Recently I was getting some medical paperwork together in preparation to go to see a new gynecologist (I have endometriosis in addition to obsessive compulsive disorder). One paper from the office of the doctor who performed my laparoscopic surgery for endometriosis listed various diagnoses for me. There, listed among their diagnoses were not only endometriosis but fatigue, nausea, pelvic pain, depression/anxiety, etc. etc…..and OCD.

I read this and then looked at the date on the paper. It was months before I had my contamination OCD take over which lead me to self-diagnose and finally seek professional help. So I saw that “OCD” and thought, “Really?”

Did he diagnosis me based on things I had said? Did I tell him I had OCD and just blocked it out? Did I actually know, realize, and publicize that I had OCD this whole time and blocked that out? Or had the diagnosis been passed down through my medical records from the doctor who originally told me I had OCD over ten years ago?

Lag Time

After finding this paper and still being a little freaked out, I went on twitter and asked “Did anyone else have a lag between getting a diagnosis and accepting/understanding/acknowledging your mental illness?”

Because I personally feel like I had a long lag time. Part of me feels like I had no idea, like I thought I just had anxiety or other problems…even though I discovered a few months ago that I wrote in a journal over ten years ago that a doctor diagnosed me with OCD.

The whole thing shakes me up. What happened? Why didn’t I embrace my diagnosis and start my journey to recovery properly back then? I am even having obsessions and anxiety now over whether or not I did (quote unquote) know that I had OCD the last 11-12 or so years of my life. I feel like I’ve misled or am misleading people somehow if I did know.

Which brings me to the real question. Which is more important: the diagnosis or our own acceptance and internalization of the diagnosis? 

For me, I feel like I must have heard that diagnosis from the doctor so long ago but not taken the time to really figure out what having OCD meant. I went on medication and trusted that would be enough. Over time, I guess I forgot or just got used to it. But it wasn’t until things got so difficult and debilitating that I realized this wasn’t something I could sweep under the rug anymore.

I think that sometimes we can live with mental illnesses or habits or personality traits and “just manage.” Maybe we can forget that we have a mental illness. Maybe we can forget it long enough that we drown it out and go into denial. But can we ignore our issues long enough that we successfully convince ourselves that they don’t exist or aren’t severe enough to warrant taking any action?

Breaking and Starting Points

Maybe. But then, occasionally, something happens. Something snaps, changes, or tips the scales. It is at these critical turning points that we can make a choice. Are we going to do something about it? Are we going to acknowledge our issues or mental illness or personality trait and actually do something different? Or are we just going to shrug and say, “Well, that’s just the way I am”?

When it comes to mental illness specifically, I, for one, think a diagnosis is critical. But it is not enough. It was not enough for me to get lasting and transformative care or to even understand that OCD was a part of me that was there to stay. I had to really accept it. I had to understand it and acknowledge what it meant and implied.

Stigma Blocking

For me, I think that’s where stigmas of mental illnesses do significant damage, especially when it comes to OCD. So often, people consider OCD to mean certain superficial habits such as organization and cleanliness. Because of this, someone who receives an OCD diagnosis from a doctor might just shrug it off before researching or understanding the breadth and scope of obsessive compulsive disorder.

After the Diagnosis

So yes, a diagnosis is one step, but it should not be the end. It is the beginning. Then comes the work of accepting, internalizing, researching, acknowledging, and owning that diagnosis and what it means for you personally.

So, honestly, I don’t really know if I “knew” I had OCD this whole time. Yes, I was diagnosed. I was told. But does hearing and being told equate to understanding? Not always, and not for everyone. I suppose it doesn’t matter in the long run. What matters is what we do once we understand and accept. How will we act? How will we live now? How does this change us, and how will we help others as they work through similar struggles? That’s what matters.

Thoughts? Are diagnosis and internalization of a diagnosis different? Is one more important than the other?