Diagnosing Mental Health Disorders

How Mental Health Conditions are Diagnosed

Mental health conditions are diagnosed through a comprehensive process that considers all relevant factors. A mental health professional will look for common signs and symptoms of mental disorders, and the degree to which they’re impacting your life and general functioning. This may be done through direct questioning or through more formal measures, such as forms, questionnaires, or diagnostic interviews.^[1][2]

After enough information has been gathered, the mental health professional will compare the symptoms to professional diagnostic manuals to determine if someone meets the criteria for a mental illness. The specific diagnostic manuals are discussed in the next main section.

Who Can Make a Diagnosis?

Common mental health disorders, such as types of anxiety or depression, can often be diagnosed by your primary care provider (PCP) or general practitioner (GP). However, more complex cases are typically diagnosed by a mental health specialist, such as a psychiatrist, psychologist, or psychiatric nurse practitioner. ^[2]

What is Used to Make a Diagnosis

The two main diagnostic tools used for mental health diagnoses are the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition, Text Revision; DSM-5-TR) and the International Classification of Diseases (11th Edition; ICD-11). These diagnostic manuals contain a list of all of the established mental health disorders, which are listed under specific categories. ^[2]

Therefore, both the DSM-5-TR and the ICD-11 have a primarily categorical approach to defining and diagnosing mental health disorders. Each mental health disorder has a list of specific symptoms. And to be diagnosed with a mental health disorder, you have to meet a certain threshold of symptoms, which are clearly defined in both diagnostic manuals.

DSM-5

The DSM-5-TR is the diagnostic manual used for diagnosing mental health disorders primarily in the United States. It contains a wide variety of mental health disorders, which are all grouped under broader categories, such as Neurodevelopmental Disorders, Bipolar and Related Disorders, Depressive Disorders, and Anxiety Disorders.^[3]

ICD-11

The ICD-11 is a diagnostic manual primarily used by countries outside of the United States. It is broader than the DSM-5 because it lists not just mental disorders, but also physical conditions and diseases.^[2]

Tests and Assessments Used

There are many possible tests and assessments used to diagnose a mental health disorder. Ultimately, it depends on the specific mental health disorder and accompanying symptoms.

Commonly used tests and assessments for a mental health diagnosis include:^[4]

• Clinical interviews.

• Symptom severity scales.

• Disorder-specific questionnaires.

• Behavioral observations.

• Disability assessments.

• Personality inventories.

To rule out other possible causes and gain a more complete picture of someone’s health status, a physical exam and detailed history are also typically conducted. This may involve blood tests, imaging, neurological tests, or other measures, depending on what’s deemed necessary.^[5]

How to Get a Mental Health Diagnosis

To get a mental health diagnosis, you typically schedule an appointment with your PCP or GP. During this appointment, they’ll ask you questions about your current issues and how they’re impacting your life and ability to function. It’s important to be as honest as possible to get the most effective and appropriate care.

Sometimes, your doctor will be able to diagnose you. Other times, you will be referred to a mental health care professional, such as a psychiatrist or psychologist.

To get a mental health diagnosis, you need to meet a certain number of criteria. These criteria are specific symptoms listed under each diagnosis in the DSM-5-TR or the ICD-11. The mental health professional will incorporate your symptoms along with all other relevant information (e.g., information from interviews, medical exams) to see if you meet criteria for a mental health disorder.^[1][5]

Diagnosing Children

Diagnosing children with a mental health disorder requires a focused, individualized process. Children may present with different symptoms than adults for a given mental health disorder, so mental health professionals often implement tests and measurements that are uniquely relevant for children. Many times, parents fill out these forms, depending on the child’s age.^[2][4]

Furthermore, it’s sometimes difficult to distinguish if a child’s symptoms and behaviors are simply a part of childhood and maturation, rather than evidence of a mental health disorder. Diagnosing children with a mental health disorder thus often requires several steps, including: ^[6]

• Complete medical and physical exam.

• All relevant history (e.g., history of trauma, family history of mental illness, medical history).

• Interviews and discussions with parents/caregivers.

• If necessary, discussions with teachers and information on school history.

• Behavioral observations.

• Mental health tests and questionnaires.

When Should You Seek a Diagnosis?

