[knownastron]

I'm for destigmatizing mental illness so that people who need the help don't have to face that barrier to getting help. However, could it be that the focus on mental health is in a perverse way making things worse?

The way it is analogized here [1] was interesting to me:

"If we told people that fear of flying was something everyone struggles with, that it was the result of what others have done to them, or structural racism or whatever, I’m sure we’d get more of it. Imagine further if TV, music, and movies taught kids that fear of flying made them deep and interesting, and schools and universities had fear of flying awareness weeks. This is pretty much the modern approach to mental illness."

[1] https://richardhanania.substack.com/p/how-i-overcame-anxiety...

[retrac]

The strongest evidence in favour of this line of argument is the large variation in the presentation and prevalence of certain mental illnesses, depending on culture. It would seem roughly 1% of people hear very literal voices talking to them, in every culture. But the prevalence of anxiety or depression-like illness varies by like an order of magnitude, at least based on people's self-reporting.

Our trauma-focused mentality is so prevalent in the West that many Westerners cannot help but project it. For example, when presented with evidence that suggests quite few Sri Lankans developed PTSD after being victims of the tsunami, it's an automatic reflex, isn't it? What's preventing them from recognizing and discussing their trauma? Perhaps instead something about their culture or environment, prevents them from developing trauma? That would have interesting implications.

[NoSorryCannot]

Then you have to admit the alternate explanation that people do not identify as having PTSD when they do, either because they don't know the signs or because it would be useless or embarrassing to do so.

Self-reporting is fraught when it comes to psychiatric disorders for a lot of reasons.

[tayo42]

I dont think this works because we as a society never tried to tell people to hide their fear of airplanes. And its not necessarily true we would suddenly have more people scared of airplanes. The premise of the analogy isnt based on anything true, its just another feeling the writer has.

The focus for mental health isn't to have people diagnose them selves with some condition. I think its more like going to the gym, but for your self to feed good mentally. Its more like telling people "hey your fat and this isnt normal and making your life worse in objective ways" (which we probably should do but off topic lol) At least Americans pretend that emotions don't exist and if they do acknowledge it internally, definitely don't ask for help. The idea is feeling anxious or sad, or whatever is normal and you might need help getting through it. These shouldn't be bottled up and ignored until it becomes something that can't be corrected.

[Gormo]

I get your point re distigmatizing mental illness, but why have we accepted the medicalization of normal emotional and cognitive aspects of human life? I don't understand how things like fear, frustration, or sadness have ended up being subsumed within the mantle of "mental illness" in the first place.

[Eleison23]

Several reasons, but one major watershed is because it was viewed as "more humane" to drug us rather than restrain us with shackles or strait-jackets. Invisible chemical restraints are more palatable to the general public, and produce much better income streams for the producers.

[Gormo]

What? How did being "restrained", either via straitjackets or via drugs, ever enter the conversation about people dealing with the routine stresses of life?

[foldr]

Leaving aside the fact that Richard Hanania self-identifies as a troll at the beginning of this piece, it seems to me that his outlook is based on a deep underling anxiety about women and sex:

>To put it in stark terms, if you are a single male, every time you see a woman that you might be interested in dating and you don’t at least talk to her, you have failed on a moral, intellectual, and spiritual level.

The claim to have overcome anxiety and fear is a popular self-help trope. In most cases, what really happens is that the person's baseline anxiety transmutes into a second order anxiety about being too anxious. The usual effect of this – which we can certainly see in Hanania's case – is to make them obnoxious assholes rather than cowards.

[jayd16]

> I’m sure we’d get more of it.

Is this based in fact or just made up? I'm not sure I put a lot of weight behind this comment.

[jrochkind1]

So one thing to distinguish from is:

a) Having emotional/mental/psychological distress

b) whether you classify that as "mental illness", and what effect classifying it as mental illness has.

My gut reaction is that with regard to (a), people are having a lot of emotional distress these days, and that this is not a response or effect of focusing on mental health or suggesting that everyone has mental illness. I think it is probably cultural, but for deeper and more structural cultural reasons than "whether we believe everyone has mental illness" (or even whether we believe everyone has "emotional distress"... although clearly everyone does to some extent? i think in any culture?)

