The Purpose of the Symptom

Many people who come to me for help, have already made a determination about their diagnosis based on what they have seen on social media. Now, that's not necessarily a bad thing, but there is something that is often overlooked in these social media posts. "Ron, what could possibly be missing from those social media posts," you might be asking yourself. Well, let me tell you. There is almost always a reason for a symptom to exist. Understanding the reason for the symptom is extremely important in understanding what is really going on. For example, nearly every symptom of PTSD is a coping strategy to keep oneself safe. The problem is when those coping strategies persist beyond the presence of the threat. 

One of the things that causes so much confusion, even for mental health professionals, is that a symptom can be caused by several different things, each one, suggestive of a different diagnosis. Let's take social anxiety as an example. Social anxiety may be caused by: 

1. The fear that one is going to be hurt again by another person. This is reflective of PTSD, or mistreatment by people in the past. 

2. The fear of being embarrassed in the presence of other people, which is the driving factor of Social Anxiety Disorder. 

3. The fear that a panic attack may occur in a social setting, making it difficult to leave or escape, which is the core factor behind Panic Disorder. 

4. Feeling like you have to put on a persona to engage with other people, which can be exhausting. This is common in introversion and depression. 

5. Having had bad social experiences because one struggles to read social cues, understand the dynamics of socialization, and being able to respond effectively in different social situations. All of these may be reflective of Autism. 

6. Feeling like the emotions and drama of other people are too consuming and difficult to handle may be a sign of Schizoid Personality Disorder. 

7. Believing that people are out to get you may be a sign of paranoia. 

I could keep going on. The point is, that a person's anxiety about interacting socially and their corresponding behavior, can be caused by several different things. Knowing the reason for the anxiety or its purpose, can help us better understand what is going on. 

When professional go about making a diagnosis, our goal is to "rule out," things. In other words, identify what it is not, in an effort to reach a conclusion as to what it is. This may sound strange, but if we do not try to rule out things, then we end up ignoring all the other possibilities and settling on the one that seems most obvious. Did you know that hypothyroidism is a major cause of Major Depressive Disorder? If we make the diagnosis without considering it, then we could be doing therapy for years while your thyroid sits there getting worse. 

Given the dramatic increase in Autism Diagnosis videos on social media platforms, there has been an increase in people thinking that they meet the diagnostic criteria.  People frequently cite these videos and and list similarities of their own behaviors. "Well, this person said that they feel uncomfortable around people, and they tend to like the same things, which is all part of Autism." True, it can be part of Autism, but it can also be something else, or even a normal experience. Humans do tend to like the same type of things and sometimes we don't feel comfortable around people. If everyone who experienced this was diagnosed with Autism, then 100% of the population could have been diagnosed with Autism at some point in their life. 

In summary, it is very important to have a thorough understanding of the condition which you think you have. Part of this thorough understanding is to know where the symptoms overlap with other conditions, what is considered "normal," and the primary cause/reason for the symptom. Most importantly, an effort needs to be made to rule other conditions out before coming to a conclusion.