Sometimes, it’s difficult to know whether your mental health symptoms are just a part of normal life stressors or if they constitute a legitimate mental health disorder. To help make this distinction, it’s important to look at the overall impact, frequency, and severity of your symptoms. Specifically, you should seek a mental health diagnosis if your symptoms are significantly interfering with your normal functioning and/or if they’re causing significant distress regularly.^[5][7]

While exact symptoms of mental illness will vary in each individual,  listed below are common signs of mental illness that warrant seeking a diagnosis:

• Significant changes in sleeping or eating habits.

• Mood swings.

• Marked agitation or irritability.

• Trouble calming down.

• Excessive worry, anxiety, or fear.

• Persistent sadness, emptiness, or depression.

• Difficulty concentrating.

• Struggling to perform activities at work or school.

• Neglecting basic self-care (e.g., showering, changing clothes).

• Withdrawing from others.

• Thoughts of harming yourself or others.

This is not an exhaustive list. Above all else, you should seek a diagnosis if your mood, ability to function, and overall well-being become markedly different compared to usual. Always err on the side of caution and seek a diagnosis, even if you’re unsure if it’s necessary.

Crisis Helpline

Severe mental health symptoms require prompt action. One of the quickest ways to get help is through a crisis helpline. You don’t have to be diagnosed with a mental health disorder to use these crisis helplines, as they are meant for anyone in need of mental health support.

If you’re experiencing suicidal thoughts, thoughts of harming others, or other severe mental health symptoms, you can contact the following crisis helplines: 

• 988 Suicide and Crisis Hotline: Text or call 988 to be connected with a counselor

• Crisis Text Line: Text HOME to 741741 to be connected with a crisis counselor

• Veterans Crisis Line: Dial 988 then press 1, or text 838255

You can also read our guide on how to respond to a mental health crisis if you are unsure or if you are seeking advice on how to help someone experiencing acute mental health difficulties.

Issues with Diagnosing Mental Health Disorders

There are a few issues within the process of diagnosing mental health disorders, many of which have been addressed in recent years. For example, some mental health professionals argue that the classification systems used in the DSM-5-TR are overly categorical. This leads to creating distinct diagnoses when, in fact, there may be a lot more overlap between diagnoses.

Therefore, this can sometimes lead to trouble distinguishing the symptoms of one disorder from the next. In addition, this often leads to comorbid diagnoses, which are when there are two or more diagnoses made at the same time. ^[2]

In addition, mental health disorders require a certain threshold to reach before a diagnosis is made. While this is generally helpful, it may sometimes fail to account for the unique differences of each individual. In turn, this could lead to over- or underdiagnosis, depending on the exact person and situation. ^[2]

Researchers and mental health professionals are working to move towards a more dimensional and dynamic understanding of mental illness, rather than the more categorical and rigid forms used up until this point. While the current system still has many benefits, moving toward this more dimensional, dynamic classification may lead to more accurate diagnosis and more effective treatment.

What Happens Once You Have a Diagnosis?

Once you have a mental health diagnosis, the next step is formulating a treatment plan. Receiving a diagnosis doesn’t automatically mean you’ll need mental health treatment, but most individuals do benefit from some form of treatment or, at the very least, self-support strategies. Your exact treatment/management plan depends on symptom severity, your current level of distress, and how the disorder is impacting your daily life. ^[5]

Treatment Options

The exact treatments you’ll receive depend on your specific diagnosis, symptom severity, and other individual factors. The most common types of treatments for mental health disorders are psychotherapy and medication. For more severe issues, a combination of both is usually the most effective. ^[5][7]

Daily Management

In addition to professional treatment, certain lifestyle and self-care strategies can help manage symptoms and promote greater overall well-being. Examples include adequate sleep, a healthy diet, regular exercise, and regular social connections. Support groups may also play a role as part of a comprehensive treatment plan. ^[5]

Takeaway

The current mental health diagnostic system is not without its flaws. But overall, it still provides an effective way to diagnose mental health disorders, which in turn can help lead to appropriate and effective treatment. If you’re experiencing significant mental health symptoms that are interfering with your life quality and functioning, don’t be afraid to seek out a diagnosis; it may be one of the most beneficial decisions you make.