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Tests and diagnosis
By Mayo Clinic staffWhen doctors believe someone has a mental illness, they typically run a series of medical and psychological tests and exams. These can help rule out other problems that could be causing your symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
- Physical exam. This may include measuring height and weight, checking vital signs, such as heart rate, blood pressure and temperature, listening to your heart and lungs, and examining your abdomen.
- Laboratory tests. These may include a complete blood count (CBC), screening for alcohol and drugs, and a check of your thyroid function.
- Psychological evaluation. A doctor or mental health provider talks to you about your thoughts, feelings and behavior patterns. He or she asks about your symptoms, including when they started, how severe they are, how they affect your daily life and whether you've had similar episodes in the past. You also discuss any thoughts you may have of suicide, self-harm or harming others.
Pinpointing which mental illness you have
It sometimes can be difficult to determine which particular mental illness or mental illnesses you have. For one thing, many mental illnesses share similar symptoms. Also, a diagnosis is often based largely on how you describe your symptoms, along with how your doctor interprets those symptoms and observes you behaving. Because of this, it can take some time and effort to get an accurate diagnosis. Be sure to stick with it, though, so that you can get appropriate treatment designed for your particular illness and situation.
The symptoms and clinical features for each mental illness are detailed in a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
To be diagnosed with a particular mental illness, you must meet the criteria for that illness listed in the current version of the DSM. Mental illnesses are grouped together in the DSM based on their symptoms. The concept of mental illness is somewhat controversial, and even experts sometimes disagree about what's considered normal or abnormal mental health. The scope of what's considered a mental illness continues to evolve.
Classes of mental illness
The main classes of mental illness are:
- Mood disorders. These include disorders that affect how you feel, such as persistent sadness or feelings of euphoria. Among them are major depression, dysthymia and bipolar disorder.
- Anxiety disorders. Anxiety is an emotion characterized by the anticipation of future danger or misfortune accompanied by a feeling of being ill at ease. Examples include panic disorder, obsessive-compulsive disorder, specific phobias and generalized anxiety disorder.
- Substance-related disorders. These include problems associated with the misuse of alcohol, nicotine, caffeine and illicit drugs.
- Psychotic disorders. These disorders impair your sense of reality. The most notable example of this is schizophrenia, although other classes of disorders can be associated with psychosis at times.
- Cognitive disorders. These disorders affect your ability to think and reason. They include delirium, dementia and memory problems. One of the most recognizable is Alzheimer's disease.
- Developmental disorders. This category covers a wide range of problems that usually first begin in infancy, childhood or adolescence. They include autism, attention-deficit/hyperactivity disorder and learning disabilities. But just because they're all grouped in this category doesn't necessarily mean they share a common cause or that there's a relationship among the disorders.
- Personality disorders. A personality disorder is a lasting pattern of inner experience and behavior that is dysfunctional and leads to distress or impairment. Examples include borderline personality disorder and antisocial personality disorder.
- Other disorders. These include disorders of impulse control, sleep, sexual functioning and eating. Also included are dissociative disorders, in which your sense of self is disrupted, and somatoform disorders, in which there are physical symptoms in the absence of a clear physical cause, such as hypochondriasis.
