Diagnosis of Mental Health Conditions as an Art

Medication and diagnosis safety note

This page is for general education. It is not a diagnosis, medication review, prescription advice, crisis service, or substitute for care from a trained professional who can assess you directly. Reading or commenting here does not create a doctor-patient, therapist-client, or counsellor-client relationship. See the full website disclaimer.

Diagnosis needs a real assessment

Diagnosis can be clinically nuanced. It should consider symptoms, duration, impairment, risk, physical health, medication and substance effects, developmental history, culture, trauma, and what else could explain the experience. A webpage can help with questions, but it cannot make or exclude a diagnosis.

When to use urgent help

Use urgent medical or emergency help for overdose concerns, severe allergic reaction, seizures, chest pain, fainting, severe confusion, symptoms of serotonin syndrome, dangerous withdrawal symptoms, new mania or psychosis, severe agitation, or thoughts of harming yourself or someone else. In Ireland call 112 or 999, or go to the nearest Emergency Department. Outside Ireland, use your local emergency number.

Sources checked for this safety note

There are many factors that play a role in mental health conditions, which cannot all be covered by diagnostic manuals, recommendations and guidelines. In the end, much depends on personal observations, clinical experience, information on similar cases, and selecting what seems important.

Symptoms are largely subjective with few reference points. The diagnosis often depends on the focus and the diagnostic system one uses. Since the symptoms reported by patients are subjective it is difficult to operationalise them. There are different diagnostic manuals, such as the DSM-V and the ICD-10, which, while they agree on many things, do differ. Adding to this millions of pieces of potentially relevant information, variations in focus and even the patient’s partial lack of access to information about himself or herself, makes the application of a straight forward scientific approach difficult.

Since one usually does not know the exact probabilities, one has to compare observed patterns heuristically to compare up with a new theory or an insight that may apply to the specific case. Impressions from memory and (relatively) free associations play a role in the process, which is reminiscent of the artistic process.

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