I’m a Mental Health Therapist, and I Believe the Way We Talk About Diagnosis Is Making Us Sick
Let me be clear: Mental health struggles are real.
When you’re buried under depression, it’s not just sadness—it’s a complete loss of color in life, a weight that makes every action feel pointless.
When you’re battling anxiety, it’s not just overthinking—it’s an endless loop of tension and fear, convincing you that something bad is always about to happen.
When your brain feels scattered, unfocused, and restless, it’s not just distraction—it’s feeling like you’re constantly falling behind, no matter how hard you try.
If you’ve ever felt like life is harder for you than it seems to be for everyone else, you’re not imagining it.
And when you finally sit down in a therapist’s office, desperate for answers, you’re given a diagnosis.
It can be hugely cathartic and relieving because now, it makes sense. You’re not imagining things. There’s a name for what you’ve been feeling. There’s a reason life has been so hard.
And having that understanding? That alone can be powerful.
It removes shame. It helps you realize you’re not just “failing at life.” It gives you a framework for why things feel so difficult.
But it also has another side effect—one that most people don’t see coming:
When you believe something is a fixed part of you—when you believe your brain chemicals are the problem—you lose the ability to have influence over it.
Because if it’s just a malfunction of your brain, then what’s left to do besides manage it?
This is why people have been told for decades that depression is caused by a “chemical imbalance,” a serotonin deficiency in the brain, a bad roll of the genetic lottery. It’s why so many people, myself included, were left coping with a handful of diagnoses.
But here’s the problem: That theory has never been proven.
In fact, recent research shows that there is no evidence to support the serotonin theory of depression at all.
The Serotonin Theory of Depression Was Never True
In 2022, a comprehensive review of decades of research was published in Nature Molecular Psychiatry, concluding that there is no scientific evidence that low serotonin causes depression.
For years, people have been told that their depression is the result of a serotonin imbalance, a defect in their brain chemistry—something they were born with or destined to have.
And it turns out, that story was just that—a story. A belief. We don’t know if there is a biological cause
That’s not to say medication can’t be helpful. About half of people find great relief from medications, and that’s wonderful. It is important to mention although that this paper suggests that the real relief people feel may not be caused by fixing serotonin deficiency, but instead may actually be a placebo effect (more on that in a moment).
And yet, we’ve built an entire mental health system around this idea.
A system that convinces people that their suffering is hardwired. A system that encourages people to identify as a diagnosis. A system that tells people that their best hope is symptom management—not recovery.
And when you believe that your suffering is permanent, it becomes permanent.
This is The Belief Effect—your mind actively shapes your reality based on what you expect to be true. Back to that placebo. If you believe that you have a chemical balance and you take a pill to fix it, you gain hope and the belief that you can actually be well. Unfortunately, this also comes with a few side-effects (literally and figuratively, the side effects can be brutal): it reinforces that your brain is defective, and for many, that leads to a constant cycle of medication management focused on illness instead of medication being a tool for recovery.
If you believe you’ll never recover, you don’t have a reason to look for ways to. If you believe you’re broken, you find endless proof that you are. If you believe your brain is the problem, you may not delve into the other factors that may be at the root of your challenges.
Even worse, we’re reinforcing it. At the core of depression, you’ll almost always find two beliefs:
Hopelessness—the belief that things will never change.
Defectiveness—the belief that something is inherently wrong with you.
Now think about how we talk about depression in the mental health world.
“You’ll always have this condition.”
“Your brain is chemically broken.”
Our attempts to treat people, while well intentioned, have stopped people from recovering at best, and have made them more ill at worst.
Therapists Are Required to Diagnose
Here’s something most people don’t realize:
If you’re using insurance for therapy, your therapist has to give you a diagnosis—immediately.
No diagnosis? No billing code. No insurance reimbursement.
But it’s bigger than that.
Not only are therapists not taught that people can fully recover, we’re explicitly and implicitly taught that they can’t.
In graduate school, we’re trained to help people cope with their symptoms, not to guide them toward a full recovery.
The messaging is clear: Mental illness is chronic. Symptoms can be managed, not eliminated. Coping is the best we can do.
