Labelmakers

People are becoming obsessed with labels.

Every day that I work in mental healthcare, this reality becomes more and more evident. People are coming through the door with a “self-diagnosis” that is more similar to amateur pop-psychology on TikTok than a diagnosable condition requiring medical treatment. 

I want to be clear. I am glad people are seeking help.

There was a time when having a therapist was either a luxury for celebrities or a stigmatized treatment that people didn't want to be caught participating in. We have come a long way since those days, and I am very glad for the awareness, the accessibility, and the attendance in therapy. People are definitely much more likely to seek help when they need it.

Unfortunately, a subsequent cost to increased awareness is increased misinformation. There are a large number of people, especially on social media, proclaiming to be experts. When mental illness became a more widely discussed topic online, people sought more help for anxiety and depression. I would consider that a net positive.

This has radically shifted lately. The new popular topic appears to be neurodevelopmental disorders. People are specifically seeking diagnoses of Attention Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder (ASD).

ADHD is an impairment in attention or self-regulation that is neurological in nature. It involves many brain regions and online has been characterized as a deficiency in dopamine, which is a chemical in our brains that tells us what is important and needs to be remembered and attended to. While this dopaminergic system is involved in ADHD, so is our serotonergic system (sleep/hunger/mood), cholinergic system (memory/attention/etc), noncholinergic system (inhibition), and noradrenergic system (mental arousal). In other words, attention in the human brain is extraordinarily complex and is misrepresented very often. Attention can also be impaired by an amazingly long list of things. Stress, anxiety, and depression all can have profound impacts on attention. It's okay to talk to your therapist about it, and I would encourage it.

ASD on the other hand is a combination of deficits in social communication and repetitive behaviors/restricted interests. This is developmental and is present through the whole lifespan. It typically includes delays in development and has very high rates of insomnia, epilepsy, and associated genetic disorders. The rates have gone from 1 in 151 children diagnosed to 1 in 32. The reasons for this increase are guessed at by lots of people, but a big part of this reality is that ASD was previously several different disorders (Aspergers's syndrome, pervasive development disorder, autism, Rett syndrome, and childhood disintegrative disorder) lumped into one category. The original diagnosis was Schizophrenic disorder of childhood. Here's the deal, everyone has to learn how to make friends and get along with other. It doesn’t always go well. And if you are having difficulties in your social relationships, that doesn't mean you have ASD. There can be a lot of reasons for that. 

These two are the new, and unfortunately popular, things to seek a diagnosis for among older teens and young 20-somethings. But adults in their 30s and 40s are showing up as well requesting psychological testing. 

Why choose unchangeable neurodevelopmental disorders to be diagnosed with? There are several possibilities. Some may argue that these folks want an excuse to not have to improve or change things about themselves. Others (myself included) would point towards bad information and misrepresentation online. 

I suspect this is the same developmental process that has existed forever: the search for identity in adolescence and young adulthood. People are trying to answer the age-old question, “Who am I?”

While part of me can be frustrated with wasted valuable resources in psychological testing (especially with 1 to 2 year waitlists, delaying help for children who need it), I do recognize that this is part of a normal phase of life, and I don’t want people to return to the old ways of not seeking help. But there is a problem with placing so much emphasis on one aspect of ourselves:

We are too complex for one label to define us.

It used to look different. Everybody probably remembers the Breakfast Club. The main characters each represented some kind of group: athletes, burnouts, nerds, popular girls, and outcasts. The theme of the movie: we just aren't that simple. 

While labels can be helpful in understanding patterns of symptoms, diagnosing, and determining the proper course of treatment in a medical and psychological world, they are not helpful in knowing the individual. Labels don't show us a person's potential. Labels don't provide strengths, weaknesses, limitations, or gifts. They are in and of themselves limiting.

You are not one thing; you are so many.

If you think about it, you are very unique. You have your family, your friends, your experiences, your position at work, your way of thinking, your memories, you dysfunctions, your gifts, and your confusions and knowledge. You are also more than those things.

The simple reality is that we are complex individuals with many parts, and the whole is greater than the sum of its parts. So be you, and don't let the labels of the world define you.

In that spirit, I will leave you with the words that ended that movie.

“We think you're crazy to make us write an essay telling you who we think we are. You see us as you want to see us - in the simplest terms, in the most convenient definitions. But what we found out is that each one of us is a brain, an athlete, a basket case, a princess, and a criminal. Does that answer your question?”

My name's Jason, and I'm an addict, an entrepreneur, a husband, a father, a professor, a hot wing lover, a reckless driver, a therapist, a researcher, a fan of rock 'n' roll and late 90's early 2000's rap. I'm a Buckeye fan. I'm a nerd. I'm a former college athlete. I'm also more than that, and so are you.