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I feel like there has been a great increase in mental health issues: anxiety, depression, etc., especially among youth. I don’t recall these being major issues from when I was a youth in the late 80s and early 90s. I’m told that I’m wrong and people just didn’t talk about it so I wasn’t aware of it. But even amongst close family members and friends it wasn’t a thing. Now, I’ve seen some claim it is the post 9/11 world or social media, but I have to wonder if there is some chemical we are exposed to more that might be causing mental disorders in addition to early onset cancers.

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> but I have to wonder if there is some chemical we are exposed to more that might be causing mental disorders in addition to early onset cancers.

It's always easy to point the finger at a single cause, but the reality is that it's a series of factors that together act like a sophisticated, compound "attack" to the psyche:

- Social media weakens your self-confidence and makes you feel in a constant state of inferiority, i.e. your present self.

- The "post 9/11 world" you mention, is simply a result of a general worsening of Western political relations over time, which are becoming especially evident recently. That state of turmoil weakens your sense of stability and security, making the future look bleak - i.e. your future self.

- Further blows for the knockout: climate change, pollution / micro-plastics / rising costs of living, etc.

I'm actually surprised depression, anxiety and other mental disorders aren't more common...but perhaps they will be.

Excluding the microplastics thing, I think that your two latter points are actually both derived from the social media changes.

Life today for almost everyone in the West is better than ever before, but people are exposed to a lot of thought on social media that 1. life is worse now, 2. in your lifetime there will be terrible destruction happening, which contributes to a sense of fatalism and doom.

It is super appealing to the human psyche to think things are worse in [current-time period] than in the past. This is why there is an intuitive appeal to things like "Make America Great Again." Social media only amplifies this effect because people are exposed to things that are maximally appealing to their psyche.

> Life today for almost everyone in the West is better than ever before,

I'm 60. You've just got to be joking.

When minimum wage was $3.30, a one-bedroom apartment cost $285. Now the same apartment is well over $2000.

My university tuition averaged about $1200 a year - that was about 10 35-hour weeks at minimum wage. But I got small scholarships that paid for it. My girlfriend worked in a sub shop two nights a week and had a summer job. No one went into debt.

One working parent could support a stay-at-home parent and pay off a mortgage.

Or you could work part-time and have a modest life and pursue your dream.

People just walked into career jobs right out of university.

Listening to young people today, unless they're in one of a small number of very much in demand fields, the idea of stability, steady advancement, or buying a home seem impossible.

Life today is better if you're already established, i.e. have a well paying job, own a home, etc.

Being young in todays world is exponentially harder than it was, say, 40 years ago. Many young people have given up on the idea of home ownership. I'm 26 and I've had friends laugh in my face when I suggested owning instead of renting. It's simply unattainable unless you're in a lucrative field. I'm in Canada for reference (our home price to income ratio is one of the worst in the world).

I think you are just falling to this same nostalgia bias.

In terms of the material abundance that one experiences today, it is just on a different level from 40 years ago.

Housing ownership is also not the be all end all. And while the prices are higher, the rates are lower so that you will not be paying a greater proportion of your income on housing.

Compare to 40 years ago: https://fred.stlouisfed.org/series/MDSP

To look at housing and say that the high price of homes negates all quality of life improvements in the last 40 years seems wrong to me.

> - The "post 9/11 world" you mention, is simply a result of a general worsening of Western political relations over time, which are becoming especially evident recently. That state of turmoil weakens your sense of stability and security, making the future look bleak - i.e. your future self.

The relations have not simply become worse, they have been very deliberately driven to be worse:

https://www.tabletmag.com/sections/news/articles/media-great...

Just look at these hockey sticks. People talk about divisive rhetoric, but hot damn.

I don't remember hearing much about anxiety or depression, but do remember hearing about things like alcoholism, domestic violence, and 'laziness.' I'm pretty sure these are largely the same psychological issues- it's just people used to hide it, and deny it even to themselves- so you would only see the resulting dysfunction. Nowadays people are getting a diagnosis and treatment rather than just silently suffering and hiding it.

It's frustrating to see how many people don't understand this. To say mental health issues didn't exist until we started diagnosing and treating them is like saying oil didn't exist until we started drilling for it.

