In Sylvia Plath’s The Bell Jar, the main character gets hold of a diagnostic checklist of psychological conditions. In her downward spiral, she concludes that she is suffering from all of them. The episode is partly black humor, but many people today would probably miss the joke. They’re too busy diagnosing themselves with as suffering from all sorts of conditions, both dubious and real.
I first became aware of this modern tendency in the days after the 9-11 attacks. In the aftermath, people who lived on the other side of the continent from the attacks, people who had no friends or relatives killed or wounded in the attacks, and, in some cases, had never been to the sites of the attacks, were suddenly claiming that they were suffering from post-traumatic stress. Nor did they have any pre-existing trauma that the attacks might have triggered. Having heard of the condition, they were dignifying their alarm by elevating it to a psychological state. Very few (in fact, none, I would guess) had been officially diagnosed, or saw any need to be.
Soon after, I became aware that some computer programmers liked to claim that they were suffering from Asperger’s syndrome, a mild form of autism. The claim provided an excuse for any anti-social behavior, and, because Asperger’s is often associated with high intelligence, helped them to feel better about their shyness. Yet I never met one who had consulted a clinical psychologist to be properly diagnosed.
Since then, the habit has spread like a fire from an oil-soaked rag. I have heard people struggling to get by on four hours’ sleep each night allege that they were suffering from Chronic Fatigue Syndrome and people wired on eight or nine cups of coffee announce that they were suffering from Adult Attention Disorder Deficit. One person, starting to exercise after over a decade of inactivity and feeling a soreness and trembling in their arms and legs, claimed that they had Fibermyalgia; another, notoriously self-centered, states that they suffer from Prosopagnosia, or face-blindness. In one or two cases, I have heard people make one of these claims even after they had been diagnosed as not having the condition with which they identified so closely.
What makes these self-diagnoses particularly ludicrous is that some of these conditions are either not widely accepted as a physiological or psychological condition or else exist only under very specific conditions. However, such details are generally over-looked by the would-be sufferers.
Why people should make such unsubstantiated claims is not hard to understand. Saying that you have, for example, Chronic Fatigue Syndrome is more interesting, even to yourself, than admitting that you don’t take care of yourself. It also requires much less effort than changing your habits.
In the same way, to say you have face-blindness sounds far better than saying you are incompletely socialized, and need to learn to look beyond yourself and notice other people.
More importantly, if you have a psychiatric condition or a genetic predisposition, then your behavior isn’t your fault. You don’t have to do anything about it. You can excuse your behavior (at least to yourself) and go right on doing it. If anyone calls you to account, then they are the crass ones, not you. You are the victim of circumstance, and are not obliged to help yourself.
I make these statements with some confidence, because people who truly have these conditions generally act very differently. They do not announce their conditions to everyone they encounter – to the contrary, they often go to great lengths to conceal them, often changing their lifestyles or employment, or adding a battery of work-arounds to their arsenal of habits so that nobody will ever know. Far from being proud of their problems, they see them as handicaps or deficits for which they have to compensate and struggle against.
That is to say, people who really have problems don’t try to ennoble or publicize them. They’re too busy trying to do something about them.
In fact, what concerns me most about the self-diagnosing is that they can reduce the credibility of genuine sufferers. If employers encounter too many people using post-traumatic stress as an excuse for anti-social behavior, they may run out of patience and not give the necessary sympathy for the genuinely shell-shocked.
Similarly, anyone who encounters Adult Attention Deficit Disorder being used as an excuse for lack of concentration might very well be out of patience when they meet the real thing. After all, even reputable psychologists need time for a proper diagnosis, so how is anybody without training going to be able to separate the dubious condition from the true.?
I’m almost tempted to wish that the self-diagnosing could be inflicted for real with the conditions they already claim to have. But that would be cruel – many of these conditions are not ones that I would wish on anyone.
So instead, I’ll wish that the self-diagnosing would either grow up or keep quiet. What they are talking about is far too serious to tolerate their games. Unlike Esther Greenwood in The Bell Jar, many of them do not even have the excuse of adolescence or actual problems to justify their self-indulgence.
