Do I Need to Change Treatments? How to Tell You’ve Been Misdiagnosed

Being misdiagnosed with a mental health disorder can set you on the wrong path and interfere with your efforts to get healthy and improve your state of mind. But mental health care takes time. How can you tell if you’ve been misdiagnosed and need to change treatments, and when should you stay the course?

What are the Chances of Being Misdiagnosed with a Mental Illness?

Mental health disorders can be hard to diagnose. Many different disorders have overlapping symptoms. Often, you – the patient – may not even realize your symptoms are related to your mental illness, or that they are symptoms at all. Your primary care doctor may have only limited knowledge about the complex mental health issues you face and may not take the necessary steps to rule out other options.

In 2011, one study of Canadian patients revealed missing or misdiagnosis for several major mental health disorders well above 50%:

• Major Depressive Disorder: 65.9%
• Generalized Anxiety Disorder: 71%
• Panic Disorder: 85.8%
• Bipolar Disorder: 92.7%
• Social Anxiety: 97.8%

More recently, in 2021, a found that more than a third of patients with severe psychiatric disorders like schizophrenia were misdiagnosed.

This often happens because doctors making diagnoses and treatment decisions based on incomplete information, picking the disorder that fits with the constellation of symptoms they know about while ignoring or disregarding others as unrelated issues. In other cases, comorbidity may cause both you and your doctor to assume you are treating the whole issue, when in fact, there is more than one condition interacting to cause you to feel the way you do. While the diagnosis – and the psychiatric prescriptions that go with it – they issue may be consistent with what you have told them, it may not accurately reflect your mental health conditions, or the best treatment for your full mental health picture.

How to Tell You’ve Been Misdiagnosed

Unfortunately, there is no pill to correct a mental illness overnight. Psychiatric medications are not like antibiotics, where you will start to feel better after just a couple of days. Instead, many mental health treatments require weeks, or even months, before you will start to realize their effects. It can take just as long to tell you’ve been misdiagnosed. So how can you tell that you aren’t just waiting for the treatment to become effective? The chances of misdiagnosis increase if you:

• Have a condition that overlaps with other mental illnesses (such as bipolar with depression or ADHD with anxiety)
• Did not have a thorough mental health evaluation or testing prior to diagnosis
• Weren’t specific or thorough in describing your symptoms
• Never spoke to a mental health professional prior to diagnosis
• Were told your symptoms were nothing to worry about or that you should “wait and see” if things improve
• Continue to experience symptoms despite regularly taking your medication
• Experience a worsening of symptoms
• Encounter side effects from your medication without any benefit

Unfortunately, unconscious biases can also affect a doctor’s diagnosis of your condition. For example, one study found that African Americans are diagnosed with schizophrenia disproportionately frequently compared to white individuals. Similarly, women are underdiagnosed with ADHD and certain types of Autism.

How Long to Wait to Seek a Second Opinion

One way to tell if you’ve been misdiagnosed is to seek a second opinion from a specialist or another doctor. A second opinion is especially wise if you were diagnosed and prescribed medication by your primary care physician (PCP), without any diagnostic testing or mental health evaluation. You may want to go back to your PCP first and explain why you think you have been misdiagnosed – and any additional symptoms you didn’t discuss before. They may suggest you change treatments, or consider more testing.

Your doctor should be willing to give you a referral to another doctor for a second opinion. If they refuse, talk to your insurance provider to find the right specialist. There is no specific time to wait before seeking a second opinion – remember that some medications and treatments take time to take full effect. However, if it has been more than a month and you are not seeing improvement, experience side effects or worsening conditions, or if you experience suicidal thoughts at any time, you should schedule a follow-up appointment and consider getting a second opinion.

Right Diagnosis, But Still Wrong Treatment

Even if you haven’t been misdiagnosed, you may still not respond well to the first treatment suggested. Many mental health disorders – like depression and ADHD – have multiple medications that can be prescribed. In addition, psychotherapy and other modalities can bring relief on top of or instead of taking a pill. You don’t have to have been misdiagnosed to be unsatisfied with your mental health treatment. If you are experiencing undesirable side effects, or aren’t receiving the relief you had hoped for, talk to a psychotherapist and your doctor about changing treatments. While you should never stop a psychiatric medication without your doctor’s supervision, you don’t have to wait for your doctor to try something new.

David Stanislaw is a psychotherapist with over 30 years of experience. He helps adults, teens, and children, with a variety of mental health concerns. Contact David Stanislaw to get help today.