I think there's a lot of both. Over diagnosis is especially problematic here in the US where they need a diagnosis within their 15-30 minute assessment to get insurances to pay. I myself was horribly over and misdiagnosed, and it resulted in over three years of being heavily medicated with drugs that literally changed my personality (for the worse) and made me mentally ill and unable to function. I was diagnosed with something different every time, which was due to the lack of having a consistent psychiatrist and them trying to figure out what was wrong in a half hour and then not knowing what was me and what was cause of the meds. And I trusted them too much and took everything as prescribed, never questioning whether the meds could be causing the worsening/new symptoms.
Turns out I have ADHD, PMDD and some anxiety issues. Very treatable with fairly minimal meds. All I take now is Ritalin, although I'm considering going back on anti anxiety meds. Anyway, I was immediately diagnosed bipolar when an antidepressant made me suicidal (even though I was 17 so right in the expected group for the black box warning), and it just spiraled downhill from there. Meds upon meds upon meds. I've heard almost every diagnosis before the right one was finally stumbled upon, from bipolar, to PDs, to schizoaffective. All because of hasty diagnosis and over/mis-medication. All the while I'm being made sicker by meds my body doesn't need and can't handle, and other people who truly need them are not getting them.
At least in the US, our system is terrible at pinpointing who needs treatment vs those who don't, and then even worse at figuring out what type of treatment. It's really unfortunate because you have people who are very ill and could greatly benefit from the medication but don't get it, and then people like me who need some help but not that kind and are either not helped or sometimes even made much worse, as in my case. It's really due to the way insurances try to not pay for anything, how underfunded our state mental health systems are, and the resulting lack of continuity of care since they can't create half way decent working conditions for psychs to want to be in state care vs expensive private care. So if you're like me and in the state care for people without tons of money, it's Russian roulette whether you'll actually get something that helps you or just be made even worse.
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