Off the Wall 
You forgot lactose intolerance, Crohn’s disease, and celiac disease on your list!
It’s the same thing with this new fad for blaming poorly-behaved children on all sorts of Deficit Disorders: ADD, ADHD, and the rest. When we were kids, there were no such conditions. If a kid’s behaviour was out of line, they were suffering from B.R.A.T. (Badly-Raised Anti-social Tyke) syndrome, which wasn’t a disorder as much as it was the result of poor parenting. This business of not-my-faulting everything is pathetic. I sure hope it goes out of vogue soon.
This is long … I apologize, but I have a complex set of feelings on the subject …
While I do understand what you’re saying and some people go overboard, as someone who is genuinely diagnosed with depression and anxiety, I don’t try to hide it. Not that I try to make a huge thing out of it, but there has been such a traditional stigma that can lead to people committing suicide or completely melting down rather than seeking help, I make a point of being willing to talk about it.
Being willing to talk about it has led me into meaningful conversations with people who’ve been struggling, and I think ultimately helped them (and sometimes me too). The most surreal was during a tour in southern Spain where I (a pagan) ended up essentially counseling a Catholic priest.
IMO self-diagnosis sometimes comes from a feeling of being “broken” and trying to understand what’s wrong. You notice things that seem strange about yourself and search for an explanation. For other people it’s totally attention-seeking. Perhaps for most it’s a blend of the two.
A personal example: my husband has suggested to me that I might have some level of face-blindness, as I’m constantly complaining that I can’t tell the difference between people in various movies/shows if their builds and hair are too similar. I’ve always recognized people in new situations by their hair and clothes as well, which has always screwed me up the next day. I’m also always meeting people who seem to remember me and desperately scrambling to try to place them (though to be fair when you attend/speak at a lot of conferences it’s common to have this problem). This isn’t helped by me having a problem remembering names as well.
Am I narcissistic and too self-absorbed to bother? I hope not. I’ve noticed that when I meet people or even do a talk, I often forget to offer my own name. I’m trying to get better about that and focusing more on other people’s to remember them.
Here’s another place where ultimately I just fess up and apologize. My memory is mostly contextual. If someone can give me a context of how we met I can often place them.
Am I hopelessly face-blind? Of course not. There’s actually online assessments you can take and as with so many things I test borderline (they’re pretty fascinating tests to take, really, I almost find them fun in a weird way). I think we all lie on spectrums with many of these things.
I admit that the latching onto 9/11 thing in particular was very annoying. “9/11 changed everything” was a phrase that made me roll my eyes every time I heard it, like no act of terrorism had ever been performed before. But it was the excuses toward responding with death and violence or persecution that really made me angry. The rest of it was just whiny.
And I do recall reading that experts actually do think that many talented computer programmers do suffer for a mild form of autism/asperger’s, which is one of the things that makes them so talented. But using such a thing as an excuse is a different thing than struggling with it, for sure.
Reminds me of how annoyed I get with the women who see PMS as an excuse to go wholesale b*tch on wheels on people. It’s one thing if you’re struggling and getting a little out of control. It’s another to throw yourself into the moment and enjoy being awful way too much. 😛
Dee-Ann:
Perhaps I went a little too far saying that people who really have chronic conditions try to hide them. It might be more accurate to say, as you do, that they don’t “make a huge deal of it.” By contrast, the self-diagnosers tend to mention their alleged problem almost as soon as you meet them, even if you might not have otherwise been aware of it.
I think that Occam’s Razor is a useful tool when you are wondering about whether you have a medical condition. For example, I’m sure I could find some proposed syndrome to explain why I can be clumsy. Perhaps some defficiency in my nervous system? However, the simplest — and, therefore, the most likeliest — explanation is that I am just a typical left-hander trying to cope with a world that isn’t set up for me. I would only be inclined to search for a more detailed explanation if I had had experiences that suggested something more; I haven’t, so I don’t. But this is the complete opposite of what self-diagnosers do — they immediately seize on an extreme explanation when there is a much simpler one, often to do with their own behavior.
