Proper mental health diagnoses require significant examination and contemplation.  Much of this is done both in the mind of the professional and through collaboration with other experts.  In order to make this process more transparent and procedural, I will write out initial diagnostic impressions of the client and then examine them in depth, one by one.  Additionally, due to the popular nature of the clients, some other people and websites have asserted their diagnostic impressions.  Though these are done by lay persons and not professionals, I will nevertheless examine their validity.

 

Mental health diagnoses do not predict behavior; rather, they categorize existing symptoms into groups.  In other words, people don’t burn things because they have pyromania, but rather they are diagnosed with pyromania because they burn things.  I believe this is an important (and often misunderstood) distinction because diagnoses can be used to understand ourselves, but cannot be used as an excuse for behavior.

 

Diagnoses will be determined by my clinical judgement and the use of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM).  The following passage from page xxxii seems relevant “The diagnostic categories, criteria, and textual descriptions are meant to be employed by individuals with appropriate clinical training and experience in diagnosis.  It is important that DSM-IV not be applied mechanically by untrained individuals.  

The specific diagnostic criteria included in DSM-IV are meant to serve as guidelines to be informed by clinical judgement and are not meant to be used in a cookbook fashion.  For example, the exercise of clinical judgement may justify giving a certain diagnosis to an individual even though the clinical presentation falls just short of meeting the full criteria for the diagnosis as long as the symptoms that are present are persistent and severe.  On the other hand, lack of familiarity with DSM-IV or excessively flexible and idiosyncratic application of DSM-IV criteria or conventions substantially reduces its utility as a common language for communication.”

 

 

For your information, official mental health diagnoses are displayed on a five axis system:

Axis I is for mental health issues, typically that can be treated.

Axis II is for personality disorders, which are more difficult to treat.

Axis III is for medical issues.

Axis IV is for generalized issues that may be causing distress.

Axis V is for general functioning on a scale of 0 - 100; zero is akin to active suicide attempts and 100 is fine and dandy despite stressors.  The number will have "GAF" in front of it, which is from a standardized scale of "Global Assessment of Functioning."

 

The term “rule out” is often confusing to laypersons with regard to diagnoses.  Contrary to what one might think, “rule out” means NOT to rule out a diagnosis.  For example, if a person is diagnosed with “Schizophrenia, paranoid type (rule out)” this means that the clinician thinks the person MIGHT have schizophrenia, but is not sure given the available information.

 

I think I should also add that, in case this isn't obvious, this is all for fun.  In fact, I don't really like the idea of labeling people with a diagnosis.  In my opinion, diagnoses are helpful for professionals to talk to each other more easily, but other than that they are mostly for insurance companies.  In rare cases I think it is helpful for people to know their own diagnosis, but in general I would rather not label others.  I believe that people are not really looking for a label, but rather to know that they are understood, that their issues are not unique, and that there is hope for improvement.  I believe this can be conveyed without a diagnosis.  Nevertheless, I'm only diagnosing fake people so I don't think it will be harmful to attach labels.

Diagnosis

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