The Name Game – Do Mental Health Labels Really Help?

I’ve been having trouble lately labeling my current state of mind. Do I still have depression? Is this PTSD? Do I actually have a disorder at all? How will I know when I am healed, and my issues are no longer a disorder, but just life?

I keep thinking and writing as if I had depression. I had PTSD. Past tense. But is this true?

I am not going into DSM-IV criteria here, that’s not my point. (Yes, I do occasionally have a point) I’m trying to reconcile how I feel now, compared to how I used to feel when a psychiatrist so easily put many many labels on me. I was eager to accept any label attached to me at one point, because a label meant someone knew what was wrong with me, and therefore would know how to help me.

When the first psych told me I was “homesick” my first year of college, and that Prozac would help, that he sees it all the time with freshman so far from home. Of course he did not know I had just left an abusive home, and my suffering came from the fact that even though I escaped it, and physically left, I was still me, and still miserable no matter where I was. I thought leaving home was all I needed.

The Prozac did not help, so they prescribed talk therapy and advil too. The campus therapist was an egotistical A-hole that told me I was not suffering as much as I said. He told me I was struggling with my new responsibilities as a young adult. I was looking for attention and constant thoughts of throwing myself off the bridge, my long lonely walks along the river while it called out to me, the times I climbed the fence and just stood there wondering what the cold water would feel like as it hit my face and filled my lungs – those were nothing, inconsequential fleeting thoughts of a girl afraid to work hard for the first time in her life. Even through my pain, I wanted to punch that man. But I did not want to give up and go home, so soon after escaping, and so I went to this A-hole twice a week as a condition to remain in school.

My family doctor listened to me, and told me I was severely stressed and depressed. This doctor had treated my stomach ulcer at age 16, my bout of Mono when I was 15, my exploding ovarian cyst when I was 17, my chronic bronchitis since I was 10. He knew me. He also knew my brother had schizophrenia. This doctor switched me to Zoloft (which did not make me so sleepy as Prozac) and recommended a therapist. Problem was, I was still on my dad’s insurance, and he did not believe in psychobabble, or that I needed to waste any more of his money. The therapist was $125 an hour without insurance. I could not go, and so I returned to the free therapy on campus, but requested a new A-hole. They gave me a very sweet, but very dumb middle-aged woman. But I can handle dumb, I was used to tolerating dumb, as dumb was all around me. (I will have to describe my very first therapist in another post, as she was not dumb or an A-hole, but entirely useless in so many other ways – mainly because I was not ready for her at age 16. She wanted me to deal with things that I can only now begin to understand)

Are you getting that I was angry? Frustrated? Worn out? It seemed the entire adult world, the world I had been so anxious to join, was full of people I could not respect, and could not help me.

Fast forward a few years, after the stress and depression caused a complete breakdown and I lost my first job. More doctors, more labels, more meds, more experiments, more therapy. One psych doc actually tried me on so many meds that it caused hallucinations. Depakote, lithium, klonipin, ativan, indural, and I don’t what else. Every time I tried to explain my thoughts to him, he would prescribe something else. One day I was kept waiting for an hour for my scheduled appt, in a waiting room full of “crazies” (so sorry, I hated the other patients then and KNEW I did not belong there with them. I had to believe that to keep going) and my anxiety was so high I was dizzy and sweating, and in walks Dr with his golf clubs, and super tan, and I hated him. I wanted to leave right then, but hubby got me through the last meeting without punching him, thankfully, or I probably would have gotten a straight jacket with some new meds. I had a pile of unfilled scripts in my purse, as I knew it just wasn’t right. I did not go to Med school, but I knew my body was not being helped by so many meds and changes and side effects and withdrawals. I weaned myself off of everything (not recommended – do not do this on your own, it was stupid and dangerous and painful), and never went back to that psych doc.

But sadly, I went to a deep dark place, and my couch. I stayed there for quite some time – dreaming of and planning my death. The only thing that made me feel better about myself and my world was the thought of leaving it.

