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> The label is a shield against change

Surely it could be used for that. But it could also be used to get people who seem to fit the label to connect and discuss their own puzzling patterns of behavior, perhaps better understand why they never fit in no matter how hard they tried and so on. What is absolutely clear to me is that we as a population aren’t uniform at all in thinking and operating; being a minority could be a painful experience as you’re expected to conform to the norm. I think most discussion that expands this understanding is useful.

For official diagnoses I think labels can be a useful way to begin conversations about improvement. However what looks like a growing trend is self-diagnoses. In those cases what seems to be happening more often is the label becomes an excuse and an identity to try to live up to.

I don't think self-diagnosis is something that should be encouraged or lauded in any way. It seems more harmful than good so far.

Self diagnosis seems completely natural when mental health care is unavailable because of a shortage of providers, or expense. What else are people going to do?

I didn't say it wasn't understandable. I just don't think it's a good idea or something to encourage. If it actually makes things worse, even if it sounds like a good idea, it's not something that should be encouraged. And I do think it has a tendency to make things worse.

Worse, in mental care you're better off doing g some self-diagnosis to narrow down the possibilities and know which specialist to go first. If you just go to the first general psychiatrist you can find, it's likely they'll first want you explore depression.

The problem with the above is, treating depression is a long process that can take years to yield perceptible results. If you try to explore it first, chances are you'll never explore anything else. Many of the other diagnoses can be tested and ruled out much faster, possibly in days to weeks (e.g. ADHD), so this is what you'd be better off starting with - but you have to suspect it first to know to seek out a psychiatrist specializing in that particular condition and ask them for an evaluation specifically.

Growing up in the 80s, kids usually weren’t diagnosed with autism unless it was severe. There’s no cure/medication, so seeking an official diagnosis is of no real benefit. But many people eventually connect the dots as adults, maybe do some reading, and suddenly make sense of their struggles and behaviors. Are they really less ‘valid’ than those with an ‘official’ diagnosis?

I need to do something and this is something is not usually a good justification for anything.

It takes literally years of experience to properly diagnose someone, so yes, I do think it is potentially less valid than an official diagnosis. Self diagnosis has an effect of becoming a self fulfilling prophecy many times. Therapists have to get training in avoiding leading a patient into a wrong diagnosis because it leads to some terrible outcomes. It's called "iatrogenic illness" in the literature. Self diagnosing patients have none of that training and are at significantly higher risk of causing it to themselves.

> Therapists have to get training in avoiding leading a patient into a wrong diagnosis because it leads to some terrible outcomes.

I suffered incredibly negative consequences to my life after being incorrectly diagnosed as bipolar 2.

It shattered my confidence and belief in myself as I was continually told the things I believed and the decisions I made were from a position of mania. It’s too hard to explain in a short comment but it’s potentially one of the most damaging medical interactions I’ve ever had in terms of what it did to my life.

Your first two questions I'd answer with, "Yes, trauma."

Additionally, I suspect an expert would say, "Domestic Violence is a crime caused by mental illness."

Some conditions can make it very difficult for a person to figure out who they even are. Undiagnosed autists and others can go decades trying and failing to be as successful and "normal" as others and may see it as failure on their part. For a lot of those people finally having a label that explains who they are and why can be a huge step for improving their life. Can such labels/identities be used as an excuse? Sure. But often it's also a legitimate explanation, and I think it's actually helpful in at least as many cases. To be fair it can be difficult for people to judge whether an affected person uses it as excuse or honest explanation, partly because they don't know the symptoms let alone understand them.

There’s no question kids (and immature young adults) identity shop, they always have, and DSM diagnosis is a nifty badge. And there’s always profit in this desire to be unique just like everyone else. Whether it is a mall store that sells specific identity adornments, or today, doctors who will sign a prescription, both are ways to profit off kids anxiety at being individuals.

But today’s social media (even HN) is dominated by this generation so it is hard to discuss it without being downvoted into oblivion.

Perhaps the pendulum has swung too far, but for me as a kid psychiatric treatment and diagnosis was shameful. Before my time, it was grounds to send people to be locked away forever (which is probably why it was shameful in my childhood).

