For some patients, a mental health diagnosis brings relief. For others, it doesn’t. Regardless, we must take the time to educate patients and caregivers about symptoms, what to expect during the course of illness, and warning signs that suggest the need for attention.
Lifelong Learning in Clinical Excellence | May 16, 2022 | 1 min read
By Leslie Miller, MD, Johns Hopkins Medicine
“So that explains what’s going on with me.” This was a recent response from a teenager after I explained that his difficulties with attention, focus, impulsivity, and academic struggles were due to ADHD. For some patients, sharing a diagnosis can offer relief and understanding about what they’ve been experiencing.
Other times, patients feel shame or embarrassment. Since psychiatric illnesses can impact functioning and decision making, this can lead patients to feel ashamed of their choices or decisions when experiencing these symptoms. We want to openly process this as well with the patient and remove the burden of shame.
After taking a very thorough history from the patient and family I share the diagnosis. I then check in with them and ask what their thoughts are and what is their understanding of the diagnosis. Sometimes patients will offer they’ve been reading information and trying to make sense of their experience. We discuss what they’ve read, if it aligns with what we’ve been discussing, and what questions they may have.
For some patients, a diagnosis can affect how they see themselves, their identity. These patients may benefit from more discussions over time about what the diagnosis means to them. For those who struggle with how the diagnosis fits in with their identity, I encourage them to continue thinking about it and to discuss it with myself and their therapist. The goal is for the patient to not lose themselves in this diagnosis. The message is, “You’re still the person you thought you were.”
Some diagnoses may require lifestyle changes, such as a consistent sleep/wake cycle. I share education about what lifestyle changes may impact their mental health so they can make educated decisions. It’s also important to educate the patient’s parents and caregivers. I’ve seen many young adults who tell me, “My parents think it’s my mental health disorder whenever I get angry, but it’s not. I am just angry at what they said.” Providing education about symptoms, what to except during the course of illness, and warning signs of worsening symptoms can be important for both the patient and family.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.