Sometimes, you can't tell the severity of someone's needs until they're already dead. We should err towards trusting patients, and informed consent.
> Minesh Patel, associate director of policy and influencing at mental health charity Mind, said there was "no credible evidence" that mental health problems were being over-diagnosed.
> "What we do know though is that the number of people experiencing mental health problems has increased, with 1 in 5 adults now living with a common mental health condition according to the Adult Psychiatric Morbidity Survey," he said.
In an inflationary time, with shrinking social mobility and career prospects, where no one can predict what 5 years from now will look like, and no one can afford to start a family (even more so in places like the U.S.), I don't know why this is such a challenging sentiment for some to wrap their heads around. Of course distress is on the rise.
I think people misunderstand stress and distress, where the latter is personally inflicted on you, like being abused by a family member. In general, I think experiences due to systemic issues are different from experiencing personal issues, i.e., someone targeting you with specific intent and focus to inflict emotional or physical harm on you.
Lived experiences can add to stress, but everyone has a stressful nature to their lived experiences, as this article is saying. Being in distress, where you’re the particular target of a person or a group, is different.
I agree that mental health conditions probably are overdiagnosed and overdiagnosis of this kind is genuinely harmful in many cases (via nocebo effect).
But equally I do think it's true that there really are more people with mental health conditions, largely because:
* life is genuinely worse today than it was 20 years ago, mostly because of technology
* the excessive amount of screen time that the average person experiences is fundamentally harmful to the natural balance of neurotransmitters in the brain
A UK doctor friend mentioned they believed a lot of people being prescribed anti-depressants were suffering from "shit life syndrome" rather than real depression. This wasn't to belittle the issues but rather to highlight the issues they maybe facing, which society doesn't deem valuable enough to fix and the GP is one of the only perceived options they have for help.
I've seen work environments that are chaotic, and people are expected to deliver things that they can't deliver without navigating and taming the chaos to do their bidding.
If course that's stressful. You can't expect individuals to tame the organization.
I think some parts of IT have deteriorated into anarchy with tyrannic leadership.
Sure, you can have anarchy. But then don't expect any particular timelines.
You can hire armies of people. But then don't expect one corner of the org to be able to deliver something that involves talking to everyone.
Maybe, just maybe life has gotten legitimately more stressful? Like, even my parents' generation wasn't forced to move away from family and friends (aka their support network) just for career. And on top of that, a single income was enough to afford a decently sized home, stay-at-home spouse, car and children.
Compare that to today: more and more adults have to live with their parents due to cost of living, you need until age 23 until you earn your own money because you're effectively worthless without an academic degree, you get saddled with debt from acquiring said degree, when you finally have a job it's usually impossible to afford even a run-down slumlord shack unless you have two (or, worse, three) incomes... and we never had the time to actually reset after the polycrises - 2007 ff financial crisis, euro crisis, refugee crisis (in Europe), refugee crisis 2 (in Europe), Trump 1, Covid, Russian war, Trump 2...
Particularly the fact that our generation can't rely on our parents and friend networks for support any more is the largest factor to blame. And obviously, earlier generations were significantly underdiagnosed, partially because medicine literally didn't know better, partially because their parents beat them into submission with sheer violence.
The title is kind of baiting junk takes and misses the nuance here. Life stressors can induce depression or symptoms of it. Medication has shown to improve these symptoms. It does make treating actual chronic pathological mental illness more difficult, because of the exact attitudes expressed here.
Hint: mental illness and life being stressful is often comorbid and causal.
It's also entirely possible that life is indeed just messed up in a way that human brains didn't evolve for and can't deal with - all the societal changes, breakdowns of close relationships and communities (e.g. the disappearance of the 3rd place in addition to work and home), as well as most people being stuck in an endless stressful rat race that they will not ever escape due to the state of the economy and the moneyed interests, alongside the daily stress and social media making things worse. All the injustice out there, maladaptive behaviors, normalization of hate and borderline tribal "us vs them" mentality at pretty much every turn (genders, politics, race, everything). Might be a consequence of being too exposed to information out there and not ignorant enough, but go figure.
Life being non-stop stressful for a majority of the population is not a personal illness, it's a societal illness. Although societal illness can definitely lead back to mental illness which is a very personal affliction.
