Why self-diagnosis deserves far more respect

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By Lucy Foulkes

Even if the patient is wrong, their theory can provide useful information. And sometimes they get it right.

Several years ago, after I gave an academic talk about the impact of mental health awareness campaigns, a psychiatrist said something that stuck with me. He said that he was noticing a swell in self-diagnosis among his patients, particularly young people. One after the other, they were turning up to assessment appointments with a clear conviction of the disorder they had. When the patient was wrong, a difficult discussion ensued. In this doctor’s words: “I now spend more time undiagnosing than diagnosing people.”

This phenomenon – patients arriving at appointments with their own opinions and expectations – is not new. The concept of “Dr Google” first appeared in the research literature around 2008. Even way back in 1998, in the very early days of the internet, psychiatrists worried that patients may surf the web to access the latest information on their disorders, raising expectations and insisting on treatment options, some of which may be inappropriate or even unknown to doctors.