A question of diagnosis-comments welcomed

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What should diagnosis be based on? How you are off meds/med not being taken consistently? Or how you are with meds being taken consistently?

I ask this because my dx has been changed back to schizophrenia. I was asked about mood symptoms, but found it hard to answer as since being on depot(2009) my mood symptoms have not been much of a problem (mildly depressive at times)

This was the situation mood wise when meds weren’t taken regularly.: irritability,inner tension, busy mind,depression,contentious,impatient,

On what basis did they diagnose you with schizophrenia?

Psych appointments whether F2F or virtual are never totally ideal. 2018 dx= schizophrenia, 2019=schizoaffective 2020=schizophrenia . The last change due to currently low level of mood symptoms.Being asked to recall symptoms you've not really had for ages due to your meds working well, but historically, pre taking meds consistently, were there is not easy. There is always a time element in such situations that necessitates rapid recall I tend to go into 'brain fart' mode in such situations. I'm a strong believer that how you are off meds/taking meds inconsistently is the better guide to diagnosis than how you are doing when taking meds(through depot) consistently .
This is an academic/intellectual issue rather than having taken a dislike to my psychiatrist etc here. They are much, much better than the mental health professionals in Essex were. Better but imperfect (Wiltshire) is vastly preferably to thoroughly incompetent and not very nice with it(Essex).

My doctor told me it was a tool, used in order to determine the best treatment plan. I would assume both on and off drugs, medical history, and even childhood anamnesis matter.

Also, she told me diagnoses are a secondary concern. Finding a treatment that works and improves the patient's level of function always take preference.