I don’t like labels. I’m constantly telling my patients that it’s not about their diagnosis, it’s about their recovery, yet I find myself trying to label myself all the time.

Labels serve a purpose. As humans, we tend to categorize the things around us to help in our understanding of the world and its processes. If I described something as “that living thing that hides in a tree,” you may not know to what I’m referring unless I provide a category – Animal? Plant?

The intended purpose of a diagnosis is to help clinicians identify a grouping of symptoms. Labels get dangerous when people misuse, overuse, or make assumptions regarding a diagnosis.

You see misuse all the time. “I’m so bipolar today!”

Shut the fuck up; no you aren’t. You’re moody and perpetuating the stigma of mental illness. Honestly if one could be bipolar for only 24 hours…

Overuse is just as bad. “I have bipolar manic depression.”

…No you don’t. Manic depression, as a classification, no longer exists. The correct term is “bipolar disorder.” The danger of over-using these terms is the stigma that follows along with it. Why are we over diagnosing ourselves? Isn’t being on the multi-axial system ENOUGH?! /rantoff

The reason for all of this is a recent quest I went on. You see, I’ve been studying the new DSM-5 (I’m a tad nerdy) and stumbled across something called “excoriation disorder.” Now, under DSM-IV-TR, excoriation seems to be a symptom of OCD: dermatillomania.

Why is any of this important? Because I’ve been doing this for years and didn’t know it was a fucking disorder. I didn’t think it was a problem.

Granted, my mother thought it was disgusting that I’d “picked at my nails” so much that I’d permanently damaged my nail beds, causing my nails to grow short, brittle, and very misshapen. I just thought it was a bad habit to pull my cuticles until they bleed (and sometimes after they do). I thought it was just anxiety for me to take sharp objects (safety pins, push pins) and use them to pull the nail away from the nail bed.

It’s just something I’ve done for a while. It just got worse when I started working full time.

So I spoke to my psychiatrist about my symptoms; I tried not diagnosing myself, but I know me and I know the DSM. My doctor gave me some meds for impulse control/OCD.

I painted my nails tonight; maybe if I don’t see the beds, I won’t pick at them so much.

Sometimes it’s nice to put a name to the bully that’s been shoving your face in the dirt for 20 years. Knowing your bully’s name is only a part of it – you need to know how to fight them; that comes through education, support, and inner strength.


One thought on “A sweet girl – POSSIBLE TRIGGER

  1. I always tell people to focus on symptoms and what to do about them. Diagnoses change over time as you note, and they don’t direct treatment nearly as much as people usually assume. And clearly, badly, widely, diagnoses get overused and misused all the time. Strong post!


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