I’m a Psychiatrist, and I No Longer Just “Treat” Symptoms – Here’s Why
Seven minutes into a follow-up visit, it hit me: I’d failed her.
Lucy (not her real name) sat across from me – a highly accomplished executive, “stable” on paper. Her medication was right. Her panic attacks had stopped. Her depression score had improved dramatically. By every textbook measure, I’d helped her.
But then she described her days as moving through “a dull, compliant emptiness.” And in that moment, something in my clinical training cracked. We had treated her depression. But we had completely missed… her.
That session changed everything for me. After fifteen years in practice, I realized we’d become experts at reducing symptoms while losing sight of the human being right in front of us. So I’m saying what many feel but few in my field say aloud: It’s time for psychiatry to move beyond the diagnosis.
Where Modern Psychiatry Falls Short
Life is messy, diagnoses aren’t. Our diagnostic manual takes the vast, tangled experience of human suffering – your unique mix of grief, stress, trauma, and biology – and flattens it into a code for insurance. Recent research shows most people don’t fit neatly into one box anyway; their struggles overlap across many. We end up treating the label, not the person.
A diagnosis can change how you see yourself. When someone is labelled with a disorder, something shifts. They don’t just have a problem – they can start to feel like they are the problem. “I am bipolar” replaces “I go through intense mood swings.” That label can start to speak louder than your own story, quietly stealing your sense of agency.
Medications help, but they can’t do it all. Let me be clear: psychiatric medication is crucial. It can be lifesaving. But the data is humbling: medication alone does not always lead to full recovery. Why? Because you can’t medicate your way out of a meaningless job, a lonely life, or a society that pathologizes normal human stress. As one patient told me, “You fixed my brain chemistry, but I still feel trapped in life.”
What Science Is Telling Us
The evidence has been pointing beyond diagnosis for years. We just weren’t fully listening.
The brain doesn’t read our diagnostic criteria. New research approaches ask, “What’s specifically working differently in this person’s brain?” instead of “What disorder do they have?” This approach is proving more accurate at predicting what will actually help.
Your environmental matters more than we admitted. Where you live, the safety of your workplace, your access to nature and community – these aren’t just footnotes. For many, they are the main story. A 2024 study found life circumstances often impact mental health far more than genetics.
Your strengths matter more than your symptoms. While we’ve been focused on reducing what’s “wrong,” positive psychology has shown that building on what’s strong – your curiosity, your perseverance, your sense of humour – is a better predictor of lasting well-being than just removing symptoms.
What I Do Now Instead
I’ve moved to what I call Strategic Psychiatry. It’s built on three pillars:
From Label to Story. We swap the diagnosis for a collaborative understanding. We ask: What happened to you? What’s your unique wiring? What in your life right now is keeping you stuck? It’s a living story, not a static label.
From Symptom Management to Life Expansion. Our goal isn’t just a lower score on a depression survey. It’s about “Can you reconnect with an old passion? Set that needed boundary? Design a week that doesn’t leave you drained? “ We target your life, not just your symptoms.
From Patient to Partner. You are the expert on your own experience. My role is that of a consultant – offering neuroscience insights, therapy tools, and yes, sometimes medication, to support your plan for your life.
A Call for a Courageous Shift
This isn’t about rejecting science. It’s about embracing a fuller picture of it. We need to hold two truths at once:
1. The brain is an organ that sometimes needs medical support.
2. The mind is born from our brain, body, relationships, and world – and healing it requires more than a prescription.
To my fellow colleagues: I know this feels uncertain. Moving beyond clear-cut diagnoses can seem like losing our foundation. But what if that foundation was too narrow to begin with? It takes more courage to evolve than to keep doing the same thing.
To anyone who’s been “treated” but not truly helped: You were right. Ther was always more to your story. You weren’t “treatment-resistant.” You were context-sensitive. The parts of you that were labelled as problems – your depth, your sensitivity, your need for meaning – might be the very seeds of your strength.
This is an invitation to build a better way forward. We’ll explore the science of your complexity. We’ll develop tools for designing a life, not just managing illness. We’ll explore what it means to be fully well, not just stable.
This shift starts when we have the courage to ask for more.
If you’ve ever felt reduced to a diagnosis, I see you. Let’s begin a new conversation.
Dr. KC
Specialist in Psychiatry | Founder of “Beyond the Diagnosis”
First Step:
In the comments, share one thing about your experience that a diagnosis could never explain. Let’s start rewriting the story together.
