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annielovesbacon
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Default Jun 19, 2018 at 11:37 PM
  #1
It's my understanding that for billing and/or legal purposes, a therapist has to have a diagnosis for you, but they may not necessarily tell you what that diagnosis is unless you ask or they deem it to be helpful.

Has your therapist told you your diagnosis, and if so are you glad they did? If not do you wish they would?

My therapist never really discussed diagnoses with me. My pdoc diagnosed me with bipolar within 10 minutes of meeting, and I told that to my therapist. She said "okay, it's good that we know that, so we can keep an eye on your moods" but mostly wanted to focus on my symptoms rather than a diagnosis. I know that last year, before my bipolar diagnosis, she had diagnosed me with major depressive disorder and generalized anxiety disorder because she wrote a letter to get me disability accommodations. I like having the label, it makes me feel valid and not like a fraud.

Thoughts?

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Default Jun 20, 2018 at 12:26 AM
  #2
M therapist seems pretty label aversive which I think in general is a good thing. It means he's treating me as a person, not a diagnosis. That being said, I'm quite obviously depressed and that is what he's reported for insurance purposes. We also had a discussion recently about whether I have PTSD. When it came up in session, he ran through all the diagnostic criteria and all the symptoms I have that meet each criteria. For that diagnosis, I feel it was helpful to me, because I suspected it was true, but wasn't sure. I feel like I can stand up for myself more now if that makes sense.
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Default Jun 20, 2018 at 01:07 AM
  #3
For insurance purposes, its depression. For an actual diagnosis, no idea. She doesn't like to label people.
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Default Jun 20, 2018 at 01:17 AM
  #4
In my country health insurance will ask about the diagnosis plus want a more in depth report from the therapist after one year of sessions. When my T had to write that he told me about my diagnosis. That was the only time it was mentioned and I don't think we've ever focused on it more. I'm not sure whether my T tells other people earlier and whether he just doesn't like to tell people they have BPD. I think I was mostly told because he wanted to make sure I agree with what he will put in the report.
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Default Jun 20, 2018 at 01:20 AM
  #5
In the USA do you have to have a formal diagnosis in order to get your health insurance to pay for sessions?
Surely not! That would be completely idiotic. That would of course cause gross over and mis-diagnosis. Surely that is not the case...
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Default Jun 20, 2018 at 01:27 AM
  #6
As far as I know it is the case that US health insurance requires a diagnosis to have therapy paid for. That is why loads of people are 'depressed'. Everyone seems to just put down depression if there is no well-fitting diagnosis, or if it would be not good to mention it.

Most countries I assume require a diagnosis at some point, insurance is not just going to pay for you talking about the weather...
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Default Jun 20, 2018 at 02:15 AM
  #7
I've been curious about this myself. I didn't ask for a diagnosis per se, but I asked how my progress was. All my therapist said was that I should ask the people around me if there has been a change from me.
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Default Jun 20, 2018 at 04:37 AM
  #8
I always thought I had OCD, but my T dx'd me with CPTSD

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Default Jun 20, 2018 at 05:46 AM
  #9
My T isn’t big on diagnoses either, and focuses on symptoms. After a few years in therapy, and some dramacic events, I asked to be diagnosed - officially. We did a formal assessment and she presented me with a report. Since then, we haven’t discussed it it terms of a specific disorder, but rather that I feel/react/experience things differently than most. I’m ok with that course of action.
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Default Jun 20, 2018 at 05:55 AM
  #10
T and I discussed it for quite a while because psych NP had diagnosed me with bipolar. T had previously diagnosed me Major depression and CPTSD. T completely disagreed with Psych Np. I totally disagreed with np. T agreed with me but explained why she suspected np came to that diagnosis. Eventually I talked to np and she agreed with T but had never changed it. She did that day.

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Default Jun 20, 2018 at 07:54 AM
  #11
I was using the out of network benefits of my insurance to get reimbursements. Both of my Ts put Generalized Anxiety Disorder as a diagnosis. The first one handled it more appropriately, I think: he asked me what diagnosis we could use and GAD was my suggestion. The second one just put its code on the first invoice without ever discussing it with me. I was fine with a GAD diagnosis, even though the real main issue was substance use, which I would not have liked filed.

I personally am not against diagnoses and think it can be useful to have an idea what I am dealing with, especially if medication is involved. I do think that the practitioner should discuss it with the client though.
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Default Jun 20, 2018 at 07:56 AM
  #12
You do indeed need a diagnosis for insurance to cover your sessions in the U.S. Some therapists use a diagnosis that's sort of generic (I think it's like "adjustment disorder") if they don't want to disclose something more specific to insurance.