The new era where everyone has a disorder is, in my opinion, preferable to the one where any disorder was viewed as inherent weakness that needs to be toughed through, even if that means some are diagnosed (or claiming diagnosis) undeservedly.

It means that those that actually need these services (and yes, it's more than just make believe) have an easier and more socially acceptable route.

I view it much the same way I view allergies. Sure, some people are "faking it" to be special, but enough aren't and allergens are a major problem for them. I have a family member that has been hospitalized multiple times because someone decided to test if they really had their allergy.

I don't think most mental health professionals would say that mental illness is a reason to maintain a damaging lifestyle. Quite the opposite - damaging normal healthy function is one of the defining traits of a mental illness, and one of the ways that mental illness is distinguished from normal variance in human cognition and emotion.

But mental illness, as a framing, suggests a different course of action.

When I was severely depressed many years ago, I was constantly trying to force myself to take more actions, to do more to change my life circumstances. I was nearly always screaming at myself inside my head to JUST DO SOMETHING AHHHHH. But that didn't work.

It wasn't that I didn't want to do things. It was that I was, in a local sense, incapable of doing them. Not in the sense that I physically could not, say, move my muscles to go clean up my kitchen, but in the sense that I could not trigger the series of brain processes required to do that. The analogy I used a lot at the time was that it felt like being one of those old cord-pull lawn mowers. I could pull and pull and pull and pull and all I'd ever hear was the engine sputtering, and it was the most frustrating thing in the world.

But today, here's how I'd frame the state I was in:

* I was under significant stress from my living situation and self-criticism.

* I was under too much stress to emotionally cope with, so

* I disengaged from feeling anything too strongly about my life or the world around me,

* Which drained the positive and negative reward structures that feed into motivation, and

* I spent so much energy trying to fend off those thoughts that

* I didn't have sufficient mental energy for anything else, so

* I couldn't do the daily maintenance tasks needed to avoid further deterioration

Put another way, ability to overcome one's natural tendencies is a finite resource, and I was exhausting mine completely just getting through the day without losing it, which was disabling my ability to fix my situation.

I didn't need to yell at myself more. What I needed was an environment that wasn't constantly stressing me out, and to train myself not to burn all my mental energy hating myself. Once I got that environment, once I understood that motivation is only very weakly under my direct control, and once I trained myself to maintain an environment that didn't add stress to my life, my mental health struggles abated.

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To put this in more HN-y terms, mental illness has a lot of similarities to working with a crappy external API (that's the mental illness bit) and to technical debt (that's the life-state bit).

You can't go fix someone else's API. It's going to feed you crappy poorly-structured unreliable data all day long and there's nothing you can do about it. But you can build a wrapper around it. You can validate it. You can learn to view what it tells you with a critical eye, and to correct for its common errors.

And you can't fix technical debt today. Today you just have to engineer around it. But if that's all you ever do, the debt keeps accumulating and the problem gets worse. But if you can free up some time to go fix things, that frees up even more time to fix even more things, and you can find yourself on a more positive feedback loop that brings you back into a healthy place.

The way you're framing this, BLKNSLVR, is like saying "it's possible to build software on top of this foundation, so just do it". And it is possible. But it isn't easy, it burns far more resources than it should, and it doesn't fix the problem. The proper solution is to figure out a way to not be on fire today, then fix the underlying problem so you're not on fire tomorrow.

Thank you for the detailed reply. I have very shallow experience with some of what you said above, and the way you explained it makes the 'stuck' feeling make more sense.

I've treated it, in the past, as "you've gotten over it before, you'll get over it again, try not to take it out on other people in the meantime", which is treating the symptoms not the cause.

I'll re-read this a few times.

Thank you.

There are "causes," and "effects."

A lot of "effects" are actually expressions of coping mechanisms. Things like drug use, spousal abuse, excessive sexual promiscuity, hoarding, having three hundred cats, etc., are, quite possibly, self-prescribed ways to deal with the pain created by inner "causes."

