Why Self-Diagnosing Mental Health Conditions Can Delay Real Treatment

The dangers of self-diagnosis for mental health, and the safety of psychiatrists

People struggling with mental health may turn first to search engines or artificial intelligence to self-diagnose and seek relief.

But Dr. Sid Khurana, a psychiatrist and medical director for Nevada Mental Health, said well-intentioned self-care may slow recovery rather than speed it, and may send patients down errant paths.

Khurana said people who consult “Dr. Google” or “Dr. ChatGPT” (or their colleagues, “Dr. Claude,” “Dr. Gemini” and “Dr. Perplexity”) have taken an important first step.

“They might have done their own research and may have self-diagnosed. But what I view is, they are here for help, and … I inquire what are their reasons for thinking what they did,” he said. “We get that history, go through our own full process, move the self-diagnosis to the side. And then we follow our own process.”

Psychiatrists, licensed physicians who have attended medical school, specialize in diagnosing mental health conditions. These clinicians can prescribe medication when appropriate, but only after comprehensive evaluations that transcend symptom checklists and pattern matching.

Getting to the core

If patients’ self-diagnoses align with psychiatrists’ findings, great, Khurana said. But when the two differ, clinical methodology and practice become especially important.

“People may have done their own Google searches and come in with a self-diagnosis. I ask what led them to think that. We talk through their reasoning, get the history, and then we go through our own full diagnostic process.”

“I’ll ask them, ‘Do you really want to be a guinea pig, where different things are tried without a clear understanding of what’s actually going on?’” Khurana said.

Otherwise, patients may be guessing at their own treatment, throwing darts at the proverbial board, hoping that something will stick. Patients may see symptoms that seem straightforward and draw facile conclusions — Low mood? Lack of energy? Must be depression.

But Khurana said patients can miss underlying or overlapping conditions. Depression like symptoms, for example, can mask anxiety disorders, attention-deficit/hyperactivity disorder or other problems requiring medical intervention.

A holistic approach

Psychiatry seeks to deliver mental health care by understanding underpinning contexts — physical conditions, life experiences and day-to-day stressors. By studying these life layers, psychiatrists can help patients.

“When you go to a psychiatrist who has medical training, you will be evaluated and assessed for other medical conditions that may look like or present like depression,” Khurana said. “(A psychiatrist will weigh) whether the problem is the side effect of the medications you’re on or the thyroid problem or cortisol problem, other hormonal conditions, electrolyte problems.”

Psychiatrists can order and interpret lab work to determine whether symptoms stem from a psychiatric condition or an underlying medical issue.

“All that is assessed for and the lab work’s done to actually diagnose whether what looks like depression is actually depression, or is it a medical thing that’s going on?”

Finding the right path

Treatment begins not with a prescription pad, but with conversation, about past treatments, current struggles and continuing life circumstances.

“The psychiatric interview is free-flowing,” Khurana said. “Patients can talk about what’s on their mind, their history, their stressors. That context is very important.”

From there, psychiatrists may recommend lab tests or screenings, including electrocardiograms, to ensure treatment choices are safe and appropriate.

The goal is finding, and treating, the root cause, and knowing what conditions are, and isn’t. For example, Khurana said, irritability or anger can arise from stresses at work or home, but they can also reflect diagnosable conditions that psychiatrists are trained to identify and treat.

“We take the biology into it … the psychology and the social aspects of it, put all those components together, come up with a diagnosis,” he said. “And then we come up with a treatment plan, which is really hard to do without the expertise of a qualified mental health professional.”

Continuity of care

Telepsychiatry has expanded access to care, letting patients and psychiatrists meet wherever there is an internet connection. That convenience can help build trust and boost care.

“You, as a patient, continue to follow with the same psychiatrist, so there is that connection that is being built … there is rapport being built,” Khurana said. “So, you can start talking about what you need to talk about rather than feeling the discomfort of, ‘I don’t know this person. Should I trust them?’”

Medicine only when necessary

Before deciding whether treatment plans should include medicine, psychiatrists will rule other potential medical complications and whether treatment can succeed drug-free. If something needs fixing at once, though, psychiatrists, as doctors, can deliver emergency pharmacological care.

“Medication does not treat all psychiatric conditions, so I think that’s where the thoroughness of an evaluation comes in,” he said. “But we also recognize some situations and conditions are very urgent, and they need a fix right then. A stitch in time saves nine.”