But as to (b), how we understand emotional distress and how we classify it is definitely very culturally defined. I am not convinced that, for instance, classifying it as a "disease" or "illness" is accurate or useful. (useful? In helping people experience less distress or live the lives they want, I suppose). I am especially not convinced that classifying it as the result of a "neurochemical imbalance" is accurate or useful. I think the way we classify and understand this kind of emotional distress matters for how well we deal with it, and we may not be doing so very well.

But I don't think that "unhelpful classifying" is what's causing the, I think, actually escalating levels of mental distress.

And in general, I think acknowledging that lots of people feel a lot of emotional distress these days is helpful, that you are not alone, that you are not broken, that in fact that you may not be "ill" or have a "disease" (which doens't mean you aren't having a problem, or that things can't change for you). The category of illness or disease, after all, is necessarily exceptional rather than universal, right?

You may or may not agree with my analysis (I'm not sure how we'd investigate in an evidence-based way, or if we can), but perhaps still find the distinction between (a) and (b) helpful.

[kbelder]

I think the same can be said for addiction. Not that it's untrue, or imaginary; but that the cultural acceptance of it as a horrible disease makes it paradoxically worse. I remember reading an article by an ex-smoker who said (paraphrasing) that he could never quit because he bought into the idea of how addictive cigarettes are, and how quitting them is the hardest thing he'll ever do, and he'll need counseling and assistance and medication... once he cleared his mind of all that baggage, and realized it was just a choice, he was able to quit cold-turkey.

[fullshark]

A lot of mental "illness" is just being sad, which is a natural and healthy thing for humans to experience from time to time, even for possibly an extended period of time. I'm disturbed by the effort to "destigmatize" it from employers who see this as a challenge to productivity and therefore the bottom line. Like the idea that burnout is some special mental health condition and not just realizing your job stinks.

[trgn]

By labeling it, the human condition is further being commoditized. With taking a therapeutic approach, part of our wellbeing is now yet a little more objectified, can be assigned a market place value, and becomes interchangeable (two months of therapy online vs one month of therapy in person vs a weekend in vegas vs a new jacket). As a commodity, it can now be captured by branding and marketing as well.

This sort of reification of, well, everything, is absolutely relentless and been ongoing for 150 years now. Even if we do recognize it, which people have for just as long, we keep getting warned about it, it seems we are also completely powerless to stop this process.

[fullshark]

I mean I'm not objecting to that necessarily, more the idea that you should share your mental state with your employer, or complete strangers on the internet and this is healthy and good (destigmatize mental illness). I don't particularly think it is, and perhaps it's healthier to have the employer/employee relationship or the internet creator/consumer remain at some distance. Your employer and audience are not your friends or family.

[trgn]

> I don't particularly think it is, and perhaps it's healthier to have the employer/employee relationship or the internet creator/consumer remain at some distance

I definitely agree with that. Sorry if I side-tracked your point, because you are 100% correct.

[fullshark]

Ehh I conflated two points really initially by bring up the objection to the burnout labeling, which is your side-track.

[germinalphrase]

"part of our wellbeing is now yet a little more objectified, can be assigned a market place value, and becomes interchangeable (two months of therapy online vs one month of therapy in person vs a weekend in vegas vs a new jacket). As a commodity, it can now be captured by branding and marketing as well."

Unless one separates themselves from modern society, couldn't this criticism be levied against everything human?

[trgn]

Yes, I'd agree, this is a problem of modern society in particular. I think the challenge is to keep what's valuable and discard what is not. We are terrible at the latter.

[Eleison23]

School shootings and other mass violence is the best thing that ever happened to mental health care systems. Every time there is a big shooting, legislators scramble to shovel more money into the pockets of insurers, providers, and pharmaceutical companies providing "mental health care" as if that will prevent violence somehow (hint: more drugs cause more violent behavior).

So it's a vicious circle: more drugs -> more violence -> more legislation -> more money -> more treatment -> more drugs.

[jacobsenscott]

I don't think money actually ever gets allocated to mental health. This is just the standard distraction to stop people from talking about the real cause of school shootings.

[germinalphrase]

The vast majority of therapists do not - and cannot - prescribe drugs.

[Eleison23]

Psychotherapy is usually not a covered benefit in public mental health plans. Most poor people are drugged, locked up, etc. Therapy requires trust, commitment, funding, and stability on both sides. It's the most effective cure but it's also the slowest and most expensive treatment.

[theGnuMe]

Do you think this analogy is sound and if so why?