Dear EKC: Do I Need a Diagnosis?

Dear EKC,

I’ve lived in like five different countries and I’ve been struggling a lot after this last move. Some days, it feels like my brain is trying to run through molasses. I zone out in class, forget simple things, and just stare at my homework for hours without doing it. Other times, my thoughts race so fast I can’t keep up, and I feel completely overwhelmed. I get anxious over things that never used to bother me. When I tell my parents, they say I’m overthinking or just stressed from school or our most recent move. 

A couple weeks ago, I started looking up mental health topics online. I came across stories from people with anxiety and ADHD. A lot of what they described sounded really familiar. I started wondering, what if this is what’s happening to me? Would getting a diagnosis help me figure things out? 

Part of me feels like it would be a relief to have an actual name for what I’m going through instead of just feeling like I’m bad at handling life. But another part of me worries that if I get diagnosed, I’ll have a label for the rest of my life. What if teachers start teaching me differently, or it impacts what jobs I can get? 

My parents don’t think I need an assessment. They say I’m managing fine, that everyone struggles sometimes, and a diagnosis wouldn’t change anything. But I keep wondering–would knowing for sure make things easier? Or is it something I don’t really need? 

-Feeling Stuck

Dear Stuck,

I’m really glad you wrote in. You’re not alone in wondering about this. A lot of people ask whether they need a diagnosis and, I won’t keep you waiting—most of the time, the answer is “no.” It’s not something that’s required to get support and not having one doesn’t make your struggles any less real. That said, it’s also not a bad thing if you decide that you do want one! It’s just not always necessary. 

At EKC, we don’t work within the standard diagnostic model. We have good reason for this: the system used to diagnose mental health conditions (the DSM) was originally created for researchers. It was designed to make sure different studies could compare data accurately, not to define what does or doesn’t “count” as a mental health condition. Over time, it got picked up by insurance companies and turned into the rulebook for who qualifies for help. But if you look at how it works, it doesn’t really make sense to use it that way. 

For example, why does someone have to show symptoms for exactly two weeks for it to be called depression? Why not three, or ten, or one? Why does it require a specific number of symptoms when the severity isn’t even considered? Someone could be deeply struggling, but if they don’t check all the boxes, they don’t “fit” the diagnosis. That doesn’t mean that they don’t need help.

A lot of modern research is moving away from these strict categories and toward a more flexible way of understanding mental health. We’re looking at patterns of symptoms instead of trying to fit people in boxes. But that shift hasn’t made it into everyday mental healthcare yet. Because of that, we treat people for the symptoms they have, regardless of if they have a diagnosis. And so, a diagnosis isn’t always necessary. But there are some reasons it can be helpful:

• If you personally want a label: Some people find it reassuring to have a name for what they’re experiencing. If knowing for sure would help you make sense of things, that’s completely valid. EKC’s approach is client-centered. If this is something you think would be good for you, then we support that choice. 

• If you need school accommodations: Many schools require a diagnosis to offer extra support, like more time on tests or different learning methods. The process of getting diagnosed can also come with recommendations on what might help you. Since students who grow up internationally often switch schools, having a formal diagnosis can make it easier to carry that support from one place to the next. 

•  If we suspect autism or ADHD: Autism and ADHD are unique cases where a diagnosis can open up access to communities and resources that might not otherwise be available. A lot of people find that it helps them understand themselves better and feel more connected to others who share similar experiences. Because you’re wondering about this for yourself, it’s definitely worth considering. 

• If you’re considering certain medications: Some doctors will prescribe based on symptoms alone, but others require an official diagnosis, especially for certain types of medication. This is quite true for many ADHD meds, so it’s another reason to think about diagnosis in your case. 

A lot of parents worry that a diagnosis could lead to stigma or unfair treatment. In reality, most of the time, it leads to positive things: understanding, support, and access to help. That said, discrimination does happen in some cases, which is why a diagnosis isn’t always the best choice for everyone. If you don’t need one to access the help you want, and your school is willing to work with you without it, then you might not need to go through the process. But if the benefits outweigh the risks in your situation, it makes sense to get one. 

I’ve also seen people hesitate because they think they don’t “deserve” support unless they have a diagnosis. That’s just not true. A diagnosis isn’t the only way to access help, and not having one doesn’t mean you’ aren’t “struggling enough.” I’ve seen a lot of self-judgement around this–things like “I’m not bad enough,” or  “Other people have it worse; I’m just complaining.” But struggling is struggling. You don’t have to hit a certain level of difficulty before you deserve support. 

At EKC, we focus on what you’re actually experiencing rather than whether you fit into a specific category. A diagnosis can be helpful in some cases, but it’s not a requirement for getting help. No matter what, you deserve to live the best life you can. We’re rooting for you!  

Take care,

Jamie Fehribach

Psychologist & EKC Team Member