I couldn't give a damn about getting a label on it. It is what it is. While it's much less of an issue with the bipolar (which after my most recent, undoubtedly manic phase, I'm not really in doubt about) because the NHS hands out psych drugs like candy, even though mechanisms of action and indeed efficacy are pretty much unknown and unproven for most drugs and most indications. The Seroquel/quetiapine was prescribed to me to prevent relapse into depressive episodes. I stopped because of the side effects, but later read in AstraZeneca's own literature that no study had shown that the drug had a statistically significant advantage over placebo for that indication.

That's a problem in its own right though, a whole other story. The problem is that, whether I care or not, I need the right label to get access to the right treatment any time soon. Which is why I am going to have to find a way to be treated privately - the NHS requires the label, but also decides who gets the label.

It particularly gets to me that it was agreed that I suffered all the requisite symptoms with the requisite severity to meet those criteria, failing only at the subjective interpretation of a sentence in the ICD-10. Surely it's the symptoms that matter, and how can anyone begin to claim to know how traumatic something was to me?

I sometimes wonder if my "game face" coping mechanisms screw me over. I've never had a consultation report which didn't mention that I seemed socially confident, cracked the odd joke, etc. But that's how I operate, and in fact how a huge number of people suffering from mental illnesses operate - the outer facade is the absolute last thing to crumble.

Your last point about the exact diagnosis not mattering is bang on. It just seems that mental health in the NHS is very much label-based, and it's in the private sphere that you get doctors who actually treat you, not a pigeonhole they try to put you in. I have two close friends with other mental health issues, both of whom struggled and suffered for years in the NHS system, and seeing a good private psychiatrist turned things round like magic. I think it's the only way. I don't see why it should be - I don't honestly think the last doctor to see me honestly believed that there was nothing wrong with me, but I can totally see that in a situation of limited resources and bureaucracy, the system just forces that utterly ridiculous, rigid approach.