But I also think "back in the days" life was more fixed. Probably getting a full time job as employee, starting a family, getting a house was not really optional. Now there are much more choices. Add to that all the hyper-connectivity. I don't really think people were better off but were just forced to handle everything more calmly. Growing up in the 90s, what I've found is that things changed a lot when people were starting their jobs.

Not to mention living in America is like playing life on hard mode; at least relative to other OECD countries. There's a lot more things you have to take care of / think about in America. There's a level of mental overhead that does not exist in other developed countries that many Americans do not realize are optional. eg health insurance, education, unemployment safety net, or even little things like way too many coverage options when buying car insurance.

When you do not have to worry about your health or physical safety if you lose your job, you can chill out a little bit. You don't need to bend over backwards for your job, it is easier to enforce boundaries. This dynamic puts adult Americans under a lot of stress, and it manifests in many ways. And it propagates to the children too, through lack of attention or stressful home.

There's a level of mental overhead that does not exist in other developed countries that many Americans do not realize are optional. eg health insurance, education, unemployment safety net, or even little things like way too many coverage options when buying car insurance.

I occasionally try to stress how these things seriously improve living standards. Just health insurance itself does a great deal to eliminate stress. I can go and get a weird mole checked out. I can get an MRI when I've been having headaches to make sure it isn't cancer. I can get the spot on my pancreas scanned every 6-12 months to make sure it doesn't do weird stuff. All for less out of pocket than $300 per year and my taxes are less than state + federal + premiums.

It’s hard mode if you’re poor and easy mode if you’re rich. For the top 1-2 deciles I think most of these things are much better in the US than other countries. I’m a long time proponent of universal healthcare, but I’ve heard terrible experiences in Canada and the UK in getting relatively basic treatment in a timely manner.

I think a lot of HN doesn’t understand that all the shitty things about the US that people from other countries love to rag on basically don’t apply to many people in the US. If you have a job that is in demand you will not need to worry any more about these things than if you live in another developed country. Especially in American corporate culture, sure people are worried about their mortgage and some do live paycheck to paycheck, but the culture of excessive work in places like tech or finance is not generally about getting thrown out to the streets with cancer.

You're right and wrong. You are right that it is hard if you are poor and easy if you are rich. But you are wrong that HN or people outside of the US do not understand that it is only hard for poor people. It's just that external to the US, people care about the welfare of poor people more. The fact that you felt it necessary to state that caveat illustrates how systemic problems which victimize poor people can be excused and remain unchanged in the US.

For context I've lived for decades in both Australia and the US. Pros and cons in both cultures, and I love both.

I brought it up more to illustrate that the work culture of the US is not just a result of precarious financial situations due to lack of a safety net.

I would agree that it's not entirely the result of precarious financial situations. But even in tech and other high paying sectors, I would argue it still plays a factor, even if it is unconscious. Golden handcuffs are in part evident of this. Everyone in America wants to make enough money they can retire comfortably. Which is an entirely rational thing to want to do. But other countries do have higher paying pensions, so the fear of retiring destitute is less.

Also keep in mind employer expectations are a market just like any other. You as an employee compete against others willing to go lower. If you have a portion of the population in precarious financial situations, that will still impact you somewhat as they compete for jobs indirectly with you.

> Not to mention living in America is like playing life on hard mode;

Do you have any idea what living in third (or even second) world countries is like?

> at least relative to other OECD countries.

Such as Turkey? Or Mexico? Why do you think Mexicans escape to the US? Because their life was too easy and they wanted to have more of a challenge?

I explicitly wasn't talking about second and third world countries, so your comment is mostly moot. I don't know about you, but I prefer we compete with our peers on quality of life rather than the tiers below. We should strive to be the best, not just better than the worst.

> Such as Turkey? Or Mexico? Why do you think Mexicans escape to the US? Because their life was too easy and they wanted to have more of a challenge?

They come the US because the quality live in the US is superior ... I didn't say it wasn't.

Puberty coming on ever earlier is my pet theory for what's causing this.

It might come in a way that's uneven. An adult set of sexual characteristics and drives without the corresponding development in executive function must be difficult.

Add to that the sudden arrival of sexual characteristics and attention at an age where our culture has no scripts and rituals with which to handle them. Kids must feel like adrift aliens, within the world and within their own bodies.

More likely it’s the endocrine disruptor chemicals in the environment that are causing earlier puberty AND increased cancer rates.

What about constant stimuli fighting for our attention by exploiting our lizard-brain emotions every waking hour?

