When Diagnosis Becomes Who You Are: The Quiet Rise of Diagnostic Identities

Psychiatric labels are quietly transforming from clinical descriptions into personal identities, and two Dutch researchers argue that this shift may be reshaping how millions of people understand themselves, sometimes in ways that are difficult to reverse. In an opinion article published in PLOS Mental Health, Lars Veldmeijer of NHL Stenden University of Applied Sciences and Jim van Os of UMC Utrecht trace how diagnostic concepts have spread far beyond the clinic, seeping into social media, workplaces, schools, and everyday conversation, and warn that the mental health field itself may be feeding a self-reinforcing loop that is hard to escape.

The authors build on an observation made a decade ago by the Danish philosopher Svend Brinkmann, who described how psychiatric concepts were already being used to interpret everyday experiences and forms of suffering. Today, they write, this development has gained further momentum. People increasingly adopt psychiatric narratives to explain everyday, non-psychiatric problems, a trend that reached mainstream visibility when The New Yorker published a 2024 article asking why we are turning psychiatric labels into identities. What was once a philosophical concern has become a visible feature of popular culture.

Part of the explanation, the researchers argue, lies in how care systems are organized. A person must first have a diagnosis to be eligible for covered care, and to receive a diagnosis, the problems a person has must be translated into diagnostic language. The system effectively requires people to speak in diagnostic terms before they can receive help. But the authors point to a second, faster-moving accelerant: digital culture, where self-diagnosis and identity-based diagnostic frameworks are widely promoted.

The concern is not that people’s struggles are imaginary. The authors are explicit that people’s challenges are real and should not be disregarded. Their worry is different: that people increasingly turn to diagnostic concepts for relief and come to identify with them. The diagnostic system, they note, was never designed to shape and validate people’s identities in the first place. Yet lived experience perspectives suggest that overidentifying with diagnostic concepts can lead to what the researchers call a diagnostic identity, and that once this identity is fully internalized, it can become difficult to shake off.

To describe the mechanism at work, Veldmeijer and van Os introduce the term identity intervention. An identity intervention, in their definition, is an intervention that influences the self-concept, expectations, and life story of a person with mental health issues in a potentially harmful way that goes beyond the descriptive function of the diagnostic label. The concept also applies to self-diagnosis. In the case of mental health problems, there appears to be a powerful mechanism wherein a person’s pre-diagnostic self-conception differs from their post-diagnostic one, sometimes for the better and sometimes for the worse.

The idea has deep philosophical roots. The authors situate their concept within the philosopher Ian Hacking’s theory of dynamic nominalism. According to Hacking, classifications influence how people causally understand themselves and change the kind of people they are, while these changes, in turn, can alter the meaning and application of the classifications themselves, producing what he called looping effects. The label and the labeled person shape each other in an ongoing cycle. Correspondingly, scholars have argued that internalizing classifications can be world-disclosing and shape identity and life expectations in restrictive ways, or, metaphorically speaking, cage recipients in diagnostic concepts.

The authors walk through a typical trajectory to show how this happens. Consider someone who, after a period of intense struggling and impairment, is diagnosed with a mental health condition. The classification may offer immediate relief and a socially accepted language to describe the experiences that led to a decline in their quality of life, and the researchers acknowledge the potential therapeutic benefits of that moment. Over time, however, the diagnostic lens may extend to an increasing range of everyday experiences. If the concept is perceived as explanatory rather than descriptive, it can become part of one’s sense of self, as if it captures one’s very essence. For people who have internalized a diagnostic classification as part of who they are, being told that these classifications merely describe patterns and do not explain an underlying condition can feel like a denial of their explanatory model and, by extension, their identity.

That blurring of description and explanation is, for the authors, a broader problem with current diagnostic language, one that affects not just the general public but mental health professionals as well. Their prime example is the recently published Independent review into mental health conditions, ADHD and autism, also known as the Fonagy review. Although the report’s working definition of diagnosis is pragmatic and refers to internationally recognized criteria for diagnostic categorization, its earlier statement that diagnosis explains the nature of a condition sits uneasily with that definition, blurring the distinction between describing patterns of experiences and behaviours and explaining the nature of such patterns. The Fonagy review, the authors write, illustrates how diagnostic concepts can easily become quicksand, making clear communication difficult even for the most distinguished mental health experts. It is thus understandable that the general public struggles to discern what these concepts can and cannot do.

This raises a provocative question: could the dominance and ambiguity of diagnostic language in society, alongside the broadening of diagnostic concepts, actually contribute to worsening mental health? The authors do not think the hypothesis is far-fetched. Both from the bottom-up and the top-down, people are influenced and incentivized to relate to and behave in accordance with diagnostic concepts, and people rethink themselves in response. Moreover, society has, through a process the authors call psychiatrization, adopted, reified, incorporated, and commodified diagnostic concepts across diverse domains of public life, becoming increasingly attached to them. The domains they list read like a map of modern life: social media, everyday conversations, popular culture and journalism, education, the workplace, identity-based communities and advocacy, self-help and the wellbeing industry, and public policy, law and social services.

The result is a self-reinforcing loop in which both society and the mental health care system struggle to view and communicate experiences of mental health difficulties separately from diagnostic concepts, sometimes treating these concepts as definitive explanations, leaving patients and the public, as the authors quote, with a picture of the mind that is far too simple. Breaking that loop, they argue, and preventing a potential epidemic of diagnostic identities, may require remaining attentive to the broader historical and social forces that influence our lives. Perhaps the first step is to create space for other ways of articulating mental distress and suffering in daily life, without feeling the need to resort to clinical terminology.

Subject of Research: The spread of psychiatric diagnostic labels into personal identity and everyday social life

Article Title: The rise of diagnostic identities in society

Article References: Veldmeijer, L., & van Os, J. (2026). The rise of diagnostic identities in society. PLOS Mental Health, 3(11), e0000779. https://doi.org/10.1371/journal.pmen.0000779

Image Credits: AI Generated

DOI: 10.1371/journal.pmen.0000779

Keywords: diagnostic identity, psychiatric diagnosis, self-diagnosis, identity intervention, looping effects, psychiatrization, mental health, PLOS Mental Health, diagnostic language, digital culture, Fonagy review, mental health care