Katiera Sordjan | A hypochondriac mind

The Melting Pot | We are just as guilty of over-diagnosing mental illness as we are of overlooking it entirely

By Katiera Sordjan 04/28/15 12:52am

The story is becoming all too familiar. A student struggles with symptoms of anxiety and restlessness because of academic and personal stress. They make an appointment at Counseling and Psychological Services or a local clinic, only to be told that they most likely have a much more serious, underlying mood condition, like bipolar disorder or major depression. The student is subsequently handed a prescription and sent on their merry way.

However, the student has never had the basic mood issues of these disorders and displays symptoms that so far can only be considered acute and episodic.

The change in tone about mental health on campus has been apparent. Previously silent students are sharing their stories and experiences with others, in the hopes that as a community we can move towards addressing the issue in a more productive and healthy manner.

But as we think about the widespread problem of not recognizing mental illness, we may also need to consider the implications of jumping immediately to the conclusion of disorder.

Diagnosing illness is by no means an easy task. This is one reason why the medical profession is so demanding and esteemed. Many diseases have overlapping symptoms, and often, problems have to be ruled out before it can be definitively said what the patient is suffering from. Get it wrong, and doctors can expect hefty lawsuits, hence why practitioners maintain a malpractice insurance policy should they be sued.

In mental health, the debate over proper diagnosis can have serious implications for the population involved. For example, the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders now extends bipolar disorder to children, even though the onset is commonly understood to occur during the teen years and early 20s.

We risk not only completely polarizing the discussion of illness and health, but also undermining its severity. Today, either everyone has a disorder, or no one does.

When it comes to pharmaceuticals, the stakes are high as far as identifying proper treatment. Adjusting to psychiatric medication can be difficult at best. Headaches, tinnitus, appetite changes and sleep disturbances are just some of these side effects. For someone without the illness that the medication is supposed to treat, adverse effects can persist without the emerging benefits that an ill patient will experience.

Perhaps the most infamous case of misdiagnosis is the Rosenhan experiment, where Dr. David Rosenhan and seven other associates visited various American psychiatric hospitals in 1973 pretending that they were hearing a voice. As soon as they were admitted, they reported that they no longer had the hallucinations and continued behaving as normal. Yet, they were all treated as schizophrenic patients “in remission” except for one. To further prove this point, a research hospital aware of the study picked out patients as being actors from Rosenhan, when he never actually sent anyone there.

Even worse, our current healthcare policies ensure that mental health treatment remains problematic. There is little incentive for insurance companies to prioritize long-term care for chronic illnesses over immediate and invasive treatments. It is cheaper to pay a psychiatrist 10 minutes for a consult and medication than for an hour-long therapy session. The 2008 Mental Health Parity Act mandates that insurance companies must treat mental and physical health care equally, but not that all companies have to provide coverage.

At Penn, if you are referred out of CAPS, as I was after my first year, you can expect to either pay a hefty out-of-pocket bill or search for a doctor that both fits your needs and takes your insurance.

The medical care I received while I was away is what enabled me to return to school. But on the surface, it could certainly seem problematic. For months I was walking into the doctor’s office and returning 10 minutes later with a prescription for a new, mind-altering medication, with my own research and knowledge having to fill in the blanks during this trial-and-error period.

Healthcare requires a holistic approach, and mental wellness is no different. Medication is enormously beneficial, but is only one aspect of treating people. Seeing mental health solely through the lens of illness not only leads to overtreatment, but leaves no room for preventative care and overall well-being.

KATIERA SORDJAN is a College junior from New York studying communication. Her email address is skati@sas.upenn.edu. “The Melting Pot” appears every other Tuesday.

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