For many people, receiving a mental health diagnosis brings mixed emotions. There can be relief from a sense that you finally understand what’s going on. There can also be fear, confusion, anger, or grief. Some people feel seen for the first time, while others may feel reduced to a label that doesn’t quite fit.

These reactions make sense. Mental health diagnoses are powerful tools, but they are not neutral, and they are not complete stories. Understanding what a diagnosis is, what it isn’t, and how it’s used matters deeply for healing.

From an existential therapy perspective, diagnoses are best understood not as verdicts, but as meaning-making frameworks. They are tools that have the potential to deepen understanding for individuals and support their healing.

What is a Mental Health Diagnosis?

At a basic level, a diagnosis is a shared clinical language. It helps professionals communicate, guides treatment planning, and allows people to access care, insurance coverage, and accommodations. For many, it offers validation, relief from years of self-blame, and more clarity about their needs.

However, diagnoses are also limited by design. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) itself acknowledges that diagnoses are descriptive categories, not explanations of cause or meaning (American Psychiatric Association, 2022). They describe patterns of distress that tend to cluster together. They do not explain why those patterns developed in a specific person, within a particular life.

A diagnosis is not:

• A full description of who you are
• A definitive explanation of your suffering
• A prediction of your future
• A measure of your worth

Harm can occur when diagnoses are mistaken for identity or viewed as having absolute outcomes.

When Diagnoses Can Be Genuinely Helpful

Used with care, diagnoses can provide orientation. They can help people recognize patterns, feel less alone, and find language for experiences that once felt chaotic or unspeakable. Naming experiences can reduce shame and increase engagement in treatment when the diagnosis is offered collaboratively and respectfully.

Diagnoses can also:

• Guide evidence-based treatment options
• Help people find community and shared understanding
• Support access to workplace or academic accommodations
• Offer a starting point for self-reflection and healing

A mental health diagnosis can function like a map. It doesn’t tell you who you are, but it can help you understand where you are, how you function, and what supports you need.

When Diagnoses Can Do Harm

Diagnoses themselves aren’t negative. However, harm can occur when they are treated as fixed truths rather than evolving tools.

One common example of this is the pathologizing of trauma. Many symptoms, such as hypervigilance, emotional numbing, dissociation, and difficulty trusting, are understandable responses to chronic stress or trauma. When these are diagnosed as a disorder without adequate attention to trauma history, people can internalize the belief that something is “wrong” with them, rather than recognizing that their nervous system adapted to survive (van der Kolk, 2014).

Another harm occurs when diagnosing obscure neurodivergence. Autistic traits, ADHD patterns, sensory sensitivity, or differences in emotional processing are often framed solely as deficits. In reality, distress frequently arises from environments that are invalidating, overstimulating, or rigid. It’s important to distinguish between intrinsic traits and stress responses shaped by social exclusion (Kapp, 2020).

In these cases, the diagnosis may accurately describe distress, but misunderstand its source.

Are Diagnoses Helpful or Harmful?

Rather than asking whether diagnoses are good or bad, a more helpful question is: How are they being used, and in whose service?

Diagnoses are most helpful when they:

• Invite curiosity rather than shut it down
• Reduce shame rather than reinforce it
• Encourage compassion for self and others
• Leave room for context, culture, and meaning

They become harmful when they:

• Reduce a person to a checklist
• Ignore trauma, oppression, or environment
• Are used to dismiss lived experience
• Imply permanence where there is change

From an existential perspective, suffering is something to be understood. Diagnoses can be used to support that understanding, not replace it.

Mental Health Diagnosis as a Tool for Meaning-Making

Existential therapy invites a different relationship with diagnosis. Instead of asking “What’s wrong with me?”, the question becomes: “What has my suffering been responding to?”

Seen this way, diagnoses are lenses, not identities. They can help illuminate patterns while still honoring the complexity of a life shaped by lived experience, relationships, culture, trauma, values, and choice.

For example:

• Depression may reflect not only mood symptoms, but grief, loss of meaning, or chronic invalidation
• Anxiety may point to a nervous system shaped by unpredictability or threat
• Personality diagnoses may describe relational strategies learned early to maintain safety or connection

A thoughtful approach to diagnostic assessment recognizes that diagnostic systems evolve, that people change, and that no manual can fully capture human complexity.

This looks like a mental health provider:

• Letting diagnosis inform care without defining a patient’s identity
• Revisiting it as understanding deepens
• Naming what it explains and what it doesn’t
• Allowing lived experience to remain central

Reclaiming Agency in the Diagnostic Process

When diagnoses are imposed without collaboration, they can feel alienating. However, when they are explored together—curiously, gently, and with respect—they can become tools for self-understanding rather than sources of shame.

Meaning is not something a diagnosis gives you. It’s something you build with it, and a great psychiatrist and therapist can support you in this process.

Collaborative Diagnostic Assessment | Seattle, Washington

At Existential Psychiatry, diagnoses are approached as one part of a much larger human story. If you’re seeking answers or want a psychiatrist who views you as a whole and complex individual, Dr. David Zacharias approaches diagnostic assessment with nuance, care, and depth. If you have questions or would like to begin services, please reach out for a free consultation.

Written by Existential Psychiatry Staff

References

• American Psychiatric Association. (2022). DSM-5-TR: Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
• Kapp, S. K. (2020). Autistic community and the neurodiversity movement: Stories from the frontline. Palgrave Macmillan.
• van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.