It must be a daunting task to be a psychiatrist. I was doing some reading on the various disorders and truly some of them are so close that there is no wonder that it sometimes takes a few tries before the correct diagnosis is made. For my part my doctor is still more than a little hesitant to fully label me but has made what he terms as a "treatment diagnosis". Does this really mean that if the patient is responding to the drugs that are used for diagnosis X that they actually do have X, could they not actually have Y with a slight occurrence of Z and still respond just fine to said drugs?
Not only is diagnosis difficult but treatment is really essentially playing Russian Roulette with those very same drugs being the ammunition. Administer drug A to patient Q...no effect, drug B...violent allergic reactions, drug C...ohhhhh works...wait false alarm, patient went back to ground zero in two months and so on and so forth until you find that magic drug that works for more than two months, does not make you break out in life threatening rashes or causes liver failure, or as any woman or self conscious man would tell you in a plus...does not make you put on weight. There you are, stable, functioning normally, looking normal, smiling, not threatening to kill co-workers, friends, family or self. All feelings of self loathing, mutilation and disgust are gone. Breathe big sigh of relief. Doctor pats self on back a. for not killing you in the trying and b. finally finding something to get you stable. The important thing for the patient to remember at this point in time is...You are not cured, whilst your illness is under control you are not cured.
The most difficult thing in getting at a diagnosis would actually be how open and honest the patient is being with you. In my case it was not a matter of being open or honest, it was a matter of honestly forgetting little things that were acutally big things and not being able to correctly identify my different emotions. Another way of helping diagnosis along is to actually tell them everything that has been happening in your head and life.
So yes I feel sympathy for psychiatrists, their's is a hard job and sometimes they just don't get it right