My T and I have talked about my diagnoses because I came into therapy knowing what they were (long-standing depression/anxiety). She doesn't treat me like my mental health issues define me or anything, but it's helpful to talk about what's symptoms and what's "me."

Knowing the diagnoses also helps me find books and resources to learn more and get new ideas about what might help me feel better. I don't think labels are all bad, necessarily. But I admit that my diagnoses are not as socially stigmatized as some others.
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Default Jun 20, 2018 at 12:20 PM
  #13
i am pretty sure my T just uses the adjustment disorder one. Though very early on she told me I was depressed and had a lot of anxiety. I’ve been diagnosed as depressed before, so that didn’t surprise me, but the lots of anxiety did. I thought mine was specific to health-related situations, but i’ve come to agree withy my T.
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Default Jun 20, 2018 at 12:29 PM
  #14
No; the therapist doesn't like labels or the DSM. I think it's more helpful to understand one's internal workings than to slap a label on someone. I've had therapists in the past who diagnosed prematurely. When therapists do this as soon as within the first three sessions of meeting with you, it can really cloud their judgement and make them incapable of really understanding and listening to you because they already hold a preconceived notion about you in their minds.
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Default Jun 20, 2018 at 02:16 PM
  #15
Yes, she's diagnosed me. But, it's informal since she doesn't bill insurance. She focuses more on symptoms then diagnosis, but I like having a diagnosis. Like previous posters have said, it helps me feel validated.

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Default Jun 20, 2018 at 04:52 PM
  #16
he diagnosed me with cptsd.. schizoaffective disorder... and an eating disorder.... and opiate dependence (in remission)

I don't put much stock into diagnoses personally so it doesn't affect me much

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Default Jun 20, 2018 at 04:54 PM
  #17
every doctor visit (therapists included) and procedure has an alpha numerical code attached to it in the ICD and CPT manuals.... and the sole purpose of that is billing insurance
Quote:
Originally Posted by Amyjay View Post
In the USA do you have to have a formal diagnosis in order to get your health insurance to pay for sessions?
Surely not! That would be completely idiotic. That would of course cause gross over and mis-diagnosis. Surely that is not the case...

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Default Jun 20, 2018 at 05:27 PM
  #18
Yes my therapist has diagnosed me with dysthymia. I'm ok with that. It is reasonably accurate. As far as I know he hasn't added any other diagnoses, although I have most definitely developed an anxiety disorder (probably a specific phobia, and/or an acute stress disorder) since I started seeing him. Historically I have been diagnosed with major depressive disorder, which was accurate, but I no longer meet the criteria for that. My other therapist, who is strictly self-pay, says that she has not diagnosed me. Since she doesn't take insurance she doesn't have to.

I don't care if they diagnose me or not as long as it is accurate. I spend a lot of time researching things, and I have a mental health background, so I'm pretty sure I can do as good of a job as they can diagnosing me. So if they are wrong, I'm not happy. I once had a therapist diagnose me with personality disorder NOS...that's it. No depression, no anxiety, nothing else. I don't believe that I have a personality disorder, but if I did have one, I want a real one, not a "not otherwise specified" one. That sounds like "there is something chronically wrong with you, but I'm not going to say what."

Since then I always ask. I also make sure to list specific symptoms to point them in the correct direction. Once I told a therapist that I had dysthymia and major depressive disorder, recurrent, moderate, without psychotic features, and my GAF was 58. I should have double checked. She probably wrote down OCD or something else completely wrong. She wasn't that bright.
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Default Jun 20, 2018 at 07:04 PM
  #19
I've had SO many different dxs since I was 17.
Here's some....

Major depression, bpd, generalized anxiety, panic disorder,
PTSD, bipolar 2, alexithymia, bipolar 1

My official standing diagnosis from my psychiatrist is: bipolar 1, rapid cycling with psychosis, hx of bpd, panic d/o and PTSD.
Now-the one that actually fits me best and my psychologist gave me is shizoaffecgive bipolar type and PTSD.

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Bipolar 1 w/psychotic features or schizoaffective bipolar type
PTSD
generalized anxiety
OCD

celexa, prazosin, Lybalvi and prn zyprexa and klonopin
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Default Jun 20, 2018 at 07:08 PM
  #20
I can't remember if it was my tdoc or pdoc — either way, neither one told me directly. I ended up finding out through a bill that I got in the mail. It had two DSM codes and I looked them up. Neither were a surprise, but at least the social anxiety diagnosis felt validating, like I'm not just shy and I really do struggle with it. Beyond that though, I haven't thought much about it.

If I was able to look at anything, it would the notes from either one of my treaters. Only mild curiosity though. You never know what you're gonna find and there's probably a good chance it's just as likely that it'd make you feel good as upset you.
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