We didn't do as much writing as we wanted to for Mental Health Month, (which is now coming to a close) due to our Northeatern USA road trip. We won't make any more excuses than that, we write all the time, monthly, for coming close to two years now, about mental health, attempting to raise awareness for not only ours, but other diagnosed issues of people.
Four days left of mental health month, this is our last contribution using the blogging badge. (even though the entry is not even ours). Tomorrow we leave for roughly six days of camping in New York State and the state of Massachusetts, and we don't know when, or if, we'll have wireless/MiFi access adequate enough to blog with.
What's in a name, why do we need labels and diagnosis? There are many people who have asked about Frankie and viewed her through her diagnosis of DID. There are many people who have viewed my through my diagnosis of cancer, I guess since I am due to have more surgery for my cancer that my treatment is still ongoing. But what does it actually mean?
There are people who rail against their diagnosis, fighting it every step of the way. They see their diagnosis as an enemy to fight. That somehow being labelled by the medical profession is a bad thing. Certainly there have been any cases in the past and in the present where diagnosing and labelling people could have been handled better; times where health care professionals have completely screwed up. When people are treated as their diagnosis e.g. Frankie is DID and I am only a cancer patient, then it is really quite unsurprising that some people hate their diagnosis.
On the other hand, fighting it may be not the most productive method to change how people perceive you. I am aware that as a cancer patient being surly and/or aggressive will only lead to a brick wall of distain from health care professionals. I have seen, as a mental health professional, patients who behave like that in mental health services are handled more warily and with more caution. Of course it is possible that there is a process here that patient's need to go through. No one likes to be labelled but perhaps patients (and I include me in there) need to go through the process of being angry, cross...pissed off. Some people hate their label with a passion and do their best to distance themselves from their diagnosis. I often wonder if this is a reflection of the care that they are receiving or have had in the past, or if it is a direct reflection of their personality type. I also wonder if they can see how destructive their behaviour is. How it not only erodes any current or future relationship with health care professionals but also it has a knock on effect for other people with the same diagnosis by either directly influencing the health care professional's attitude (I know that this is not good but then again we are all human after all) or be non directly putting people down how have the same diagnosis.
So if labelling people can cause so much friction, why do it in the first place?
Well as a nurse, I always find that if I have a label I have a fair idea what I am going to expect and what treatment plan or plans I could potentially offer, prior to seeing the patient. This cuts down on uncertainty on both parties parts. It gives the professional some confidence about how they approach the patient, and that in turn leads the patient to have more confidence in the health care professional. Medication is divided into what illnesses it can be prescribed for, so therefore it makes sense to have a diagnosis.
Where I work, mental health teams are divided into psychosis and affective (mood disorder), I work in the affective team. Having a diagnosis dictates which team you are referred to, with (hopefully) each team being specialist in their areas. On the other hand, there is no difference in treating someone which psychotic depression compared to psychosis with depressive symptoms; same medication, same approach, same treatment.
Sometimes mental health professionals are loathed to diagnose. I spent last week at a personality disorder conference, it was great fun and VERY geeky! One thing that cropped up was that some professionals do not like labelling patients with a personality disorder. This may be due to it being complex in nature and people have to be in the right frame of mind with the right practitioner to move forward. However, one of the keynote speakers stated that not telling someone that they had a personality disorder just because that professional thought it would be hard to treat, is akin to not telling a cancer patient that they have cancer because there is not cure. It seems idiotic and puerile.
Seeing a person and not a diagnosis should not be underestimated. How a diagnosis is given and how it is received each time the patient/person has a new key worker is very important. Studies have shown that people with a diagnosis of personality disorder feel better for having their diagnosis explained to them and they found it empowering. In other words, by having it explained in a sensible manner, they felt more in control. It is certainly the way that I want to feel when I talk to professionals about my diagnosis and it is the way that I try to deal with people too.
So what is a diagnosis? It is something that can help you and your health care professional, it is something that can be a weight around your neck. It can grind and divide people. Ultimately, it is up to the individual how they want to deal with it, and how they deal with it influences others. When I hang out with Frankie, I see Frankie and not DID; when she hangs out with me she sees Kerry and not my cancer.
[What does a Mental Health Nurse do in England? Check out Mental Health Nursing via the National Health Service http://www.nhscareers.nhs.uk/details/default.aspx?id=122]