So 5 years into my freedom from home, 5 years of “treatment” for homesickness, depression, anxiety, social anxiety, OCD, bipolar, and probably a few more, and still no answers. I lost hope, as little as what I had left, and nearly lost my life at my own hands. It was years later, my therapist finally saw me as PTSD, and began treatment for that. I was no longer “crazy”, just hurting, and recovering.

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28 thoughts on “The Name Game – Do Mental Health Labels Really Help?

  1. I am getting so frustrated with my new computer and the touchy keys!! I had a whole response written and it just went *poof*…MIA. damn it. Ok, I’ll try to recap.

    Labels are just that. One is not their label. A label (diagnosis) is very subjective and is based on a snapshot of one at that moment in time plus a bit of history…whatever may be revealed in the assessment process. Diagnoses can be amended or changed all together as one goes through the therapeutic process. One may go to three different docs or therapists and get three different labels. This is all stuff I learned last night in my Social Work Practice with Individuals class. We’re discussing assessment and diagnosis.

    Anyway, I have been labeled with Bipolar II, Bipolar NOS, Major Depressive Disorder, and Mild, Recurring Depression with Anxiety. One therapist tried to slap a Borderline Personality Disorder label on me. I refused that one. All these labels may have been and probably were accurate at that point in my life with what I was presenting. I do have traits or symptoms at times now but overall have been the most stable and healthy these past months than in all my years so too wonder if I still am what that label represents. I think it goes back to the process that was discussed after your last post. The peeling away of damaged ‘diseased’ layers and the rebuilding of healthy layers (I love that thought!). Recovery!! I like this definition of recovery that I read yesterday. “Recovery is a more than just remission of symptoms or getting “back to normal.” True recovery is a holistic journey to a healthy, more satisfying life. And the person traveling toward recovery is in the driver’s seat, deciding what that destination looks like and enlisting the necessary professionals to help get there.”~U.S. Substance Abuse & Mental Health Services Administration (SAMSHA) So I believe I will be”in recovery for the rest of my life since I’m on the journey to a healthy, more satisfying life. I AM more satisfied and content. I don’t feel the need to change and be more improved all the time like most of my life. I fit now.

    Thank you for sharing your story. I truly am grateful for having been directed to your blog. You give me lots of food for thought.

    • Not just you, I have had many lovely replies poof away. I have started copying my long ones before I go up to scroll, because it is so hard to rewrite those words. I LOVE that view of recovery. That fits with me. It seems the labels, or diagnoses can be as fleeting as our current thoughts. Hmm.

      • I have been a Cognitive/Behavioral clinician for over 3 decades. What I’ve learned working with patients for all this time, is, just shut up and listen. Everyone has a profound need/desire for survival. My role as a facilitator for change, is to remind people that they have the capacity to take the best possible care of themselves. A good clinician will not get their own belief system and needs into the therapeutic relationship and assume what’s best for their patients. Now that said, I’ve seen the work of some very, very effective clinicians. Therapists who have a great enough sense of their own autonomy to be on a journey with someone in a mature and honest way, but always, knowing that the last word must always be in the direction that the clients sees is best for them.

  2. “in walks Dr with his golf clubs, and super tan” I think there is something really wrong with that picture.It shows no empathy or regard for the patients, no sense of decorum or respect. I’m not saying that he should have turned up with a “funeral face”, but it almost looks that he was rubbing in everyone’s faces what a great life he had (at his patients’s expense). Not very tactful at all. No wonder you never went back to him.
    I’m not sure that labels help, mainly because they make the person the source of the problem when in a lot of cases they’re not: they have been injured by somebody else, but the injurer walks away without a label (in the best of cases they get named abuser but even then their mental health is not questioned). They don’t label people who get run over by a car so I don’t see why they have to label people who have been “run over” emotionally by an abuser. Why the medical profession can’t acknowledge that when it is becoming so obvious from the increasing body of evidence is beyond me

    • Yes that Dr had no tact at all. He was difficult to talk to, and seemed condescending to me. And it seems he was willing to use my reaction to pills to make a diagnoses, rather than try listening to me. My brother has a thoughtful psychiatrist managing his schizophrenia, so I know those types of docs do exist, so people should not give up, frustrating as it is to switch doctors.

