Tag Archives: Psychiatric Diagnoses

September 11, 2026 · 6:00 am

Will AI engagement make your OCD worse?


I’ve played a bit with AI (Gemini and ChatGPT) and had both some fun and useful “conversations.” Among the fun uses, I had it explain some complicated astronomy research to me as if I was in the 5th grade. I can’t tell you if it was accurate, but it sure made sense and only took 20 seconds to produce! A more useful conversation helped me analyze the difference between taking social security at 62 versus 70 and how long I would have to live to make taking it later to be the better deal. It kept me asking questions on all sorts of possible scenarios I might experience in order to help me make a decision (side note: I didn’t make one!).

If you have used AI you have probably noticed a couple of common features in AI responses:

  1. There are no dumb questions. AI chatbots tend to treat your question as a good question worthy of serious attention. “That is a great question, here’s how I would answer it.” “I think you are on the right track with your thinking.” You know, it is nice to hear that your thought is serious, nice, smart, and on the right track. You can be fairly sure the bot won’t shame you.
  2. There will be an invitation at the end to keep the conversation going. “Would you like me to explore xyz to add to your question or research?” Since there is always more to know, the bot is likely to invite you to continue the conversation.

AI and Mental Health

Based on my anecdotal evidence, more people are using AI to ask personal questions about their mental health and relationship challenges. Some are even asking it to be a second opinion to their physicians and counselors. I can imagine the answers they are getting are probably more consistently empathic, validating, and detailed than what they might get from their therapists. Now, I’m not saying the answers will be better, that the connection they have is as good as flesh and blood, but it would be foolish to say that human therapists will always be better. And some of the examples of responses I have seen have been good!

But I have a serious concern when it comes to use of AI to help people with Obsessive Compulsive Disorder. In my opinion, use of AI to answer obsessional questions is likely to make OCD symptoms worse, not better.

Here’s why:

People with OCD tend to struggle with a search for certainty. They experience repeated unwanted intrusive thoughts and fears, often in the form of “what if” questions. What if I have committed the unpardonable sin? What if I hurt my co-worker’s feelings? What if I accidently gave someone else an illness? What if I forgot to turn the stove off? Most humans I know have had some of these “What if” questions but the difference for those with OCD is how incessant and demanding the questions are. Understandably, you would want to resolve such painful questions. To do so you might to give an answer that would provide some certainty on the matter. This is better known as reassurance seeking. If my spouse or friend tells me not to worry, I might feel better momentarily. If I wash my hands again, I feel better for a bit. If I pray more or double check with the person I thought I hurt, I feel a bit better. The problem is…the feeling doesn’t last and the intrusive negative thought returns with a vengance.

Treatment for OCD often include medications like Zoloft but also require a form of Cognitive-Behavioral Therapy where the person no longer tries to dialogue and engage with the intrusive thought. Read here my brief synopsis of what recovery from chronic anxiety looks like.

So why would engaging AI to help resolve OCD make the symptoms worse?

First, it will likely tell you that your question has merit and is important. And certainly it feels that way!

Second, it then tries to give you an answer (reassurance, information, etc). Just what you were looking for.

Finally, it offers you ways to keep exploring and engaging answers to your obsessional questions.

In the end, it is just a faster more persistent tool to try to get certainty, but certainty is not achievable and won’t ever solve our what if fears.

Could AI help if I don’t have a therapist?

Ultimately, I think human to human contact and presence is what we are designed for. Try to find a therapist who has some experience with OCD. Given telehealth options, there will be quality therapists who can support your recovery. However, If you are someone who has tried to use AI to help you manage anxiety and are still hoping AI can help, consider asking a different set of questions, like

  • Can you help me make a list of 20 things I can do to pivot away from intrusive and unwanted thoughts?
  • Can you help me develop a chart to illustrate the progress I’m making to avoid engaging obsessions and compulsions for the next month?
  • Can you find for me high quality books, apps, and websites that might help me better understand and treat my OCD?

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August 13, 2010 · 5:58 am

Who diagnoses ADHD? Comments on CNN story


CNN has run a story on the issue schools/teachers encouraging parents to get their child tested for ADHD and on medications. You can read it here. The writer quotes a doctor complaining about teachers who suggest diagnoses and treatment. Then parents go to their doctor and ask for meds to treat something that has yet to be properly diagnosed. Being a psychologist I am sympathetic with the Doc–but only to a point. True, many people fancy themselves as experts because a family member or some other experience with a mental health diagnosis. And so, whenever they see something that reminds them of it they talk as if they had done a thorough assessment. The Doc goes on to point out other problems that may create similar symptoms (anxiety, abuse, learning disabilities, etc.)–thus the need for professional evaluation.

But that is where my sympathy ends. Teachers do have front row seats to child problems. We need them to speak up. Yes, they needn’t throw out diagnoses as if they are experts. But we do want them to let parents know that something might be up and the need for further evaluation.

So, who should diagnose? Yes, ADHD is considered a medical diagnosis. But, counselors and psychologists are just as capable of making the diagnosis–sometimes even better.  If a Doc (psychiatrist, physician, etc.) makes the diagnosis, 9:10 times it is on the basis of 30 minutes to 1 hour of an interview with parent and child along with a physical examination. For most people with the symptoms, that is probably enough. However, most psychologists will collect data from 2-3 sources (parent, teacher, church) using interviews, checklists, psychological tests, and even computer based assessments. That kind of assessment may be more capable of ferreting out subtle learning disabilities or learning differences as well as developing a plan of action for changing the environment (school plans (IEP/504), parenting strategies, etc.

It is interesting that the article makes no mention of the use of counselors in this process.

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February 12, 2010 · 5:36 am

The good and bad of new diagnoses


A draft of the next edition of the Diagnostic & Statistical Manual (DSM-V) has been posted to their website and open for comments by users. The website breaks out the changes being considered in categories so it is easy to find your area of interest.  The final edition isn’t expected until 2013.

Diagnostic changes can be a help and a problem at the same time. When DSM IV removed Multiple Personality Disorder in favor of multiple diagnoses for clarifying dissociative symptoms, that helped clinicians be more descriptive of their client’s struggles. In this new proposal, they plan on eliminating Asperger’s Disorder and subsuming a number of diagnoses (Retts, PDD, etc.) into one diagnosis: Autistic Disorder. I would think this would not be helpful as it reduces specificity.

How about this new entry: Temper Dysregulation Disorder with Dysphoria? A new diagnosis for children? I think it may help in that it might hinder the ever popular “bi-polar” label given too quickly to children (and accompanied with serious meds). On the other hand, it probably will make quite a few roll their eyes. The label doesn’t have that ringing medical sound to it. Not that I’m disparaging the symptoms it tends to cover. There are children who mood is so easily dysregulated, whose reaction to frustrations are way over the top. These children tend to be impulsive to boot. Something isn’t right, but what best identifies their struggles; the etiology of their problems?

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