How the spectrum approach is helping and hurting diagnoses of mental disorders

"The Psychopath Inside" by James Fallon very strongly brings to light the enormous problem with the current system for diagnosing mental disorders.  The immense overlap between symptoms and large differences in viewpoint between clinicians very often leads to conflicting diagnoses, and treatments.  Additionally, this phenomena of over (and under, in James Fallon's case) diagnosing can causes more problems.  This was also described in a Time magazine article written by Maia Szalavitz - My Case Shows What’s Right — and Wrong — With Psychiatric Diagnoses.  She begins by describing her condition from childhood into her twenties, at which point she begins to seek psychological help, and finds herself underwhelmed by clinicians, and overwhelmed by their diagnostic methods.  As time continued on she gained a growing list of diagnosed disorders (and symptoms) before realizing that none of them were quite right, and that in fact many would have been detrimental had she chose to pursue their treatment plans. 

I collected diagnoses, but none of them ... fully described my real problems.  The addictions were real— but they didn’t simply arise because I took drugs. I took drugs because I didn't know how to deal with the depression and social isolation of what I now suspect is Asperger’s.  The addiction treatment system failed to correctly identify my underlying issues and gave me a label with little consideration.

As she begins to look back over her past and realize exactly how different she was, Maia could see the impacts a correct diagnosis could have had.  She states:

While some argue that medicalizing labels ... only do harm, my case was probably one in which they might have helped. Had I known I had Asperger’s for example, I wouldn’t have felt so bad about my bossiness and apparent disregard for other people — I would have realized that they were part of a brain difference that came with both advantages and disadvantages, not a matter of moral deficits.  I would have also been explicitly taught how to do better in ways I could understand.

While Maia's case exemplifies the large overlap of symptoms used to diagnose mental disorders, this phenomena has lead to a singular broader, but also more specific spectral design for approaching mental disorders.  There is a larger spectrum that contains the general types of disorders; manias, depressions, autism, etc.  They can often look something like this:


Within each of these categories lies their own spectrum.  Autism and depression being the largest and most explored examples, where different patterns of both external and anatomical symptoms have been observed and thus classified uniquely.  


Whiles James Fallon may have been at first surprised by his diagnosis, he openly admits that if he had not developed in such an affluent and nurturing environment he could very easily see himself in a much bleaker situation - something similar to what Maia experienced.
A combination of following this spectral approach and early acceptance to seek professional help seems to be the best approach to understanding and  improving the conditions of people with mental disorders.






Sources and Further Readings:
"The Psychopath Inside" by James Fallon
http://healthland.time.com/2013/05/17/viewpoint-my-case-shows-whats-right-and-wrong-with-psychiatric-diagnoses/
http://www.theverge.com/2013/10/31/5025744/james-fallon-the-psychopath-inside-interview
http://www.nature.com/news/mental-health-on-the-spectrum-1.12842