We know for a fact that social media causes these issues, thanks to the leaking of internal Facebook documents to the WSJ[1]. Whether or not it's the only source of the rise of mental illness isn't clear, but it's a huge factor for sure.

[1] https://www.wsj.com/articles/the-facebook-files-11631713039

Yeah, especially young people do have it bad. One interesting thing is that as society becomes more and more feminist, it's the young women who fare the worst, and especially the demographics most likely to be intersectional activists.

Maybe not all ideologies are good for us? At a quick glance, a lot of the intersectional feminist/activist modes of thought seem to be the polar opposites of what eg. cognitive behavioral therapy and the stoicism it's inspired by advocate (eg. others are responsible for your emotional reactions/state, so to control your mood you have to control others vs. you are responsible for and in control of your own emotional reactions and mental state and you can improve your mood by honing yourself).

We know CBT is effective for getting rid of dysfunctional thought patterns and lessening mental health symptoms. In that light, these numbers seem unfortunate but entirely predictable.

https://i.imgur.com/uRX0A9u.png

CBT is not effective for lessening mental health symptoms. See e.g. https://doi.org/10.1192/bjp.bp.116.187773

>the difference between CBT and pill placebo was a standardised mean difference of –0.22

The effect measured in this meta-analysis is a less than two point drop on a 52 point scale (Hamilton Rating Scale for Depression). That is not clinically significant.

Interesting. Will take a look, thanks.

From the study you linked:

> Our study has limitations. First, detection of an interaction effect requires a large sample size. The present findings require replication with a larger sample of trials designed to test the interaction. The trials from which the data were extracted were not designed to test this hypothesis, but do provide a ‘first look’ into this question using all available data. Given the wide confidence interval around zero for the interaction coefficient in the present study, it is possible that our finding represents a type II error. Although none of the sensitivity analyses were suggestive of possible interaction effects, future studies may nonetheless still reveal an interaction that we failed to detect in the data available to us...

⁣

I'd be very cautious about saying "CBT is not effective for lessening mental health symptoms" due to a single study. From the American Psychological Association [1]:

> Cognitive behavioral therapy (CBT) is a form of psychological treatment that has been demonstrated to be effective for a range of problems including depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness. Numerous research studies suggest that CBT leads to significant improvement in functioning and quality of life. In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications.

⁣

From the NHS [2]:

> Cognitive behavioural therapy (CBT) can be as effective as medicine in treating some mental health problems, but it may not be successful or suitable for everyone.

⁣

From the Cleveland Clinic [3]:

> Cognitive behavioral therapy (CBT) is a structured, goal-oriented type of psychotherapy (talk therapy). Mental health professionals, including psychologists, therapists and counselors, use it to treat or manage mental health conditions and emotional concerns. It’s one of the most common and best-studied forms of psychotherapy.

⁣

I'm not at all suggesting that we blindly trust those organizations, rather just cautioning saying it is no more effective than a pill placebo due to one study.

⁣

A different study that reviewed meta-analyses came to quite a different conclusion [4]:

> In our review of meta-analyses, CBT tailored to children showed robust support for treating internalizing disorders, with benefits outweighing pharmacological approaches in mood and anxiety symptoms. The evidence was more mixed for externalizing disorders, chronic pain, or problems following abuse. Moreover, there remains a need for a greater number of high-quality trials in demographically diverse samples. Similarly, CBT was moderately efficacious for the treatment of emotional symptoms in the elderly, but no conclusions about long-term outcomes of CBT or combination therapies consisting of CBT, and medication could be made.

> Finally, our review identified 11 studies that compared response rates between CBT and other treatments or control conditions. In 7 of these reviews, CBT showed higher response rates than the comparison conditions, and in only one review (Leichsenring & Leibig, 2003), which was conducted by authors with a psychodynamic orientation, reported that CBT had lower response rates than comparison treatments.

> In sum, our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders. However, despite the enormous literature base, there is still a clear need for high-quality studies examining the efficacy of CBT. Furthermore, the efficacy of CBT is questionable for some problems, which suggests that further improvements in CBT strategies are still needed. In addition, many of the meta-analytic studies included studies with small sample sizes or inadequate control groups. Moreover, except for children and elderly populations, no meta-analytic studies of CBT have been reported on particular subgroups, such as ethnic minorities and low income samples.