      I do think we need a label as a starting point, but not to define who we are, so your example of the car makes sense to me. I guess I just struggle because I seem to fit so many diagnoses, and the treatments are so different. I don’t envy the psych docs and therapists trying to get a whole picture of our symptoms.

  3. I’m still fairly “young” in my recovery process so I am still at the stage that having a label makes me feel more comfortable. Like you said, if we know WHAT it is we should be able to fix it. I do agree that the label is only as good as what the product inside tells about itself on any given day 🙂 . I to am glad I found your blog. It really makes me think deep about issues that otherwise would stay buried. Now if I could just express those thoughts to my therapist….slowly, I’m getting there.

    • I guess maybe these labels need a spectrum, like I used to have debilitating PTSD, I was unable to function in any healthy capacity. I now work, get out of bed everyday, only have occasional flashbacks and setbacks. So much has improved, so I don’t know if the label has changed, or just the severity. I’m so glad you found my blog too. The discussions here are so helpful to me, and seem to be helpful to others as we are all in different places in our recovery path. Keep being patient with yourself and I’m sure you will get there.

  4. I have seen many therapists and like you, some were better than others. I’ve been diagnosed PTSD, Major depression, dissociative disorder, anxiety and, the one I hated the most, dysthymic (spell check, please!) disorder, which meant constant depression without an end (or something). I accept the labels of Major Depressive Disorder and anxiety because I do believe I have a chemical imbalance from childhood trauma that responds to SSRI’s but the rest I don’t think is helpful.

    I read in your words such a wise intelligent woman. You are really on the right path to healing — proof being that you don’t need a label anymore. Stay strong! –Daylily

    p.s. Many of my replies have also vanished into thin air. I hope WP fixes that glitch soon!

    • Our symptoms are so complicated, and at least for me, constantly changing, so it must be so hard to give one name for what makes us suffer. I guess that is another reason I no longer feel “depression” applies to me, because SSRI’s used to help, and now have no effect. I am hopeful that I have healed that system and can move on to others.

      Thank you for your kind words! I think I am headed in the right direction now. Sometimes I get spun around and lose my way, sometimes even go backwards a bit, but if I compare me now to me 2 years ago, they don’t seem like the same person.

  5. Kara said: “They don’t label people who get run over by a car so I don’t see why they have to label people who have been “run over” emotionally by an abuser.”

    YES!

    My first label was schizophrenia. That was in 1967, when nearly everybody who was mentally ill in some way was given that label. Since then I’ve been told by numerous doctors and therapists that I never could have been schizophrenic… but I don’t know if I completely agree with that. If schizophrenia means having a broken mind, then that definitely describes what I was like at the age of 14. My mind was badly broken by severe abuses and overwhelming trauma.

    I, too, have been given a wide assortment of crazy labels over the years. Bipolar of various types, severe depression with generalized anxiety, PTSD, and finally Complex PTSD.

    For me, Complex PTSD makes the most sense. But it really all boils down to having been run over emotionally and left broken.

    • My brother had a nervous breakdown in his late twenties and was also diagnosed with schizophrenia. I don’t believe that he is schizophrenic, he was in a lose/lose situation and his brain short-circuited. Margaret Mead’s husband (Gregory Bateson) had a theory about this (see Double Bind article on wikipedia). Having seen close up what happened to my brother I think Mr. Bateson was on the right track, but unfortunately his theory was never followed up by researchers.

      • Thanks for the link, very interesting. Yes, our house was very confusing, messages inconsistent with actions. Children were used to brag about to friends, but then ignored at home. We knew they like our achievements, but never sure they liked us, certainly not loved us. When you can’t trust the people you are supposed to trust more than all others, your brain does, I think, short circuit and get rewired for survival.

    • A good point here, is how the labels themselves change over the years. They used to call every mental illness hysterics. We have come a long way in understanding and treating mental issues, but still have such a long way to go.

      I guess some of the problem here is the stigma attached. I have discussed openly when I have the flu, or that I had a cyst removed from my ovary – no shame there. But very few people know I have mental issues (shhh). We have had to protect my brother from the negativity associated with his label of schizophrenia. So many people still assume he must be violent, or unable to have a conversation.