And if you’ve never personally recovered from mental health struggles yourself, what frame of reference would you have to question that?
How would you know any different?
This isn’t about blaming therapists, life coaches, or psychiatrists. Most enter the field because they deeply want to help people.
But the system they’re trained in is flawed.
And that realization? It was painful for me. Deeply painful.
Because as I worked with more clients, I started seeing something I couldn’t ignore:
The way I had been diagnosing people wasn’t just giving them answers—it was keeping them stuck.
I wasn’t helping them recover. I was reinforcing the belief that they never could.
That’s a hard thing to admit.
And for any provider to move forward from this, they would have to admit the same, a truth that will likely make this cycle hard to break.
Therapy Is an Institution. The DSM Is a Bible.
The field of mental health was built on a foundation of treating illness instead of promoting wellness.
Instead of focusing on the wisdom of the person in front of us, it’s been aimed at pathologizing people and positioning therapists as the experts.
We, as therapists, have been trained to believe that we hold the knowledge, that we have the answers, that our job is to diagnose, label, and treat.
And without realizing it, that framework—one built on good intentions to help—has also served as a way to reinforce our own egos around being a helper.
Because when you believe you are the expert, you also believe your clients need you. For many of us who are motivated by helping, that can be intoxicating. It can also leave you in an ever lasting loop of wondering whether or not you’re truly helping, and doing everything that you can to prove that you are (even if that means calling the client resistant and blaming them for their lack of progress).
You become the person who “understands.” The one who “sees what they can’t.” The one who knows what’s best for them.
But the truth is, our clients are the ones who hold the answers.
And the moment we stop positioning ourselves as the authority over their experience, the moment we stop believing that the DSM (Diagnostic and Statistical manual, the tool that we use to diagnose) has the final say in who they are, is the moment we actually start helping them recover.
How I Recovered
At my lowest point, I had been kicked out of school. I had cycled through therapist after therapist, medication after medication, and nothing seemed to work.
But then, something happened.
I started reading Feeling Good by David Burns.
One day, while going for a walk, I had a realization that changed everything:
"My belief that I’m a failure is just that—a belief."
I used to fear that I would end up on the streets, because that’s what failures do.
But then I stopped myself.
I don’t see people without homes as failures. I don’t see my friends who have struggled as failures. In fact, I don’t think anyone is a failure.
So why did I believe that about myself?
And if that belief wasn’t true, what else wasn’t?
That I would always be depressed? That I would always be anxious? That I would always be stuck?
At that moment, my certainty crumbled.
And uncertainty? That was the most powerful thing I’d ever felt. I became certain in my ability to live differently.
After a lifetime of struggling with school, I returned and graduated with a 4.0. I knew I would spend the rest of my life guiding others to find this relief as well, and went on to practice therapy.
Final Thoughts: We Don’t Treat Diagnoses—We Treat People
The more I worked with people—people with PTSD, OCD, panic attacks, anxiety, depression—the more I saw something I couldn’t ignore.
They were recovering.
Not just managing symptoms. Recovering.
Because when people stop seeing themselves as permanently broken, they start responding to life differently.
And when they start responding to life differently, they start healing.
The mental health world needs a shift—not one of blame, but of understanding.
Therapists, life coaches, and psychiatrists: We have to move beyond pathologizing people and toward actually helping them navigate their experiences in a way that leads to lasting change.
Instead of reinforcing the idea that suffering is permanent, we can help people understand what their symptoms are actually telling them.
Instead of focusing solely on diagnosis, we can guide people toward responding to their experiences in a way that leads to growth.
Instead of acting as the authority on people’s lives, we can trust that they already hold the answers—we just need to help them uncover them.
The best way we can do this? By doing our own work.
If we’ve recovered from our own suffering, we can guide others from a place of truth, not just theory.
If we’ve done the deep, uncomfortable work of questioning our own beliefs, we can help others do the same.
If we’ve moved beyond identifying with our struggles, we can help our clients move beyond theirs.
That’s how we change lives—not just theirs, but ours too.
Because at the end of the day, we don’t treat disorders.
We work with people.