> Despite these weaknesses in some areas, it is clear that the evidence-base of CBT is enormous. Given the high cost-effectiveness of the intervention, it is surprising that many countries, including many developed nations, have not yet adopted CBT as the first-line intervention for mental disorders. A notable exception is the Improving Access to Psychological Therapies initiative by the National Health Commissioning in the United Kingdom (Rachman & Wilson, 2008). We believe that it is time that others follow suit.

1. https://www.apa.org/ptsd-guideline/patients-and-families/cog...

2. https://www.nhs.uk/mental-health/talking-therapies-medicine-...

3. https://my.clevelandclinic.org/health/treatments/21208-cogni...

4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584580/

edit: formatting

>rather just cautioning saying it is no more effective than a pill placebo due to one study.

It is not one study, it is a meta-analysis.

The quotes from the meta-analysis you mention do not show mention anything concrete; there are words and phrases like "robust", "evidence-base is very strong", "higher response rate". They barely tell you anything. One needs to see the numbers, not the researchers interpretation of them.

> At a quick glance, a lot of the intersectional feminist/activist modes of thought seem to be the polar opposites of what eg. cognitive behavioral therapy

What a non sequitur. Why would feminism and stoicism have any incompatibilities?

I literally gave one example in the post you quoted. The intersectional types are vehemently against owning your emotional responses in the way stoicism advocates, and instead actively encourage finding more and more ever more minute things that might be rationalized to be a slight against themselves. On a deeper level, stoicism acknowledges and is built on the idea that not everything in the world is changeable, while the intersectional mode of thought is exactly the opposite.

Stoicism makes no sense in that case? How can you own your emotions if you are unchangeable? A stoic would consider the world as perfect as it is if it is unchangeable. Everyone is a stoic in that case, including the intersectionist types

Activisim is a more masculine way of thinking. Stoicism more feminine. As society changes these different modes of thinking get more and more mixed up and seperated from preassigned roles. That could be quite a positive thing. I think we benefit from both. Sometimes passion and anger is needed to change your life and the situation. And sometimes you need to just accept the world as it is. And in something like race/sexism we need a little bit of both. Prejudice is bad, but not all prejudiced people are bad. We should be able to identify it, address it and move on without it being a big taboo that gets people in lots of trouble.

Uh, have you looked at the demographics of intersectional activists and of people preaching stoicism lately?

Oh, I guess to be honest I thought your example was so stupid I didn't feel the need to respond. Now that you reply this way, I admit maybe I am just totally confused as to what you mean.

Why would there be any conflict between "I should try to not let shit get to me" and "Also, I should campaign for there to be less shit around to get to me"?

Those are just two different ways to deal with having shit, and one in no way impedes the other.

Am I misunderstanding your claim?

> The intersectional types are vehemently against owning your emotional responses in the way stoicism advocates

For me, they're absolutely complementary. If I'm the only thing I can really control, how can I do so without the right to make my own decisions beyond whether or not to accept a marriage proposal? Before feminism, married women were legally children, at least in the parts of the world I've lived in (US and Germany). In the state I live in, Bavaria, my husband could have prevented me from getting a driver's license or working up until about 1970.

A woman fighting against feminism is a woman fighting against responsibility for herself.

1. Toxic social media

2. Toxic mass media

3. Devisive, polarizing politicians

4. Being constantly threatened with nuclear death from a madman half a world away

Humans have to be able to visualize a better tomorrow to be propelled toward it. Do you see a better tomorrow? Maybe people are depressed and anxious because deep down, in the recesses of our collective consciousness, we already know how all of this ends.

This is easily solved: quit social media (it does nothing for you, it’s just a massive advertising machine), and quit the news (why worry about things you have no influence over?)

Perhaps knowing that we aren't going to do anything significant about the climate crisis, and thus devastate our environment and the carrying capacity of the planet, might be what's making them a bit touchy.

The smartphone era directly seems to coincide with elevated mental health problems.

I think porn and social media are responsible. Those two things, heavily changing neurotransmitter and hormone patterns, are significantly amplified when everyone has a smartphone.

I think video games, TV, rock’n’roll music and the bicycle are responsible.

I think bicycles are only responsible for the drop in birthdate. All that rattling around is damaging women’s reproductive facilities!

There seems to be an empty space that people rush to fill with a newest iPhone and installing FB and Instagram instantly, I guess in 90s you would use McDonalds for that

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