I’m not a very pedantic person, nor for that matter a particularly accomplished propagandist. I do my best to avoid telling anyone what to do or think (this is one of the fundamental pillars of being a CPS and Peer Support in general). However, in the context of mental health recovery, there is a debate concerning how to think of your own diagnosis/illness and how that perception can affect the healing process. For that reason I offer the following explanation of CBTN‘s self-inflicted universal agreement to always use the word diagnosis in lieu of illness.
My diagnosis is Bipolar Type 1 (Schizoaffective type). I consider neither the label Bipolar nor whatever “condition” I have an illness. In a strictly medical context I would argue Bipolar is a diagnosis, not an illness. In a general sense I would use a third term disposition to noun-ify the concept “condition,” AKA “whatever the hell it is that’s going on with my mental health.”
Here’s the key differences:
noun: diagnosis; plural noun: diagnoses
1. the identification of the nature of an illness or other problem by examination of the symptoms.”early diagnosis and treatment are essential”
synonyms: identification, detection, recognition, determination, discovery
A diagnosis is a LEGAL LABEL. It matters in two places – a court of law or a medical facility. Often in this sense its functioning as an official label covers both legal and medical requirements at the same time. In the purely medical sense a diagnosis is efficacious in studying and analyzing common patterns and creating a coherent diagnostic hierarchy of symptoms and specific conditions. In the philosophical and linguistic sense your diagnosis is an abstract and subjective thing given/assigned to you by a quote unquote professional.
noun: illness; plural noun: illnesses
a disease or period of sickness affecting the body or mind.”he died after a long illness”
synonyms: sickness, disease, ailment, complaint, disorder, malady, affliction, indisposition
An ILLNESS is a concept independent of subjective diagnostic criteria that is an objectively extant “functional disorder” within an individual. In other words, an illness is not a matter of opinion – it is something that can not be rectified without additional external intervention, whether in the form of surgery or medicine or some other treatment.
Sometimes we also refer to illnesses as diseases – the latter has fallen out of vogue a bit in relation to mental health, but we can take a quick look at the definition in the same way and see a similar understanding. Plus, this allows us to end up with all D words – hooray pedagogical alliteration!
noun: disease; plural noun: diseases; noun: dis-ease; plural noun: dis-eases
a disorder of structure or function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not simply a direct result of physical injury.”bacterial meningitis is a rare disease”
synonyms: illness, sickness, ill health
For example, let’s say you and I drop a boulder on Bob’s head (Bob is a make believe person in this thought experiment, don’t worry). Bob gets smushed. Donzo. No mas Bob.
I look at this new pancake version of Bob and say, “Wow, Bob is dead.” That would be considered my diagnosis.
You look at this new pancake version of Bob and say, “Nah, I think he’s still twerking a little or something. He’s alive.” That’s your diagnosis.
However, you turn out to be wrong – it’s just the breeze making Bob shuffle to I’m Sexy and I Know It. He is unfortunately actually, for-real dead. You could call that his illness or disease. It does’t matter if there are a thousand people looking at pancake Bob and they all truly and honestly believe he’s just dancing to Miley Cyrus. In that case he would have a thousand different diagnoses, but still just one actual disease (pancake disorder).
To begin an indirect point, here are graphs off the usage of all three words over time:
So to take a step back, we’ve got two concepts with which to approach what we’re calling our “condition” – diagnosis and disease. Both are interrelated in meaning, purpose and usage; both have increased in popularity in the last two centuries or so; both carry an implicit understanding of our “condition” as a negative thing, whether it be a functional disorder or an officially functioning label thereof.
However, there is a third (and I’m going to argue best) concept with which to appraise your “condition” – yes, it starts with a D, don’t worry – an older, neutral, stigma-less casual label that we don’t often hear tossed around in high school hallways these days:
noun: disposition; plural noun: dispositions
1. a person’s inherent qualities of mind and character.”a sweet-natured girl of a placid disposition”
synonyms: temperament, nature, character, constitution, makeup, mentality “a nervous disposition”
And to finish that indirect point:
So in putting on our reductionist hats we’ve come up with an easy-to-remember Illuminati-copyright-infringing model of three ways to analyze your (or anyone else’s) mental “condition.”