  6. Kara, that’s so sad about your brother. I have a brother who also short-circuited and was labeled schizophrenic. He has been far less fortunate than I have. After years of being forced to take toxic cocktails of heavy-duty brain chemistry altering psychotropic drugs, plus being subjected to 21 electric shock treatments, his once-brilliant mind has been permanently damaged. He is now 51 and very child-like. He is also extraordinarily sweet, thoughtful, and empathetic, which makes him by far my favorite sibling. He lives on social security disability, as he has never been able to hold down a job. His SSDI is not get enough to keep him alive, so my husband and I buy groceries for him every month.

    Of the 7 chldren our momster had, my brother and I were the two scapegoats. Me, for being the eldest daughter on whom she mirrored/projected all her disowned badness, and my brother for the unforgiveable sin of looking so much like our father, whom our mother hated.

    Why a woman who is in no way cut out to be a mother would have 7 children, used to really baffle me. We all were treated by her on a daily basis like we were nothing but a nuisances, so WHY keep having so many? In retrospect, I believe it was because she loved the attention she got from her when she was pregnant. Plus of course she needed a captive dependent audience for her narcissistic supply, drones for her Queendom.

    Gag.

    • My brother also has disability benefits, but lives with my mom because it is not enough to live alone. He has tried to work a few times, but it always ends badly, and the failure is so hard on him. He is also quite child-like. I know some other mothers that seem to have endless babies, possibly for attention, and I think also, to reduce the expectations on themselves, as in, you poor thing you should rest.

      It saddens me quicklt to think of the toxic cocktail my brother takes daily, but it does keep him symptoms under control most days. He can function as a human, having conversations, driving to the store and such, but he could never hold down a job. He has brief moments of clarity, surrounded by a fog of hallucinations.

      • Charity and RTB, I’m sorry about your brothers too. Interestingly my brother is also on benefits and has not worked for the last few years. Surely the fact that so many of us have this family pattern should be a massive clue to the medical profession.

  7. Oh, I almost forgot, I clicked on here today to leave a link for you, “RootstoBlossom,” to the best online descriptor I have found for Complex PTSD: http://www.ptsd.va.gov/professional/pages/complex-ptsd.asp

    The best book I’ve read on the topic is: TRAUMA AND RECOVERY, by Judith Lewis Herman, M.D., a Harvard Clinical Psychiatrist. She coined the term “Complex PTSD” in her landmark book. It is pithy, scholarly reading, but her ideas make so much sense of my own crazy life that I have read it several times,and will read it again. The ptsd va.gov professional page for Complex PTSD is taken largely from that book.

    • Thank you for the link. PTSD is definitely a part of it for me. I have also read Trauma and Recovery, and found it quite helpful. Strange I need a book to understand myself, but that’s how it is for survivors. Chapter 5 was especially helpful in allowing me to frame my responses and accept myself.

  8. Pingback: To therapists and treatment providers who have been in my life « Daily Life and My Avoidance

    • Thank you, yes, the judgments are what is so difficult. Some people hear a label and think the worst, or just don’t know what it means. I feel shame for assigning those mental health labels to myself, but I don’t for other medical issues.

  9. A label gave a name to the shadow warrior that I had fought since I was 15. It had a name. I could do research. I could fight back something with substance. I was fortunate that my counselor also put it on a sliding scale meaning that as I became healthier I would move closer to how other people reacted. Now I am doing research on PTSD. I am half way through the book and it all sounds very familiar to me. My counselor has taught me a lot. I also learned that I am much closer to healthy than I realized. My counselor now says that technically I don’t fit the label any more. However, I learned that PTSD like diabetes needs a certain maintenance level, I suspect for life. I believe that labels can be abused and used to hurt instead of help. I am fortunate in how I was treated by my counselors.

  10. I was not aware when I left the above link to the ptsd.va.gov. article on Complex PTSD that it had been drastically rewritten near the end of August and now says things that I completely disagree with. I’m sure the Harvard Psychiatrist, Judith Lewis Herman, MD, who coined the term “Complex PTSD,” would also disagree with the way the article at that link has been rewritten.

  11. Pingback: Identifying Complex Triggers in PTSD | Roots to Blossom

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