My therapist once said to me that diagnoses are just labels for clusters of symptoms. She might have just said this because she knows I have an aversion to being ‘textbook’ anything. She knows I get spiky when anyone informs me that my behaviour or feelings are typical of someone with my background. So this reframing of the concept has helped.

I was prompted to think about this because tomorrow morning I have my last appointment with my fantastic psychiatrist. He’s retiring and I feel as though I am losing a cornerstone. Throughout my breakdown he has been one of the few constants. Now it feels as though a chapter is ending and I’ve got no idea what comes next.

He has labelled me, because that’s his job. But at the same time, he has always made it clear that he sees me as a person, an individual. He’s always listened and been honest with me. He’s never assumed anything. And I am so very grateful for that. I’m grateful for his honesty and his genuine care.

Of course, there are times when it is more straightforward just to say I have depression, or Post Traumatic Stress Disorder (PTSD). It’s simpler. And people get it. If, when asked in A&E whether I suffer from any illnesses I replied with an exhaustive list of my symptoms, I think they would assume I was being difficult or even sarcastic. But why is it acceptable for them to take one word and assume they understand enough about me to provide adequate treatment?

This would make sense, perhaps if I had diabetes, but what caring professionals miss in this assumption is the individuality of experience. Not every depressed person has lost the will to live, people with PTSD don’t always have flashbacks, I could keep going with examples for pages and pages. In applying formulaic approaches and standardised classifications, people forget to stop and ask questions. They forget to actually check in with a person and enquire as to whether their symptoms have changed, abated, or developed into something different.

I am extremely apprehensive because at the NHS psychiatric hospital I am just depressed patient number god-knows-what. Nobody knows me there. They don’t ask about how my therapy is going, whether my meds are working for me, if I’m taking care of myself, eating properly and getting enough sleep.

A couple of days after taking an overdose, my ‘Care Coordinator’ there asked how I was doing and was satisfied with me telling her I was OK. There was no further questioning. She didn’t quiz me on what had led up to the event and how I could have dealt with it better. She just ticked her boxes and sent me on my way.

Being brutally honest, I am scared of what happens next. I am scared of where I will end up if I can’t cope and what the long term implications of that will be. It feels like I suddenly have no room to fail, and that really is terrifying.

Image courtesy of Evelyn Flint, Creative Commons.