I do agree that it shouldn't be the job of GPs to prescribe away mental illness though, any more than they should be telling you what eyeglasses to wear. Those jobs should go to psychiatrists and optometrists, respectively. The GP should merely refer you to the specialist.
It does beg the question though, since society is so clearly sick and appears to be getting worse in many countries, whose job is that to fix? The obvious answers are either "politicians" , or "all of us". But politicians seem just as afflicted as the rest, or even to be adding to the sickness in many cases. And saying we all need to come together to fix it might be a truism but is basically useless.
Also, people might not be ready for this but, being able to focus intensely on one thing while being easily distracted when forced to do menial tasks is not a disorder.
Life is stressful (in some respects, overly so), but we’ve dealt with this for millennia by having a strong support system. Not to be reductive over the multitudes of problems people face today, but most can and should be solvable by having a good support system. Family and good friends with whom you can speak frankly can do wonders. It doesn’t solve the affordability or job problems, but having someone to talk to, someone that you can trust and has lived experience, can go a long way. I can’t tell you how many times I’ve solved “problems” or at least lessened their impact, by consulting family and friends.
The prescription here might be for people to be able to easily afford to live walkable to some of their family and friends.
Lots of things come from this: shared resources (less income need, less work stress), shared emotional support, shared childcare (less income need), etc.
Instead of single family homes (one family is not the atomic unit of the human species!) it should've been single community developments with 15 homes and a big shared backyard but still private for all the houses. And the landlord + all the tenants can select the residents based on their personal preferences and anyone can veto.
I think many challenges stem from the lack of this.
I don't know what the fix is though, because housing regulations seem difficult to change.
Neurosis (stress and depression) is the only human disease that its cutoff diagnostic criteria change (increase) through time in the last 100 years. The casual level of stress of a random person today would be insane for someone in the '50s. Especially, the stress of a teenager today is similar to a psychiatric hospital patient of the '50s.
The empirical criteria of depression, held by most health professionals, are influenced a lot by the mass trend. If all people are depressed (eg during a widespread economic crisis, loss of ambition, hope etc), like it happens today, then depression will tend to be mostly normal.
I believe today a large percentage of people suffer from an uncovered, untold stress and depression and we professionals must resist to accept this as normal. Depression is an unbearable but curable disease and is not like house prices/rents where we have to adapt and get accustomed to.
For reasons that don't matter, I've had to live with a 25-yo since summer that has ADHD and anxiety diagnosed by a therapist. Two main issues I see in her behavior:
- She changed therapist twice until she heard what she was looking for. She said she was looking for a compatible "therapist".
- The fact that she was diagnosed was a relief to her because now she can just offload any responsibility. Forgot to do something? It's normal, that's my ADHD. Not in the mood to go and work tomorrow? that's my anxiety kicking-in.
There's just no hardship anymore and her life is not even that stressful. It's just easy to come with that and give excuses.
The issue is: I want to be sympathetic to her condition and help, but it's really hard to don't sound like I'm judging. I can't just challenge a behavior because she is already doing the best she can. It's like there's an invisible ceiling.
I've seen similar behavior. I can understand that the relief that comes with having finaly a label put on the box one feels trapped into; But then the goal should be to climb out of that box. A diagnosis is only good if it helps fight the condition, after all.
I believe the issue is more broad than that though. I believe the issue comes from the very strong belief in our modern world that our behavior, our ideas and moods are what we are, what we have always been and always will be. That comes with our global theory of mind that one's character is given once and for all, from birth to death. I insist that this is a belief that is not universal, for some other cultures ideas and moods are transient external inhabitants of our minds. And indeed, people do change along their lifetime, and sometimes immensely; once you have witnessed these changes a few times you start to realize how even conditions that are usually considered impossible to cure, can actually be fixed.
22 comments
[ 2.6 ms ] story [ 32.3 ms ] thread> Minesh Patel, associate director of policy and influencing at mental health charity Mind, said there was "no credible evidence" that mental health problems were being over-diagnosed.
> "What we do know though is that the number of people experiencing mental health problems has increased, with 1 in 5 adults now living with a common mental health condition according to the Adult Psychiatric Morbidity Survey," he said.
