When I was doing my counseling internship in 2007, a pharmaceutical saleswoman presented at a staff educational luncheon. She told us that teenagers we had been seeing for depression actually had bipolar disorder. She suggested that we should diagnose them with bipolar and send them to our psychiatrist so he could prescribe the right medicine – the one she was selling.

A few years later when I was teaching at the local community college I asked my students to write personal reflections for class. Often, girls wrote about their struggle with bipolar disorder. “I know that there is a chemical imbalance in my brain, and this is something I will always have. I have made peace with it….” I can’t count how many times I read similar sentences. But – is it really true? And more importantly, is it helpful?

The medical model represents (and even creates) our cultural paradigm regarding mental health. The standard is to diagnose disorder based on a series of symptoms. In the psychology “bible”, the DSM (Diagnostic and Statistics Manual published by the American Psychological Association), there is a detailed description of each disorder and a sort of checklist of symptoms. It pretty much goes like this: If your client has four of the following 7 symptoms, and 3 of the following 5, they have this disorder.

For a lot of people, getting a diagnosis is a relief: “Now I know what it’s called. Now I know that there are other people like me”. And importantly, for parents of school-age kids, “now I can ask for accommodations at school”.

On the other hand, getting a diagnosis can seem like a life sentence. “There is something wrong with me. It has a name and probably a drug to take to keep it under control. I may have this for the rest of my life”.

The DSM and the medical model represent just one way to frame mental health and disorder. Other approaches focus more on wholeness than disorder, and on growth than on static conditions. Other cultures have different ideas about what is healthy and what is disordered.

It is important for us to remember that this time and culture in which we are living is just a snapshot in human history. In Washington’s day, it was standard medical care to put leeches on an ailing person. In the future, today’s standards of care will surely be seen as backward and often barbaric.

To the degree that a diagnosis is helpful – go for it, embrace and believe it!! But if it feels limiting, like a life sentence – remember that you are living at a time when we are led by the medical model and the DSM. It is one way, but not the only way, to frame mental health.