Oftentimes, mental health issues co-occur with substance abuse and addiction. Before effective and appropriate treatment can be given, the mental health disorder first needs to be diagnosed. The most effective treatment will depend upon the particular cause of the symptoms being experienced, so it is important that a diagnosis be accurate and thorough.
Diagnosing a mental health disorder is a process, and if often includes multiple medical and mental health professionals. The client should be evaluated not only for a mental health disorder, but for physical conditions that could be related to the symptoms being experienced. Many people have more than one mental health disorder, so a thorough diagnosis should address all the problems an individual faces.
Diagnosing Mental Health Disorders
In Step by Step Format
Step 1: Conduct a physical exam.
A general practitioner or other medical professional is often the first person involved when diagnosing a mental health disorder. The Merck Manual of Diagnosis and Therapy recommends that a physical examination be conducted in order to check for medical problems that might be causing, accompanying, or resulting from a psychological disorder.
Some disorders, such as depression and anxiety, can have physical causes. Thyroid problems and other physical diseases can sometimes be misdiagnosed as mental health disorders, so this thorough physical exam is essential. Lab tests are also typically conducted. If a doctor does not find a physical cause for the symptoms, the client will be referred to a mental health professional to be evaluated for psychological disorders.
Step 2: Conduct a psychological evaluation.
Licensed psychiatrists and psychologists can both diagnose mental health disorders. A psychiatrist is a medical doctor who specializes in mental health. A psychologist also specializes in mental health but does not hold a medical degree. Psychiatrists can prescribe medication; psychologists cannot. Specialized education and practical experience are needed to be licensed in both professions.
Mental health professionals typically begin an evaluation by having a conversation about current symptoms. Often, mental health disorders can be diagnosed through informal conversations with a therapist. Sometimes, the therapist will administer a more structured psychological evaluation in order to better determine the correct diagnosis. These evaluations come in many forms, depending on the specific diagnosis in question. Oftentimes, the therapist will assess the client’s answers to the particular test’s questions to determine which diagnosis is most appropriate.
Most psychiatrists and psychologists use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose mental health disorders. This manual includes criteria for hundreds of different disorders. The therapist or psychiatrist will determine which criteria fit the client’s condition best.
The disorders in the DSM-5 are broken down into several categories. Mayo Clinic lists the following categories of mental disorders:
- Neurodevelopmental disorders
- Psychotic disorders
- Bipolar and related disorders
- Depressive disorders
- Anxiety disorders
- Obsessive-compulsive and related disorders
- Trauma-related disorders
- Dissociative disorders
- Somatic symptom and related disorders
- Feeding and eating disorders
- Elimination disorders
- Sleep-wake disorders
- Sexual dysfunctions
- Gender dysphoria
- Disruptive, impulse-control, and conduct disorders
- Substance use and addictive disorders
- Neurocognitive disorders
- Personality disorders
- Paraphilic disorders
It is not uncommon to be diagnosed with more than one mental health disorder. Some disorders commonly accompany each other, so the treatment professional should evaluate the client for disorders that are often diagnosed together.
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Step 3: Create a treatment plan.
Once a diagnosis has been established, a treatment plan should be created. Treatment often includes a general practitioner, a psychiatrist, and a psychologist or counselor. Each member of the treatment team should be aware of the diagnoses and treatment methods being used. Many severe or debilitating mental health disorders require inpatient or residential treatment, but the vast majority of people who get treatment receive it on an outpatient basis.
Psychotherapy – also called talk therapy – is the most common form of treatment for mental health disorders. Some disorders can be treated with medication, such as antidepressants, anti-anxiety medications, and antipsychotics. The most effective treatment typically combines therapy and medication. Many people benefit from alternative forms of treatment, such as exercise, acupuncture, yoga, or massage. Mental health professionals can devise a specific care plan that incorporates the treatments that will most benefit the client.
There are a vast number of methods of psychotherapy that have been supported by research as effective in the treatment of mental health disorders. The National Institute of Mental Health lists the following modalities as some of the most commonly used:
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Interpersonal therapy
- Family-focused therapy
- Psychodynamic therapy
- Light therapy
- Expressive or creative arts therapy
- Animal-assisted therapy
- Play therapy
Some therapists specialize in a specific therapy method, while many combine elements of multiple methods into their approach. Some diagnoses tend to respond better to specific methods of therapy. Treatment of mental health disorders is highly individual; what works for one person may not work for another.
Oftentimes, diagnoses may evolve throughout the treatment process. Symptoms that weren’t present at the initial assessment may present after all substances have left a person’s system. As a result, ongoing and regular assessments should be given throughout the recovery process as the person progresses in therapy. This ensures that the most accurate diagnoses are given and the most appropriate treatment plan is applied.