Somewhere in the middle of that painstakingly-photoshopped triangle would be your “condition.”
THREE WAYS TO LOOK AT YOUR OWN “CONDITION” :
- I have a DIAGNOSIS – Think of the condition as an officially sanctioned identification of a disease.
- I have a DISEASE – Think of the condition as a disorder of structure or function.
- I have a DISPOSITION – Think of the condition as inherent qualities of mind and character.
In the CBTN podcast-o-sphere we’re sticking to the term diagnosis because it’s a derivative of the most pervasive and commonly-spoken language in the mental health subculture. Amongst the afflicted there is a good deal of humor that revolves around said labels; it is internationally standardized, and tends to have a little more utility as a vocabulary than, say, “I’m a bleebblop glorpenschtein from Mars.” As annoying and arbitrary (and annoyingly arbitrary) as diagnostic labels can be, they’re already here and in use and give us a meaningful tool to compare and cross-analyze.
The interesting thing about diagnoses (and the point we’re trying to make here with the distinction) is that they can be, and in the case of MH are not infrequently flawed, incomplete, or entirely wrong. I have mentioned elsewhere that my original (incorrect) diagnosis was Bipolar Type 2. Now they’ve accounted for Schizoaffective symptoms but aren’t sure if it’s Bipolar with Schizoaffective or the other way around. This isn’t necessarily to point fingers at diagnosticians, but more highlight the complexities, symptom overlap, and inherent difficulty in accurately diagnosing anything, whether specifically MH related or in the broader medical spectrum as a whole. Though I’d like to believe there aren’t many doctors who would botch a diagnosis as badly as you botched Bob’s (shame on you!), most of us probably could think of someone (possibly even ourselves) right now, on the spot, who has been given the wrong diagnosis.
Further along this line of reasoning, I’d like to point you to an old YouTube clip of Chris Rock [WARNING: ADULT LANGUAGE] brilliantly demonstrating the difference between disease and disposition.
CHRIS ROCK: WHAT HAPPENED TO “CRAZY”?
There was a time in the not-too-distant past (Chris Rock remembers it) when “crazy” was a considered a disposition, not a disease. Now hang on a second, you say – “my [insert diagnosis] is NOT just a disposition!”
Right – I hope you hear me saying I concur. Again, myself and all of CBTN uses the term diagnosis. It’s not a show for people with crazy dispositions made by people with crazy dispositions (though that may or may not be the case). That being said, kick this thought around for a little while:
If my CONDITION is a DISEASE, then I:
- have something objectively “wrong” with me
- will never be “completely healthy”
- have zero control
The one redeeming quality of having a longitudinal disease is:
I can use this as a (legitimate) excuse for just about anything.
If my CONDITION is a DISPOSITION, then I:
- have nothing objectively “wrong” with me
- am (at least mentally) always “completely healthy”
- have complete control
With the one seemingly discouraging quality of being in control:
I am responsible for myself and have no excuses, ever.
If my CONDITION is a DIAGNOSIS, then I:
- may or may not have something objectively “wrong” with me
- may or may not be or become “completely healthy”
- may or may not have control over my mental health
This final perspective incurs the burden:
I have to work hard, pay attention to my mind and body, and will never be sure.
Hopefully that gives you a rough idea of why we here at the CBTN podcast have decided to use the term diagnosis instead of disease/illness or disposition. Of the three ways to interpret your own condition it is without a doubt the most difficult, complex, and emotionally and mentally taxing. It is the only of the three interpretations of your condition that doesn’t allow you to rely on a static, unchanging external set of rules. You will always have to alternate between trusting others’ outside perspectives and expertise and relying on your own education, self-awareness and understanding; likewise you will have to learn to distinguish between good and bad analyses and advice, both from others and from within yourself.
If you’re interested in further debating the merits of using diagnosis versus disease versus disposition, general discussion, or other related MH topics and debates, please visit and sign up for the free CBTN community forum. If you’d like to submit a guest article, artwork, or original research, please visit the Guidelines page for more details.