I still worry at the concept of “self-identifying” disorders like autism and ADHD. This is a widely spread concept and my concerns aren’t necessarily with the efficacy of doing this. As that article says, there are widely available copies of real diagnostic instruments for autism and other diagnoses available online and compiling scores from several of those is a significant (but hardly comprehensive) part of what a psychiatrist does for a formal diagnosis
My problem is the idea of people using pathological language to describe normal variations in behavior, i.e., personality. You can be orderly – even noticeably, characteristically orderly – without having OCD or OCPD and you can be neurotic (meaning difficulty with emotional regulation and appropriate behavior) without being autistic. Analogously, you can have trouble waking up in the morning without having sleep apnea or narcolepsy.
The threshold is “clinical significance.” This is effectively the silent, hidden diagnostic criteria for everything in the DSM or even in the ICD: the observable problem/behavior must be significant enough to drive someone to go to the doctor or have someone refer them to a doctor. By definition, you cannot have a diagnosis without a doctor’s decision that you have it. That decision and diagnosis comes with an implicit statement that the problem is real and that it interferes with one’s quality of life.
This is complicated by the barriers of cost and convenience inherent to securing a medical appointment, but some of those complications are deliberate. If it’s easy to get diagnosed, then “clinical significance” is harder to determine. Me spending several thousand dollars for an hours long appointment that took months to get indicates that whatever my complaint is must be really bad to force me to jump through all of those hoops. But if I spend $20 to chat with a doctor over telehealth anytime that I want, how can they tell whether I really have a problem?
When we self-pathologize, we further cheapen terminology meant to describe impairment, disorder, disease, and outright disability. But I don’t want to imply that people are doing this with cheapening in mind. Instead, I think it’s because diagnoses are the taxonomy most available for many of us to talk about ourselves.
I say “us” to refer to some nebulous bunch of neurotics who think astrology and its “signs” are silly and who perhaps got tired of trying to remember their Myers-Briggs acronym. People love to talk about themselves but we need a language to do so; every 10 years or so it seems that astrology gets rediscovered for that exact purpose. I haven’t been on dating apps recently enough to say if people are still using it but I certainly still hear “Mercury’s in retrograde” often enough!
There’s nuance here because some people are genuinely disabled by, say, autism and simply lack the resources for a formal diagnosis. “Self-diagnosing” doesn’t give them any formal accommodation but might allow them to feel comfortable participating in a community of like-minded folk. There’s value in that, I just wish it were possible without using language that should be confined to a medical chart.