You’re Not Broken, You’re Human The Over Diagnosis Trap

You’re Not Broken, You’re Human The Over Diagnosis Trap

Julia Swartz, MSW, LICSW

Integrative Guidance, LLC

Pendulums always seem to swing. When I was in graduate school we were

encouraged to “Say you’re a social worker!”. There was so much stigma attached to the profession, largely due to a lack of understanding as to what exactly clinical social

workers did (way more than work for Child Protective Services) and mental health in

general. While this stigma still does exist, and many of the folks I work with report

shame and concern about the misperceptions in mental health and mental illness, what

is more often observed is the pathologizing of our humanness.

Today, the pendulum has swung again, way to the extreme of the opposite reaction.

Too often the folks I work with are mis-labeling and self-diagnosing their normal, typical, human responses as pathology. “I’m so depressed!” as a response to a death.

Grieving is normal and necessary. Can grief lead to depression? Yes. If ignored, not

processed, not honored or due to an underlying condition, long term grief can lead to

depression. This is just one example of many that appear to be driven the oversharing

in social media. While the initial goal was likely to normalize that many folks deal with

mental health issues, it appears to have caused much misunderstanding, pathologizing

and mischaracterizing typical, human responses.

This will be the first of a three-part series. The goal is to remind us that we are complex

and unique beings. We all need to give ourselves some grace as we navigate the

Human Condition and Life School. The objective is to clearly define some of the most

misused terms, their clinical definitions and allow for some self-care, self-understanding

and grace for our wonderful, unique and gifted humanity.

“You’re triggering me!” This is the most over and misused term. A “trigger” comes out

of the trauma literature as a precursor to a recovered memory, panic response or

extreme emotional experience such as a motor vehicle accident, war, severe abuse,

unexpected tragic death or life changing experience. According to the DSM-5 criteria,

there are nine categories and multiple subcategories to meet clinical criteria for the

diagnosis for PTSD. Trauma is real and deserves the attention and care needed to live

with, cope and manage.

When we have an emotional response to something someone does or says, this is not a

trigger. We are going to have responses to the environment around us. This is to be

expected. If someone has a different opinion, is rude, dismisses our thoughts or

feelings and we respond emotionally, then our mind, body and spirit are working.

Whatever created us (cells in a Petrie dish or some divine creative force or combination

thereof) baked into our DNA a range of emotions from the depths of despair to height of joy and everything in between. We are supposed to feel, react and respond. How we choose to navigate that is up to us. The definition of coping is to notice and identify our feelings, sit with them, let them and then let them out. Feelings are important and not to be ignored. The neurobiology of anger, for example, lasts 90 seconds. Experiencing anger longer than that is a choice. We decide how to process that anger. Do we have an effective communication, set limits, state our expectations or do we hold on, re-tellthe story, justify our indignation? It is not up to others to treat us fairly, behave morally or be empathic. It is up to us to define the terms of our relationships. So perhaps, the next time you feel upset by the behavior of others, you might try the Effective Communication technique of the “I message”. When you…..I

feel….because…For example, “When you are chronically late, I feel like you don’t

respect my time because I made an effort to be here on time.” How might the other

person respond as opposed to “You’re late! You’re so triggering!”

It is essential for us to differentiate between normal human emotions and mental health disorders. Misunderstandings, often fueled by social media, can lead to the mislabeling of typical human experiences as pathology. By recognizing and respecting these natural emotions, we can reduce stigma and promote a healthier understanding of mental health. Let embrace our quirky, lovely, sometimes messy humanness with

grace, forgiveness of ourselves and some humility.