The Problem With Playing Therapist: How Self-Diagnosis Can Derail Healing

As a therapist, one of the most common trends I see today is people arriving to their first session already convinced they know their diagnosis. It’s not unusual for someone to sit down across from me (or log into a telehealth session) and say, “I know I have bipolar disorder,” or “I’m pretty sure I have borderline personality disorder,” or “I’ve definitely got ADHD—TikTok told me so.”

I understand where this comes from. We live in a world overflowing with information about mental health. Articles, podcasts, social media posts, and online quizzes make it easier than ever to learn about symptoms and conditions. On one hand, this has helped reduce stigma and encouraged more people to seek therapy—which is wonderful. On the other hand, the sheer volume of information can lead to confusion, misinterpretation, and self-diagnosis that may not be accurate.

Why Self-Diagnosis Can Be Dangerous

The danger of self-diagnosis is that it oversimplifies something incredibly complex. Mental health conditions don’t exist in isolation. Symptoms like fatigue, irritability, difficulty concentrating, or mood swings can belong to multiple different disorders—or sometimes to none at all. For example, poor sleep could be a sign of anxiety, depression, bipolar disorder, a thyroid problem, or simply stress. Without a comprehensive evaluation, it’s impossible to know which is correct.

When people cling to a self-diagnosis, they often start filtering all of their experiences through that lens. This can make them feel boxed in and even reinforce unhelpful thought patterns: “I’m hopeless because I have this diagnosis,” or “This behavior is just who I am because of my disorder.” In some cases, it can also lead to pursuing treatments that aren’t helpful—or even harmful.

What You May Not See Behind the Scenes

When I assess a new client, I’m not just listening to their symptoms in isolation. I’m looking at the bigger picture: personal history, family history, stressors, medical conditions, substance use, trauma, and even cultural or environmental factors. I use structured assessments, clinical judgment, and evidence-based criteria to arrive at a working diagnosis. And even then, I hold that diagnosis lightly at first, because people are dynamic, and symptoms can evolve over time.

Therapists are trained to look for nuances—things that self-diagnosis often misses. For example, someone convinced they have borderline personality disorder may, after evaluation, actually meet criteria for complex trauma and depression. Another client certain they have ADHD may instead be experiencing the cognitive effects of anxiety. These distinctions matter because treatment approaches differ significantly depending on the diagnosis.

Keeping an Open Mind

One of the most helpful things you can bring into therapy is an open mind. You may be right about your self-diagnosis, but it’s equally possible that there’s more to the story. When you trust the process, you give your therapist the opportunity to explore with you, consider all possibilities, and arrive at a diagnosis (or formulation) that best captures your experience.

Trusting your therapist doesn’t mean blindly accepting everything they say. It means engaging in a collaborative relationship where you share openly, ask questions, and allow space for professional expertise to guide the process. Good therapy isn’t about labels—it’s about understanding what you’re experiencing and finding the best ways to help you feel better.

Why This Matters for Your Healing

Ultimately, the goal of therapy isn’t just to put a name to your symptoms—it’s to create a treatment plan that works. Whether that involves learning coping skills, processing trauma, adjusting thought patterns, or considering medication, having an accurate understanding of what you’re dealing with is essential.

When you trust your therapist to evaluate you thoroughly, you’re investing in a process that can lead to more targeted and effective care. You’re also protecting yourself from the risks of self-diagnosis, like unnecessary fear, inappropriate treatment, or overlooking a condition that needs attention.

A Final Thought

If you’ve ever walked into therapy feeling convinced about your diagnosis, please know you’re not alone. Your research and self-reflection show courage and motivation to understand yourself—that’s an important step. But my invitation to you is this: come into therapy with curiosity rather than certainty. Share what you believe, but also allow me to look at the broader picture with you.

Because at the end of the day, my role isn’t just to confirm or deny what you’ve read online—it’s to walk beside you, help you uncover the truth of your experience, and guide you toward healing in the most effective and compassionate way possible.