Clinical social worker chiming in here. A DSM-IV diagnosis is used to identify the What, not the Why. A person comes in, and in speaking with them you learn what their symptoms are currently, if they’ve existed in the past, and if the person is able to at all identify any precipitants to their current symptoms. Then, yes, you give a diagnosis.
I don’t understand why you bring up whether or not a clinician “gives a hoot” about the root cause. The diagnosis identifies the problem, it doesn’t create the treatment plan. A person seeking mental health treatment is given a diagnosis so you know what needs to be treated. For example, if a person comes in complaining of repeated anxiety attacks, you would give them a diagnosis on the anxiety disorder spectrum and then create a treatment plan based on the patient’s needs. And the Why *can *factor in when it comes to diagnosis, which is why there are qualifiers such as “Post-Partum Onset” with regards to depression.
That may have been a bit rambling but I think I made my point…I hope.
I was addressing the specific claim of the OP that a diagnosis of clinical depression necessitates there not being any visible ‘‘cause’’ for being depressed. It’s clear by the DSM-IV that ‘‘cause’’ has nothing to do with diagnosis.
Treatment is something else entirely–whether and to what extent cause is addressed depends on the form of treatment (I’ve noticed in CBT things tend to be less focused on cause and more focused on present concerns with functioning – in psychodynamic therapy the focus is more toward finding the root of the problem and bringing it to the forefront.) I in no way meant to imply that clinicians don’t care about what causes their patients’ ills… only that cause isn’t part of DSM-IV diagnostic criteria (you know, except in cases where it’s endemic, like PTSD.)
My ears perked up when you mentioned you do clinical social work. This is my ultimate career goal as well. Pretty freakin’ exciting.
Look, if you can get out of bed in the morning and go to work, it’s not a “mental illness”. I was a depressive teenager, but one that worked her ass off in school and got straight As, and I would scoff at the above. “Just because I manage to hold myself together doesn’t mean I’m not depressed!” I would have said. But then I hit the point where I couldn’t get out of bed. I slept all day every day. I didn’t eat. I didn’t shower- my hair was always disgusting. I couldn’t bear to walk outside, or talk to anyone. At that point, I realized the above was true. Everyone likes to believe they’re really depressed, but still go out and party and have sex and laugh and socialize… until the bad depression hits, and only then will they realize how much worse it can get.
It’s true. Fuck, it makes me so mad people have to go through this. I think suffering through that kind of depression was a new trauma in itself. Every subsequent depressive episode I have had ever since clawing my way out of the pit involved some kind of desperate panic pleasefortheloveofgod don’t make me go through that again, please, I’d rather die…
