You just found out about your new ALPHABET soup diagnosis…Now what?

A quick online research or quick flash on the news, we might hear “mental health struggles are on the rise in the United States and more people are seeking help now.” With that influx of people seeking therapy, some will have Complex or Dual diagnosis.  This means there is more happening than just anxiety and depression. There might be bipolar, phobias, eating disorders, borderline, narcissism, trauma, attachment issues, obsessions, and addictions.

It kind of sounds like an alphabet soup of labels and letters. 

I just wanted to share that IF there are complex issues brought to the surface or diagnosed, here are some things to possibly consider, and it’s important to approach them with gentleness and plenty of compassion. 

1) Are multiple diagnoses important?

Yes they are relevant because it can tremendously help navigate how to find the right course of treatment or treatments.

Getting a diagnosis beyond anxiety and depression is a humbling experience. Sometimes it happens during desperate situations in life, for example being hospitalized or going through a major crisis. But the diagnosis often answers the “WHY” something has been so frustrating, confusing or painful. It gives us all answers and clarity on how to move forward in life as a treatment team and those seeking help from us. 

Untreated mental health can be very costly and stressful on the body. Always seek treatment and find out what is causing the anxiety or depression and find a therapist you feel comfortable to talk to. 

2)  Why was the diagnosis made?

There are some diagnoses that overlap which can be confusing. Really listen to “why” or reasons the diagnosis was made from the reported patterns, observable behaviors, certain criterias that are met, and consequences that are affecting every aspect of life. Feel free to ask questions to your providers on why they are discussing that diagnosis. When getting a second opinion ask questions to find out if there are overlaps to consider as many mental diagnoses overlap. When dealing with substance use it can trigger things too, so getting free of any addiction or substance can really help uncover root issues and proper diagnosis. 

3)  Insurance / Out of pocket

Understanding how insurance works from a medical model can also explain why certain diagnoses are chosen over others. Meaning we have to treat what is medically presenting itself and work towards some elevation of severe symptoms. For example, insurance can still be sensitive to treat personality disorders which are considered chronic. However most those suffering with a form of personality disorder are also suffering from co-occurring diagnoses that are treatable such as anxiety, depression, substance use, mood disorders and eating disorders. 

There are often two stages to mental health recovery when it comes to complex issues and dual diagnosis. The first is stabilization of intense symptoms. This is great to use insurance for, a higher level of care, using evidence based practice. The second stage, sometimes, can be slower and getting to deeper issues or root issues that stem from childhood and attachment issues or trauma. After people do the groundwork to bring the structure back into life, they feel ready to move to the second stage. These two stages can also happen at the same time. Recovery is different for everyone and as providers we want to bring that stability in with who we work with, highlight deeper issues as they come up, and encourage our clients recovery in some fashion is always possible. 

4) Becoming your own expert. 


The best teacher is “doing the work” and educating oneself on the many aspects of the diagnosis. Doing the work is research on the diagnosis, and finding what is out there with treatment, having an emphasis to focus on positive and hopeful sources of recovery and thriving, and connecting to positive communities that are on their own recovery journey. If you are unsure about hope, I wrote an article on it called Guarding Hope . There is always hope. And being one’s own expert and self advocate can do a lot in overcoming struggles in life. Perhaps interview different modalities and providers out there? Lastly, learn the modality you want to try. 

Reading: When doing research, have a variety of biographies and medical books and treatment books. Just take time to read different books. But aim for those that are kind, compassionate, understanding, and knowledgeable. 

Online sources: Be careful with online forums as there can be a lot of negative trolls. Look for people that are hopeful and positive about “what works for them.” And be hopeful if one type of treatment doesn’t work, a different treatment can offer wisdom and other angles to see clearly. You tube can be super helpful but harmful if the person speaking is not hopeful, compassionate, and kind. Be careful and guard your hope. 

5) Take time in this process

Take time to unpack what this new reality is like. Really take time to read, join support groups, talk to safe people and others who know about the diagnosis or also diagnosed. Take time. Recovery is a journey not a destination.   

Take time to mourn as well. Not everyone feels relief when getting a mental health diagnosis. Learning answers as to why some struggles have happened and trauma and pain occurred from those diagnosis is a big process. It takes time to learn the details, unpack the burdens, and learn ways of thinking and thriving.

Take time to celebrate. Confusion is not fun and being lost as to why things seem so overwhelming, was probably a very isolating and fearful place to be in. So getting answers and finding a path to journey on is a big mountain you just climbed. It is ok to celebrate getting the right diagnosis finally. Life is about small celebrations when possible and appropriate. 

Take time to grow. A whole new world just opened up with whole new vocabulary, communities, research, knowledge. Take your time to learn and absorb. 

6) Realize there was in impact on family and friends

Be prepared to engage the family in conversation. 

Receiving feedback: a) Getting feedback from family members can help to explain the diagnosis and find a team to work with building a more thriving and abundant life with the family. b) Sometimes there are family members who are not helpful with feedback, but always be humble in the process and willing to receive feedback slowly and carefully, while processing with trusted providers. It doesn’t take much to say “I will take it into consideration” 

Embracing the impact: Take time to prepare to hear how this has impacted the family or friends when ready or agreed upon with your treatment team. Your family might be grieving too. Everyone is affected by the diagnosis and learning new ways of talking about it and communicating, are huge parts of thriving again in fellowship and community. The new boundaries in communication and different expectations need to be worked on slowly and with love and compassion for ALL involved. 

6) Self Esteem Work

Last topic on this subject. No matter what the diagnosis entails, the most important aspect is a healthy and realistic embracing and development of self esteem. There is a lot of stigma regarding many different diagnoses or traumas which results in low self esteem. Low self esteem is the crux of a lot of bad choices, bad relationships,  poor work environments, view of self and others, arguments, confusion, distraction, anxiety and depression. 

Most therapist, including myself, will discuss what healthy and realistic self esteem is for each person. We might challenge thoughts with CBT techniques that each person has that are judgmental, disrespectful, stigmatizing, harmful, and shaming. CBT and DBT are excellent for working on self esteem.  Low self esteem can also be related to trauma work and EMDR is a great way of removing the intense feelings trauma brings and connecting to self esteem and self worth again after processing the memories. 

There are a lot of self help books out there on the subject of self esteem, but working with the right therapist can challenge any thoughts that are hurtful towards one self in a safe and nurturing place. Therapy should be that safe place. And recovery should not be an isolated journey.