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Comment by jl6 | Hacker News Reader

Suicide is the extreme tip of the iceberg, and thankfully still rare. But the rest of the iceberg, comprising teens suffering mental health and body image issues - not to the point of suicide, but still serious - is staggering. Teens are self-medicating and sorting themselves into echo chambers that reinforce their negative feelings, entering an illness-to-identity pipeline, where they cannot see any other way of being. Doctors are completely unequipped to deal with this. Parents are powerless.

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This may be an unpopular opinion but I believe the constant focus on what we call mental health and body image issues is making the problem worse. I know those words are supposed to alleviate stigma and normalize, but if you're telling kids going through regular adolescent issues that they have mental health or body image issues, you're not helping them. And naval gazing is going to make things worse.

Maybe I'm a product of the 90s, but every issue me and my peers faced was waved off as teenage angst that I'll grow out of. I didn't have "anxiety", I was being a wuss. And they were right.

If someone told me I had mental health issues and made me focus and resolve those, through therapy or meds, I would have been much worse off. Brushing it off leaves some small percentage of teens worse off, but I would think the overwhelming majority would be better off not focusing on it. This doesn't even include things like "generational trauma" that people dump on kids.

Whatever you think about today's society, I think it's safe to say that across the board we have a lot more inward facing reflection on things like mental health, especially for children. And what do we have to show for it? Are they better off? Across the board, even kids who aren't as connected to social media are worse off. Which tells me this focus is net negative

When I was a teacher, I noticed this too: the more we talked about mental health, the more cases of anxiety our school counsellors saw. Perhaps some of that was simply awareness. But adolescence is also a time of experimentation with one's identity, and I fear we've allowed 'anxiety' to become an identity we offer to them to try on for size.

To me at 51, looking back at my own experiences, I think the things we tell ourselves work in a similar fashion to software; programming our identity.

The first "programmers" are our parents. Classic negative tropes like a parent saying "you'll never amount to anything" run in a loop in our brains for many years until finally that program expires (typically around mid life). In turn a negative identity will effect you in all areas of life, from how you interact with people to even your physical posture.

Perhaps the lowest level of "programming" you can do to yourself is the mantra - https://en.wikipedia.org/wiki/Mantra - you could see this like assembly language, and humanity has known about this for a very long time.

So yes, giving teenagers labels which they identify with and repeat to their friends has a reinforcing aspect to it. And social media has played a very significant role in providing those labels.

To me an interesting thing about TikTok in particular, compared to Instagram, is I think TikTok users are more concerned with the question "who am I?" vs Instagram which is more about "this is me" (telling the world who you are). That's what's made TikTok more popular as, especially when you're young, trying to figure yourself out is a major pre-occupation.

If you haven't already read it, you should check out "The Four Agreements" by Don Miguel Ruiz.

One of the mental models I gained from that book was (paraphrasing):

Society (other people) will try to program us with their own accumulated poison, and our job is to

(a) resist these poisonous worldviews/ideas/patterns instead of unthinkingly osmosing them "because a grown-up or peer said so", and

(b) not pass our own poison(s) along to others.

I think it is a tough balancing act.

I am a product of the 90s also. I was severely depressed all through high school and probably could have been helped in some way.

Instead I got nothing. Just suffered in silence and I didn't even know I was depressed. Any statistics from the 90s on mental health I wouldn't be counted in other than being a mentally healthy, happy, normal kid even though nothing could be further from reality.

What would be the alternative if you were suffering the same fate today? So you think you would have been better off medicated? Or some kind of therapy?

yes.

Despite claiming the opposite, teenagers are sponges for whatever floats in society around them. When most of the highly valued voices in society tell them that they should be sad and anxious and traumatized, is it really surprising that it's exactly what they turn out to be?

There's a reason the amount of self-described gay and lesbians has dropped massively in regions where it is no longer transgressive at all (but being trans is, so there's a massive increase there). It could be that homosexuality was actually just a mask for a trans identity, but that's odd because it would invalidate virtually everything that has been said in defense of tolerance of gays and lesbians.

Similarly, all this "mental health awareness" has done anything but normalize mental health issues. I'm sure this is well-intentioned however intentions don't count for much. The normalization of "minor" mental health issues has led to a situation where many more people start treatment with heavy side-effects to address issues that are often less serious than the side-effects of the treatment.

Worse, and here I'm thinking mostly about ADHD, what has been normalized is not the fact that some people have less attention than others. What has been normalized is to diagnose kids with ADHD and start medicating them. We have done the opposite of normalization here: it used to be that people with rowdy behavior were just expected to naturally grow out of it. That their education would take a little bit more time. They weren't considered broken or lesser or, crucially, abnormal or sick. In effect, we have turned slight deviations from the norm in terms of this one personality trait into a disease that must be treated. And because I can already read the comments: yes, some people legitimately have ADHD to such a degree that it interferes with their life and it makes sense to medicate. However, basically nobody starts taking ADHD medicine when they're already an adult, the decision is always made for them. And few parents, doctors and teachers will advise _against_ making an annoying child more docile unless they're acutely aware of the risks. And this tendency is further reinforced because the entire school system is run by people who have no idea what being a 4-to-18 years old boy is like and don't want to know.

> There's a reason the amount of self-described gay and lesbians has dropped massively in regions

Statistics vary, but I can't see any evidence of this?

> It could be that homosexuality was actually just a mask for a trans identity, but that's odd because it would invalidate virtually everything that has been said in defense of tolerance of gays and lesbians.

What? None of this makes sense?

> However, basically nobody starts taking ADHD medicine when they're already an adult, the decision is always made for them.

This is not really true, adult ADHD diagnosis is on the rise.

https://www.nihr.ac.uk/about-us/news/significant-rise-adhd-d...

Also, it's still underdiagnosed. There's some BS that makes it difficult to get "ring of fire" STEREOTYPICAL ADHD patients in favor of overworked professionals hitting professional plateaus.

A huge percentage of people with ADHD don't receive treatment; bear in mind the modern approach of not treating roughly half of patients with ADHD. In other words, they do pretty much nothing at all and tell you to get lost.

So the reality is that they are always under and over treating the condition and there should be awareness of this reality. Success should include working with patients and not relying on over-prescription, or scapegoating people as lost causes.

This is a very popular opinion, btw. The focus can increase harms, but the reality is that many people had poor mental health prior to this push, and after, with very little effect.

Constantly bringing up things like sex abuse and other traumatic issues causes problems for sure. It looks like the often maligned "push it down, bottle it up, pretend there's no problem" is better strategy than we pretended. It even seems to be partially adopted by the industry.

I think we overshot from „mental illness ignored or undetected in childhood last until adulthood and a lot of suffering could have been prevented if treated in childhood“ to what you describe. The intentions are good but I think nobody could have expected that this turns teenagers into mental illness collectors.

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