In an inflationary time, with shrinking social mobility and career prospects, where no one can predict what 5 years from now will look like, and no one can afford to start a family (even more so in places like the U.S.), I don't know why this is such a challenging sentiment for some to wrap their heads around. Of course distress is on the rise.
Lived experiences can add to stress, but everyone has a stressful nature to their lived experiences, as this article is saying. Being in distress, where you’re the particular target of a person or a group, is different.
But equally I do think it's true that there really are more people with mental health conditions, largely because:
* life is genuinely worse today than it was 20 years ago, mostly because of technology
* the excessive amount of screen time that the average person experiences is fundamentally harmful to the natural balance of neurotransmitters in the brain
If course that's stressful. You can't expect individuals to tame the organization.
I think some parts of IT have deteriorated into anarchy with tyrannic leadership.
Sure, you can have anarchy. But then don't expect any particular timelines.
You can hire armies of people. But then don't expect one corner of the org to be able to deliver something that involves talking to everyone.
You can't have the cake and eat it too.
Compare that to today: more and more adults have to live with their parents due to cost of living, you need until age 23 until you earn your own money because you're effectively worthless without an academic degree, you get saddled with debt from acquiring said degree, when you finally have a job it's usually impossible to afford even a run-down slumlord shack unless you have two (or, worse, three) incomes... and we never had the time to actually reset after the polycrises - 2007 ff financial crisis, euro crisis, refugee crisis (in Europe), refugee crisis 2 (in Europe), Trump 1, Covid, Russian war, Trump 2...
Particularly the fact that our generation can't rely on our parents and friend networks for support any more is the largest factor to blame. And obviously, earlier generations were significantly underdiagnosed, partially because medicine literally didn't know better, partially because their parents beat them into submission with sheer violence.
Hint: mental illness and life being stressful is often comorbid and causal.
Perhaps GPs in the future can prescribe mindfulness more often.
They do at least have an official NHS web page on the subject: https://www.nhs.uk/mental-health/self-help/tips-and-support/...
I do agree that it shouldn't be the job of GPs to prescribe away mental illness though, any more than they should be telling you what eyeglasses to wear. Those jobs should go to psychiatrists and optometrists, respectively. The GP should merely refer you to the specialist.
It does beg the question though, since society is so clearly sick and appears to be getting worse in many countries, whose job is that to fix? The obvious answers are either "politicians" , or "all of us". But politicians seem just as afflicted as the rest, or even to be adding to the sickness in many cases. And saying we all need to come together to fix it might be a truism but is basically useless.
Also, people might not be ready for this but, being able to focus intensely on one thing while being easily distracted when forced to do menial tasks is not a disorder.
Lots of things come from this: shared resources (less income need, less work stress), shared emotional support, shared childcare (less income need), etc.
Instead of single family homes (one family is not the atomic unit of the human species!) it should've been single community developments with 15 homes and a big shared backyard but still private for all the houses. And the landlord + all the tenants can select the residents based on their personal preferences and anyone can veto.
I think many challenges stem from the lack of this.
I don't know what the fix is though, because housing regulations seem difficult to change.
The empirical criteria of depression, held by most health professionals, are influenced a lot by the mass trend. If all people are depressed (eg during a widespread economic crisis, loss of ambition, hope etc), like it happens today, then depression will tend to be mostly normal.
I believe today a large percentage of people suffer from an uncovered, untold stress and depression and we professionals must resist to accept this as normal. Depression is an unbearable but curable disease and is not like house prices/rents where we have to adapt and get accustomed to.
There's just no hardship anymore and her life is not even that stressful. It's just easy to come with that and give excuses.
The issue is: I want to be sympathetic to her condition and help, but it's really hard to don't sound like I'm judging. I can't just challenge a behavior because she is already doing the best she can. It's like there's an invisible ceiling.
PS: I'm only 12 years older than her.
I believe the issue is more broad than that though. I believe the issue comes from the very strong belief in our modern world that our behavior, our ideas and moods are what we are, what we have always been and always will be. That comes with our global theory of mind that one's character is given once and for all, from birth to death. I insist that this is a belief that is not universal, for some other cultures ideas and moods are transient external inhabitants of our minds. And indeed, people do change along their lifetime, and sometimes immensely; once you have witnessed these changes a few times you start to realize how even conditions that are usually considered impossible to cure, can actually be fixed.