You, too, can acquire a psychiatric diagnosis!

If the sun has set on the age of Sigmund Freud, it certainly hasn’t set on the age of therapy. The Wall Street Journal just published a “how to” article about the quest some people have made to get, uh, whatever it is they offer. This article bears the heading, Help Wanted: a Good Therapist. Just think…Heaven forbid that one should be caught without a therapist.

Therese Borchard went through 6 shrinks before she came to the one she must have been looking for all along.

Finally, No. 7 diagnosed bipolar disorder, found medication that was effective, helped her to be less hard on herself and “salvaged the last crumb of my self-esteem,” says Ms. Borchard, who writes the popular “Beyond Blue” blog on

Wow! Therapist No. 7 diagnosed her with the immensely popular bipolar disorder! Why am I not at all surprised by this development?…

Next question, is it possible that what she was really looking for was a “disease”? We used to have a word for this sort of thing, a word that has fallen into relative disuse, and that word is hypochondriac.

Patients who aren’t sure what’s wrong with them can be stumped about the type of therapist to call and ill-equipped to evaluate what they’re told during treatment. How well a therapist’s personal style matches a patient’s individual needs can be critical. But experts also say that patients shouldn’t be shy about pressing their therapist for a diagnosis and setting measurable goals.

What’s wrong with them is the big question some patients have, a doctor answers this question by justifying their role, as patients. He gives them a diagnosis, he writes them a prescription, and usually an insurance company takes care of the rest of the deal’s details.

What perfect other might an individual be looking for besides a therapist, and why is the individual more likely to be disappointed there than on the couch? Uh, excuse me, I digress.

If anything has changed, I imagine it’s that the talking cure has given way to the chemical fix.

About 3% of Americans had outpatient psychotherapy in 2007—roughly the same as in 1998—although the percentage taking antidepressants and other psychotropic drugs rose sharply, according to an analysis in the American Journal of Psychiatry last year. The same study found that the average number of visits dropped from nearly 10 in 1998 to eight in 2007.

Then, as I indicated, you’ve got people searching for the right “disease”, I mean, therapist.

By some estimates, one-quarter of the U.S. population has some kind of diagnosable mental illness. But many don’t believe they need help, don’t know how to get it, think they can’t afford it or that it won’t be effective. There’s also the lingering stigma attached to seeing a “shrink.”

Apparently somebody is estimating a large number of nut jobs, but my question is what’s in it for the estimator? One thing I know for certain is that when a lingering “stigma” is attached to seeing a shrink, the shrinks business should do a lot better when it is “eradicated”.

Note we’ve got 2 interesting “stigmas” in the new contemporary treatment lexicon now, and I happen to think they are related. We’ve got the “stigma” attached to having a “mental illness”, and we’ve got the “stigma” attached to seeing a shrink. Few people mention the other 2 “stigmas” affecting contemporary mental health treatment. There are also “stigmas” attached to losing a “mental illness” and not seeing a shrink. I feel certain that many more people would recover from their disabilities, and their shrink tasting habits, if it weren’t for these further “stigmas”.

Some clinics and university mental-health centers offer consultations to help evaluate which treatment might be best. “Patients shouldn’t have to decide this by themselves,” says Drew Ramsey, an assistant clinical professor of psychiatry at New York’s Columbia University, who says he loves to play “shrink matchmaker.”

I don’t think we’re talking a dating service for shrinks here. No, that could get a whole lot of shrinks in a whole lot of trouble, and in more ways than one, of course.

Even close relationships sometimes fail to get at the right issues. Victoria Maxwell, 44, an actress and blogger from Half Moon Bay, British Columbia, says she worked with a therapist for 2½-years as a teenager and liked her enormously. But she never made much progress, because the therapist didn’t recognize Ms. Maxwell’s underlying bipolar disorder. “I became a really insightful depressed person. But it wasn’t helping my depression,” she says.

Remember, if a wrong diagnosis has been made, no matter what it is, its probably bipolar disorder. We call this wrong diagnosing misdiagnosis because “well” people don’t visit shrinks.