Very often, these coping mechanisms cause more problems, that also need to be coped/fixed.

Say we steal a hat.

We're a "thief." Simple, straightforward, and solves society's problem.

But why did we steal the hat?

Did we steal it to keep the sun off our head? That means we wanted it for personal security.

Did we steal it because it's a cool hat, with a cool logo, and will impress our companions? That means we stole it to improve our social standing.

Did we steal it, because we think that it will impress $MEMBER_OF_SEX_WE_LIKE? That means we stole it, because we wanted to have more sex.

We could also have stolen it, because we are compulsive thieves, and just had to steal it; for no other reason, than we could. Stealing the hat was a coping mechanism for the inner pain, created by not stealing it.

The first three causes are motivations, and aren't necessarily any indication of a particular psychiatric disorder (but there's still stuff needs to be dealt with). There's a pretty good chance that consequences can be factored into the decision to steal, mitigating the problem.

The last one, though, is straight from the DSM, and jail isn't really going to do anything to solve the problem. It will still be there, when we get out. Same goes for many people that are lifelong predators/offenders.

I'm a big believer in addressing root causes, and not just playing Whack-A-Mole with effects. This applies for finding and fixing software bugs, as well as my own pathologies. I like to fix the bug at its deepest level. When I was younger, I tended to apply the fix at the shallowest possible point.

That means that I need to be excruciatingly self-honest. We look at diagnoses of mental illness or personal pathology as "investments," and tend to deliberately deny any data that may indicate that our diagnosis is wrong, or incomplete. Basic human nature. I have close family with extremely serious mental illness, and have been watching this play out, with highly educated therapists.

Reality really doesn't give a crap about what we think. It just is. There's no "moral" component. There's no need for accolades or approval. There's no money to be made.

It. Just. Is., no matter what we do to bend it into our own worldview.

If we're good with the shallow fix (and, in many cases, that's fine), then we can go for the easy fix, and we don't need to disturb our carefully-cultivated theories.

If we really want to understand the cause, though, and apply the fix at a deep level that will ensure a robust and lasting solution, we need to be absolutely brutal about cleaning house, inventorying our own points of view, and avoiding sacred cows and third rails[0].

[0] https://littlegreenviper.com/miscellany/sacred-cows-and-thir...

The problem with brutally honest introspection is that coping mechanisms exist for a reason.

The people who would benefit the most from self-honesty are the people most vulnerable to not being able to handle the truth, and potentially leaning even harder into unhealthy coping.

> not being able to handle the truth

That's why we shouldn't do it on our own. There are many frameworks for rigorous self-evaluation.

Please share your recommendations.

What worked for me, may not work for others. It would be irresponsible to make any recommendations.

It's fairly important for each of us to take the initiative to find our own path, as that helps us to stay on-beam.

I will say that any successful path will be difficult. It has been my observation and experience, that nothing worthwhile comes easy.

> Is mental illness a crystallisation of habits we unknowingly locked ourselves into?

This has to be trolling. You have to deny even the most extreme forms of mental illness, like schizophrenia with persistent hallucinations, to be so completely obtuse in the current era as to blame mental illness on the patients.

> What if "domestic violence" was actually a mental illness?

If you plead insanity and are a danger to others, you go to an institution. This isn't an edgy thought experiment, bud. This is the sad reality of peoples' lives that you're dismissing. Fuck you with this flame bait, seriously. You aren't "just asking questions", you're an asshole.

I was not intending to offend or troll and my apologies for coming across to you like that.

It's a sensitive topic that covers myriad issues both mild and extreme and I guess my questions were around the milder side and therefore could be taken as offensive if looking at it from the more extreme side.

The article focuses heavily on autism and only mentions schizophrenia once, so my commentary was based mostly on autism. The article also mentions sociopathy / antisocial personality disorder, which feels to me fairly distant from autism, or at least the lower ends of that spectrum.

> complete lack of familiarity with being alone with only ones thoughts for company for any period of time.

Riiiight…

We’re all hanging out in the comments, none of us should be casting that stone.