Living with a mental health diagnosis

This article focuses on mental health illnesses but much of it can be applied to a neurological or developmental diagnosis, such as autism, dyslexia or ADHD, which can be accompanied by similarly complicated feelings and stigma.

Being diagnosed with a mental illness as an adult can be particularly difficult. While many mental health (and neurodevelopmental) diagnoses are made in childhood, such as ADHD, eating disorders, depression or psychosis, if a mental illness goes unnoticed until adulthood, a diagnosis can be accompanied by plenty of contradictions.

A diagnosis can feel like a relief, explaining why you have struggled with relationships or work, and many of your life experiences may suddenly make sense, but it might also highlight the ways in which you have been misunderstood or neglected by people close to you.

Even if you suspected you were living with a mental illness for a while, having it confirmed by a healthcare professional can create a range of emotions. Diagnosis can also come with a lot of societal stigmas. This can mean big or frightening conversations with family or work that feel overwhelming. 

Did I do something wrong?

A diagnosis in adulthood can make you look back and wonder if you did something to 'cause' the mental illness. Close family members can blame themselves too. And it's human nature to want to understand why something has happened. But the truth is that everyone can be vulnerable to mental illness. You are not to blame.

In fact, 1 in 4 people experience a mental health problem in the UK each year (McManus, 2009) and, while a mental health problem doesn’t necessarily lead to a diagnosis, it is far more common than you’d think. External factors can also contribute to mental health difficulties, for example:

• Stressful events, such as traumatic events, conflict or loss and bereavement.
• Stressful life situations, such as unstable housing, sustained trauma in childhood, unemployment or poverty.
• Additional health problems, such as long-term physical health issues.

Other external causes of mental health problems can be complex societal issues, such as social exclusion or racism. Being part of a group that experiences systematic prejudice can lead to a higher risk of experiencing trauma, physical and mental health inequalities and social injustices. 

A snapshot of social inequality and poor mental health

LGBTIQ+ people are 2-3 times more likely than straight people to report a mental health problem (Journal of General Internal Medicine, 2015). 23% of Black or Black-British people experience a common mental health problem each week, compared to 17% of White-British people, (McManus, 2009). Gypsies and Travellers are twice as likely to be depressed, three times more likely to experience anxiety and six times more likely to die by suicide than the general population.

Overlapping or intersectional issues, such as the experience of the criminal justice system, homelessness or substance misuse, are also massive risk factors for mental health problems. 

It is essential to realise that these statistics do not show that minority groups are predisposed to mental health issues, rather societal prejudice and systematic racism cause mental health issues, alongside the overdiagnosis of BAME people.

Why does it take so long to get a diagnosis?

Psychiatry and psychology are relatively new medical practices. It could be that when you were a child, there wasn’t enough general knowledge about mental health conditions and professionals in your life (teachers, GPs etc.) didn’t know what signs to look out for. Children are also very good at adapting to the environment around them, so you might have decided (consciously or unconsciously) to adapt or hide your poor mental health because of stigma, or due to the fear that disclosing a mental illness could make your situation worse.

Sometimes, if your parents or carers also have mental health issues, this can normalise behaviours caused by a mental illness. It is only when you get older and connect with people outside of your family that you realise you’re living with a diagnosable condition.

While a lot of mental health difficulties start in childhood, not all of them do. Events can happen in adulthood that lead to mental health problems, or it could simply take a long time to acknowledge you are living with a diagnosable illness.

Will I be Sectioned?

The fear of being Sectioned or being ‘put on Section’ runs through so much of our popular culture, as does the stigma attached to it. From children’s animations to TV shows, to theatre and film. Being Sectioned is often used as a (lazy and problematic) creative device to indicate someone is dangerous, scary or in some way less-than or flawed. These fictional depictions of being Sectioned are just that: fictional. Like urgent in-patient care when we suffer physical health problems, being Sectioned is similar for our mental health. 

While I cannot give you an indication of whether you may need to be Sectioned in your life, I can give you some basic facts to cut through the stigma, fear and general nonsense: 

• Being Sectioned means being kept in hospital under the 1983 Mental Health Act if your own health or safety is at risk or if you are a risk to others.
• Being Sectioned is viewed as a last resort, you first need to be seen by a group of healthcare professionals. 
• While you can be stopped from leaving hospital care when you are under Section, you do have some rights. You are entitled to your Sectioning paperwork, you have the right to complain or appeal your Section, the right to have access to a telephone, and to receive advice from an IMHA (Independent Mental Health Advocate) who can explain how to be discharged and other rights-based advice.
• Once Sectioned, you are able to challenge the decision if you want to!
• You can be an in-patient at a hospital for mental health reasons and not be under Section.

This is a very brief look at being Sectioned. I have worked with many patients who have been Sectioned, before, during and after my work with them. Some are Sectioned for 72 hours, some for much longer. Many of these patients leave the hospital to go on and lead fulfilled, meaningful lives. Being Sectioned does not define you and neither does your diagnosis. More information can be found in this MIND PDF information sheet.

What if my diagnosis doesn’t feel right?

You might feel that a diagnosis doesn’t match your experience of the problem, or social stigma may make it hard to fully accept a diagnosis. It can take time to view your condition through medical terms, rather than as a lived experience. For some people a diagnosis can be comforting, providing a roadmap of how to manage their illness, while others can feel restricted by it.

5 tips to cope with a mental health diagnosis

1. Find clinical support you can trust

A trusted psychology or psychiatry professional can be very important. They can explain the medical jargon as well as be a trusted source of information. It can help to make a list of questions before a consultation or appointment, so you get the information you need. 

2. Find support groups and charities

Connecting with other people who have the same or similar diagnoses can be a massive help. Not only will they understand what you are going through, but they are likely to have plenty of tips and life-hacks to help.

3. Non-clinical support

Non-clinical self-care and distractions can help. Hobbies, such as yoga, walks in nature, or online gaming, all help. Likewise, making a crisis plan for when things get hard is a good idea. Include things like The Samaritans helpline, favourite pieces of music to listen to, or comfort films to watch.

4. Help people close to you to help

Communicate what you need (and don’t need) from those close to you. Don’t feel silly if you need to prepare a list or write things down; if it helps you communicate your needs then it is worth doing.

5. Discover what a diagnosis means to you

As I mentioned before, some people feel that a diagnosis is useful, even a relief. It can help them chart out a care plan based on evidence and with mental health professionals. To other people, a diagnosis can feel suffocating and they don’t want to define their experience by the DSM, (Diagnostic and Statistical Manual of Mental Disorders). Find a way to make it work for you. 

How do I move forward?

Many clients come to me wishing to explore what a diagnosis means to them. Dedicating some time in therapy to sort through these feelings can be massively helpful.

It's important to remember that there is life after a diagnosis. You have made it to adulthood in a world that is typically not designed to accommodate many mental illnesses or non-neurotypical people. This means you have struggled in a way other people have not had to. It shows how resourceful and resilient you are.

Hopefully, over time, a diagnosis can become something you use to become even more resourceful and create even more sophisticated tools to help you navigate the world around you.