Oh, and thanks for answering those who got a false impression of what I said and leaped to the attack. I don’t mind people disagreeing with me, but, if they do, I wish they would disagree with what I actually said, not what they imagine I said.
I am a person who worked her way through undergraduate and law school while supporting herself and her child. I had a wonderful job with a six-figure income when I got the worse flu I have ever had in my life on 12-31-86. It has never gone away. Far from self diagnosing, I saw lots of doctors, who found lots of things wrong with me but were unsuccessful in treating them. In 1996 I became so ill that I was unable to work. My income plummeted, I lost the job I loved, etc. I was diagnosed in 1991 with Myalgic Encephalomyelitis (ME), which is also known as Chronic Fatigue Syndrome. I can tell you prior to becoming ill, I was happy, healthy and successful. I certainly wasn’t searching for an illness to diagnose myself with. I was too busy having a great life.
In January 2010, I was found positive for the XMRV retrovirus, which has been closely associated with ME. Retroviruses do not occur in imaginary illnesses.
In the meantime, I have been ill for 24 years, and I have seen what I have valued most in my life disappear.
Not everyone with an illness such as ME is malingering or self diagnosing. I know I am not. I also know that if there were anything I could have done in the last quarter century of suffering which would have cured me or even alleviated the suffering, I would have done it.
You do me and people who are really suffering from ME and other illnesses an injustice by assuming we are malingering.
I hope that neither you nor someone close to you ever suffers from ME. It is devastating and it steals people’s lives.
Patricia Carter
XMRV+, 24 years ME
I’m afraid you are putting words into my mouth. I neither said or implied what you claim.
If you read carefully, you will see that I am not accusing everybody who has a condition of malingering. I am saying that some people, without being diagnosed, decide that they have some condition that they have heard about in the media. I also say that these people harm those who have a real problem by trivializing their conditions.
You had observable problems, and were diagnosed with chronic fatigue, so I am clearly not talking about you or people like you. In fact, it is because I know people like you who have serious problems that the self-dramatizing anger me.
what patricia said…happen to me too….and millions others like us. so before you write your cocky litle know it all blog it might be nice if you had the facts about a truly life devastating/destroying disease.
Please read the comment I just posted to Patricia. If you read the blog again, you will see that I am not saying what you are reacting to.
Anyway, why do you assume that I have no personal experience of chronic conditions?
Bruce pretty clearly said that these are not imaginary disorders and that people claiming to have them when they don’t are harming those who do.
There are reasons why someone suffering from a disease like CFS might read something different into a piece like this. That would include cognitive difficulties, which is common in CFS, and decades of being told what should be clearly seen as an organic, physical disease, as being all in one’s head. Through a prism colored by perceptions of hypochondria and other psychological disorders which might resemble aspects of CFS to anyone who hasn’t taken the step of doing just a wee bit of research.
This is something that should be at least as objectionable as the self-diagnosis issue that this piece actually addresses.
So give Patricia a break, please. The derision aimed at those self-diagnosing here is more reminiscent of the scorn directed at those suffering from CFS in general than you might imagine. For every piece that carries this nuance one tends to see several offering their own opinion of CFS and those who suffer from it.
I would suggest that if you were interested in bizarre behavior surrounding CFS you might take a look at how medical authorities have handled this disease for 25 years. When you put names like Straus, Wessely, Reeves, White, Chalder, and Sharpe together–among others–and examine how they’ve treated this illness and those suffering from it–you’d have quite an interesting piece that I would suggest should rise to the level of interest, at the very least, that you have found in the observations that led you to put this piece together.
You are right that some chronic conditions have been too quickly and easilly dismissed over the years. But that’s another topic, and not the one that I was writing about.
As for the request to “give Patricia a break,” I hardly think that telling her politely that she has misread is being hard on her. After all, if we are not talking about the same thing, we can hardly have a discussion.