runs a marriage therapy clinic and says that 45% of couples who come in have been told by friends or YouTube videos that their partner is a “narcissist”. But, estimates for Clinical Narcissistic Personality disorder range from .5%-2% of the population.

Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.

Copyright Therapy in a Nutshell, LLC

[airi]

Such an important topic that isn’t touched on enough in a nuanced way by actual mental health professionals online. Great video!

[silvermoonuk]

Good video. I was dx with autism in 2009. I have noticed there's alot of people that sadly over diagnosed themselves with mental health conditions too easily these days. As we know, mental health disorders are real. I am happy that people are more aware about mental health issues. But I think it's important that we don't over diagnosed these conditions too easily. I'm glad we are more open in one way. Conditions like autism and adhd are real. But people can have traits of a condition, but it doesn't mean you have that condition. It is like conditions like depression/anxiety/autism/adhd, etc....are getting watered down, sadly. And I see some ppl using these conditions as a part of their identity or like a fashion statement. I have mental health issues myself. I understand that a diagnosis is important in some cases, especially if you need treatment, access to therapies, for insurance purposes, self acceptance, etc....but at the same time, we must be very careful not to quickly label ourselves to quickly at the same time. For me, I don't see my diagnosis of autism as my identity. Some ppl say autism is a superpower or a gift. But for me, it is definitely not a gift. I'm not ashamed with having mental health issues. But I definitely find it very difficult to live with autism.

[maddie]

The internet needs far more videos like this!

[geralldus]

While in therapy I was at first puzzled that the analyst studiously avoided giving any kind of diagnosis (label). I eventually realised there was a good reason for this, the patient will tend to identify with the diagnosis and thus adopting a passive attitude that can exclude change and growth.

[asetto]

Another incredible video. Love the professional, level-headed, "simmer down now" take that I think society really needs right now.

Also appreciate the shorter length of the video, which encourages me to click without having to put in too much of a commitment. That's very ADHD of me, I know, but not enough to reach clinically significant levels 😉

[dbencic]

My therapist couldn’t bill the health insurance unless she diagnosed me with something- I came to her as I needed support with grieving loss of a close friend to suicide. The therapist diagnosed me with depression. This in my opinion is another huge problem.

[CymruCreator]

having a diagnosis for ADHD has been incredibly helpful for me, because I've stopped expecting too much from myself, recognised that my strengths are in certain areas and that it's okay to seek help with the things I really struggle with. It's given me perspective that helps me understand that people aren't all assholes and that they just think and learn differently to how I do.

[PomForCalm]

Nowadays it feels like everybody is getting their doctorates in armchair psychology.

[skeptik-cixo]

I think it's important to distinguish between narcissistic personality DISORDER, and narcissistic personality STYLE (as referred to By Dr. Ramani Darvusula who is a renowned expert on narcissism). The latter might not be a disorder, in that the person who exhibits this personality style might not experience distress or inability to function; but the people in their lives most certainly do - my sister is 100% an abusive vulnerable narcissist. The reason she isn't clinically diagnosed is because she is in denial of her patterns of behavior, which are projecting, blaming others, and gaslighting. People who engage in these behaviors don't seek professional help, so they don't get diagnosed and they don't get treated. It's their victims who have to reckon with the destructive nature of being in a relationship with a vulnerable narcissist. It's a like "diagnosis by proxy, " if you will.

[Ginabina]

There's 2 sides..mental health issues run deep.. genetically and "environmentally" so if a parent has stuff and doesn't get help, the cycle continues. Then there's the self diagnosed who throw around the buzz words. Lol I think its talked about way more openly now, so we are seeing more. We took our daughter's phone away from summer 10th-11th and gave it back summer 11th-12th. The growth in her was ASTONISHING. She was not impressed by our power move.😂

[codyhld]

I am so glad you made this video. It is timely and brave to put yourself out there and advice not to listen to everyone on social is not qualified to diagnose mental health conditions. you point out that self labeling or labeling by non clinicians can be is so important that you probably are taking on these evaluations as truth.
Yes, I have been diagnosed as bipolar by 2 highly qualified psychiatrists. And it is so hard to suddenly hear so many people say they are bipolar. There are so many media figures, entertainers who all self label themselves as bipolar. It normalizes and trivializes this very real, difficult medical mental health condition. Thank you.

[marjamerryflower]

Thank you, Emma, this was gold. Yes, i spent too much time on YouTube. Two days ago i started an experiment. To bed at 22.00 and leaving my mobile phone in the living room. I slept well. And felt rested in the morning. I have more time to think a little before going to sleep. I prayed a little with more attention. During the day i was a little more aware of the consequences of my behaviour. I love your good way of talking about SKILLS. The skills I learned from you help me a lot to improve my life and the life of my dear ones. Let's build our mental and physical health skill after skill after skill

[farahb]

No one would ever put it this way better than this! Well said and informative. Thank you truly!

[eugenandreismaranda]

Some of the things said in this video should be shared by mass-media as public announcements!!

[angiecas]

Ok funny story.
I worked as a shift manager at a fast food joint. I had the night shift, so that meant most of my crew where tanagers. All of them were diagnosed with ADHD; all of them took adoral.
One day my general manager pulled me in and asked if I have considered getting an ADHD assessment. I said no. Apparently my crew started noticing how I’d sometime start and stop tasks, forget things or rapidly click my pen or tap my foot. They were convinced that I had ADHD…. I didn’t believe them and neither did my GM. But then we both watch the security cams. I definitely did all those things.
I still don’t have a diagnosis. I’m ok with not having one. It’s not imparting me. Especially now that I’m just a stay at home mom.

[VickiCataldo-gybn]

I find so much value from your YouTube channel. I have dug deep into my mental/emotional health issues via counseling and other resources. I am heartbroken by my youngest daughter's evaluation/judgment of me via her therapist who has assigned multiple diagnoses to me ( and to my
daughter ). This is very dangerous. I am very tuned in to my issues and shortcomings but to be "diagnosed" and labeled by someone who does not know me has been devastating. This therapist has also assigned many labels and diagnoses to my daughter, some accurate, some not. She is very heavily medicated. This has been heartbreaking. Thank you for what you do.

[ZPiiLe]

The internet told me I have adhd and I firmly believed I did so until I went to therapy to help me with adhd I self diagnosed
The therapist told me I have anxiety depression cycle and everything made since after it once I knew what’s wrong I identified the triggers and used the skills given by my therapist and it helped me not drastically but well enough to function day to day. Sometimes it’s the things you’re not aware of that makes it unbearable I always thought I’m just hopeless but now I understand my self more

[jeffreyzie]

As soon as I seen the title I knew I had to click. And im not mad I did. People need to hear this

[bleachelf]

Almost all my fiends claimed to have ADHD and, then after a few years decided they had autism as well. One uses it to empower herself, and every other uses it to disempower themselves.
According to the internet, I have these diagnoses too, and no, no, I do not. I’m simply human, and distraction can have a strong pull.

[redflag]

There's so much media out there a lot of it feels really good at polarizing people. People are stressed and there is so much information that it is confusing. I really just want to improve myself and be happy and help others to be happy. But that seems very hard when people seem so polarized in their ideas of what's best. In what's the right way to live and improve.