– by Lee Smith, Ph.D.

Spoiler alert: Psychiatric diagnosis is deeply problematic, in part because the cause of symptoms is difficult to find and to test for. But there’s more…

In a scene from the television series, Mad Men, which is about the people of a 1960’s Madison Avenue advertising company, a well-to-do woman shares with a shrug the upshot of her consultation with a psychiatrist, “I got my diagnosis: He says I’m bored”. There are more serious afflictions but the key here is the shrug.

Our affluent and safe society has the benefit of the best health care in the world. And yet we are more depressed and anxious than just about any other society. In Canada, after cardiovascular drugs, psychotherapeutic drugs are the most frequently dispensed, and depression and anxiety are the fourth and fifth most common reasons for physician visits.

Quite rightly, we consult a physician or a psychologist when we’re suffering psychological symptoms. We want to know what’s going on and to get help. And many people already have ideas about what to call their symptoms thanks to education from the media, including commercials.

For alot of people a diagnosis of depression or anxiety or ADHD becomes a completed step. But what has really been achieved?

Our brains love to name stuff and a name can feel like the same thing as an understanding. Even more, once we feel like we have an understanding, we tend to stop inquiring. And so, a psychiatric diagnosis can really become an illusion that we know and understand, just as so much of our thinking builds versions of our life that can be mistaken.

Consider this: In this sense of a diagnosis being a label and a concept, we might see that we ‘diagnose’ ourselves and others all the time. When we say “I’m bored”, “He’s an idiot”, “No one cares about me”, “I’m unhappy in my marriage”, we’re diagnosing. The problem again is just letting this concept or this label stand as if it’s adequate and complete.

The idea here is that when we obtain a diagnostic label, it activates this tendency of mind to embrace or get stuck on the label and to not look further.

Our reliance on medication and on diagnosis may lead to passivity and a degree of retreat from looking at our lives. We go to the doctor for something to make it better. The drug companies love it and it’s easier work for our doctors, but the evidence is that long-term resolution is infrequently achieved. We’re not a very happy culture. We’re the richest in the world but we’re suffering richly.

There is no adequate or equivalent substitute for paying honest and open attention to our lives. On receiving a diagnosis we may stop paying attention to the immediate and remote experiences that our mind and body have ingested or are ingesting still which could be a crucial part of our problem. We may stop paying attention, we may stop looking and knowing about our lives more deeply and how we are in relation to the things we’ve experienced. Our natural abilities to sort out our lives shut down if we don’t let our experiences ‘come on line’. Maybe sometimes that’s why we want some diagnosis, so that we can have the illusion of knowing and to then stop looking, and just shrug.

Being given a medication may have the same effect. It becomes about the drug working and how the drug is doing, and we go on vacation from ourselves.

So let’s say it again – we have to pay attention to our lives. And if we have children, we have to pay careful and honest attention to their lives, too.