New mental health lessons are being designed to teach secondary school pupils about the "prevalence and character of common conditions". With details due to be published over the next few days, the Royal College of Psychiatrists highlights the dangers it sees in self-diagnosis.
Recently I developed a pain in my foot. Luckily the internet is full of information about foot pain and I soon found a whole list of possible disorders. Some of these were particularly worrying, and I developed significant anxiety, sleepless nights and a whole load of irrational fears, assuming the worst-case scenario. I took my list of self-diagnoses to my GP who quickly whittled them away and gave me a relatively innocuous diagnosis which hadn’t even made it onto my short-list. Now that I had the right diagnosis, the internet was a really useful source of information, including tips for self-management.
"Children suffering with mental illness should always seek a proper diagnosis and receive the specialist care they may need to help them recover."
Yes, there is a moral to this story – doctors shouldn’t go around trying to self-diagnose, particularly when they are the type of doctors who are far more interested in how brains work rather than feet. The General Medical Council has rules about this – they’ve figured out that too little knowledge can be a dangerous thing, particularly when you’re in a high state of anxiety about what may be happening to you.
I’ve used my recent experience as an example of what can happen when you rely on the internet to self-diagnose. Young people are now bombarded with online information. Much of it can be useful, but we need to be careful when trying to understand what may be happening to us, particularly when it’s complicated by strong emotions. Dangers lie in potentially over-diagnosing as well as missing diagnoses – these issues are central to medical practice and now spill over into the vast online world.
For example, everyone feels low at times, it’s part of human existence. But having a few bad days does not usually equate to a depressive disorder. There are plenty of online screen tests which will give you a number for how depressed you allegedly are, but as all good doctors know, there is nothing to replace clinical judgement when making a diagnosis. Questionnaires can only give us some guidance around what the problem may be, but in the end clinical judgement is the gold standard in mental health and many other areas of medicine.
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Making a mental health diagnosis isn’t just about the number on a scale – it’s about understanding someone’s life and how their symptoms impact on their lives. Sometimes the problem is so great and urgent that making the diagnosis and deciding on a treatment is easy. More often though, it’s not so clear, and needs careful thought and discussion about how helpful (or not) a diagnosis would be.
Doctors are often accused of ‘medicalising’ everyday problems, but the internet now offers this opportunity to millions of users at risk of increasing anxiety and of putting life experiences in the domain of mental health disorders. Over-diagnosing can also trivialise the profound impact of severe mental health disorders on young people.
On the other hand, the internet also offers opportunities for self-help and support for young people and families who either have confirmed diagnoses or are struggling to get help for problems that are out of the remit of mental health services. For example, the Royal College of Psychiatrists website minded.org is a mine of information for families and professionals. There are modules for common problems such as lack of sleep in teenagers with self-help advice and useful resources, as well as detailed information about mental health disorders. Forums, such as those for young people with issues around their identity, can be hugely supportive and a safe space to share thoughts about subjects that are difficult to discuss elsewhere.
Classrooms will soon be used to teach children about mental health and will provide an additional space for them to talk about mental health and how to look after their mental wellbeing. Children suffering with mental illness should always seek a proper diagnosis and receive the specialist care they may need to help them recover.
So, should we be using the internet to self-diagnose? Well look at what happened to me and I’m a doctor. The message is, if you are worried that you may have a mental health disorder, go and see your doctor or someone who is trained in mental health care; then you can get the right support, including information online.
Bernadka Dubicka is chair of the child and adolescent faculty at the Royal College of Psychiatrists.