• Deviance: Whether someone’s behavior is acceptable in their specific culture (or cultures) and society. For example, “disorganized speech” (where someone is impossible to understand due to a disorder in how their thoughts are put together) is a symptom of schizophrenia. It is incredibly important for therapists (and all mental health professionals) to understand someone’s background/context before diagnosing them. The situation changes completely if the person was speaking in tongues while praying. In that case, speaking in tongues would not be considered disorganized speech aka a symptom of a mental disorder because it is an appropriate part of that religion/culture. See what I mean?

• Distress: Do the symptoms this person is experiencing cause them (or the people around them) clinically significant distress (EG: a lot of anxiety, sadness, pain, etc)? If you’re wondering why causing other people clinically significant distress in written into the diagnosis: For certain mental disorders (personality disorders, etc) and in other situations, a client may not notice their symptoms or the impact these symptoms have. This is called having “poor insight”. But just because the person can’t tell that anything is off/wrong, doesn’t mean that their loved ones and others around them aren’t affected. Example: A spouse who is currently having a manic episode and impulsively spending all the rent money. A therapist could still use this information to diagnose their client.

• Dysfunction: Do the person’s symptoms affect their ability to function in society (hold a job, pay bills, maintain social relationships/obligations, personal hygiene, etc). This does not mean the person’s whole life has to be dysfunctional. Symptoms could affect 1 area of someone’s life so much that it qualifies. For example, social anxiety symptoms that affect a person’s ability to go on successful job interviews, but don’t come up when hanging out with friends would still count.

• Danger: And finally, do the person’s symptoms cause them to be a danger to themselves or others. [Note: Danger alone does not mean someone has a mental illness. Lemme say that again: violence, abuse, and any other kind of danger (emotional, physical or otherwise) alone does not mean someone has a mental illness. So stop saying every person who is engaging in violence has a mental disorder. That’s NOT true at all. It adds to the stigma against people living with mental disorders (who are more likely to be victims of crimes/violence/abuse/neglect and therefore are always shafted in terms of healthcare and treatment because of this stigma). And it lets people who engage in violence, and this society that enables them, off the hook instead of really addressing root causes of violent behavior.

So what is Depression? Because I refer to the kitchen in my home as “my kitchen”, I find it the easiest to think about mental health disorder diagnoses like recipes. Every recipe needs ingredients and these ingredients have to cook for a certain amount of time before the meal is ready. To make a major depressive disorder, you need to cook at least 5 of the following “ingredients” for at least 2 weeks [These symptoms must cause distress or dysfunction and the symptoms must not be caused by anything else like medication/drugs or another medical condition]:

Must Have At Least 1 From Here:

• Feeling depressed (or other people think you look depressed) nearly every day; Kids might look irritable instead of depressed
  • Translation: Feeling shitty, cranky/irritable, down, etc so intensely that it causes distress and/or dysfunction, etc
• No longer interested or no longer enjoying all or almost all activities most of the day, nearly every day
  • Translation: You just don’t care about the stuff you used to or the same stuff doesn’t make you feel good anymore. You might find yourself pulling away from people and being social

• Huge weight loss/gain or appetite decrease/increase
  • Translation: Eating can either feel like a chore, be your new best friend, or all of the above depending on the context. The important part here is that your usual behavior has changed
• Insomnia or hypersomnia nearly every day
  • Translation: You have problems falling sleep and/or staying asleep or you sleep for hours more than you usually do
• Psychomotor agitation or retardation nearly every day that other people gotta be able to see
  • Translation: Agitation – Looking agitated (think restless movements like nail-biting, skin-picking, pacing, fidgeting, etc) to people or Retardation – Looking as if your speech, thoughts, and physical movements have slowed down, taking longer than usual to react, and/or you are talking much less, much quieter or with much less feeling. Psychomotor retardation is what can make doing every day activities (showering, cooking, household chores, paying bills, answering emails, doing homework, work, etc) feel impossible to do because it feels like you are physically incapable, almost like there are invisible weights/pressure on and all around you.
• Feeling fatigue or loss of energy nearly every day
  • Translation: Feeling tired to the bone. Even the smallest activities might make you feel exhausted and you don’t get shit done the way you usually do
• Feeling worthless or excessively/inappropriately guilty nearly every day
  • Translation: Holding yourself to unrealistic expectations, constantly ruminating/reviewing past mistakes, and/or seeing everything as evidence that you ain’t shit or blaming yourself for things that couldn’t possibly be your fault
• Difficulties concentrating or indecisiveness nearly every day
  • Translation: Feeling distracted often, having trouble remembering things, and/or making even small decisions feels incredibly hard
• Repeatedly thinking about death, thinking about suicide, thinking about suicide with a specific plan on how to do it, or attempting suicide
  • Translation: Passively wishing you could go to sleep and not wake up and believing that others would be better off if you weren’t alive on the lower risk end of the spectrum and constantly thinking about committing suicide, having a specific plan of how to do it, and/or attempting suicide would be on the higher risk end of the spectrum

I’m telling you all this, not so y’all can run around diagnosing people on the internet or IRL. Diagnosing a whole human being is not something you can do after reading a few pages in a manual. There’s so much work that goes into diagnosing a client: proper information gathering, taking into account the many parts of what makes each disorder, how the disorder develops in theory and in real life, risk factors, cultural issues, gender-related issues, and then comparing similar symptoms within multiple disorders to make sure that the diagnosis is as accurate as possible, etc. Basically, y’all, what I’m saying is take these good tips I’m giving you at face value and stay in your lane before you cause damage trying to diagnose or read someone’s mental status. Thanks!