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Comment by paimapi | Hacker News Reader

actually interpreting the DSM-V and running diagnostics is exclusive to clinically trained psychologists and psychiatrists. even LCSWs are remiss to offer a 'diagnosis' after years of talk therapy with a client. most official diagnoses happen within a matrix describing a cluster of symptoms paired with an eval of severity and impact on life, and a battery of tests that have been empirically and rigorously validated

as my wife (who does have an MD and specializes in psychistry) is fond of saying when people ask her to diagnose someone she doesn't know, "Sometimes people are just weird"

it could be that the guy here is just very burnt out and stressed and his healthier coping mechanisms aren't working so he's resorting to worse ones

you can be empathetic to that without calling someone 'mentally ill'

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Why are people so eager to gatekeep who gets to call others mentally ill? I don't understand it. I don't have to be a doctor to say that someone who is constantly coughing and having a fever is sick, nor do I have to be a doctor to call someone with no legs disabled. What's different about mental illness?

I don't disagree that there might be more subtle cases that are hard to tell by a lay person. But Matt is not like that. You are free to read his posts from the WP Engine lawsuit, including his post on hacker news, or his prior posts from some tumblr moderation drama. To me, the consistency and degree of his actions crosses the boundary of "bad day at work" and lands firmly in the "crazy guy in the park screaming at squirrels" territory. In fact, I'd argue that if he doesn't have tech wealth and was instead working a more traditional white collar job he might have already ended up just like that.

becase most people are not qualified to distinguish mental illness from emotions, stress etc, and obviously you are not either. A broken, protruding bone is obviously broken and protruding; you see it with your eyes and you know that it's broken. Mental illness is much tougher to diagnose because you're looking at symptoms, not the actual brokenness. You said it yourself - you are a layperson, not a doctor, which confirms that you are nowhere near qualified to diagnose mental illness. Your "argument" stinks of ad hominem.

Because some people would go insane without having an external authority to appeal to; the extant systems of academia and qualification create an "objective" truth these peoples' psyches can cling to.

Without the certifying board, one might wonder about the nature of problem described.

because it contributes to stereotypes and increases stigma around mental health. this leads to even more social isolation and self-doubt for people with those disorders which worsens their quality of life, something that is already much lower on average than those without

https://www.psychiatry.org/patients-families/stigma-and-disc...

it's the same idea as not calling people the 'r' word and why that word itself is no longer used in official diagnoses. it's a boundary condition grounded in compassion. advocating for using a new word doesn't need some soapbox tantrum about the fatuousness of the modern world a la Ignatius J. Reilly

There is nothing more stigmatizing and dehumanizing than the idea that there is a class of human condition that is taboo to describe in words.

how is that in any way what I am saying? you are not describing the actual condition. you're ascribing what you see as anti-social or negative behaviors you heard about an individual (who has not disclosed any diagnosis) to a complicated illess that requires years of training to formally diagnose

this bloviating about free speech when all anybody is asking you to do is to not be an asshole is so overwrought and childish

That's not what anyone is saying. There are many classes of human (and non-human) condition where it's best to allow a subject-matter expert to diagnose, and where armchair diagnosticians can do a lot of harm. This is one of them.

The idea that you can "diagnose" someone with a mental illness based on reading their court filings and things they've written online, without ever speaking to them in person, is... well, just bonkers. It's irresponsible, at best.

Someone can exhibit anti-social behaviors without having a mental illness.

This is as frustrating as people I know who are constantly saying "I think so-and-so is autistic/has ADHD". Yes, sometimes it's correct, but often it's not, and the outward symptoms of those two conditions often lead to a true diagnosis of something else entirely.

> Why are people so eager to gatekeep who gets to call others mentally ill?

Because calling someone mentally ill is a serious thing to do, and doing so without being qualified to offer that diagnosis is irresponsible and cruel.

> I don't have to be a doctor to say that someone who is constantly coughing and having a fever is sick, nor do I have to be a doctor to call someone with no legs disabled. What's different about mental illness?

If you can't understand the obvious, huge difference between those things, then I'm not sure what to tell you.

Come on, if you see someone naked on the street, screaming at a wall, eating a pigeon or whatever, are you really going to think:

"I don't know if this person is mentally ill or not, I need an expert to come here and apply the DSM-V"?

Oh and also, the DSM-V is not even used to diagnose those things ...

Someone "naked on the street, screaming at a wall, eating a pigeon or whatever" could be having a bad trip on some drugs, not necessarily mentally ill. The drugs will wear off, and they will be a regular neurotypical person again. But by slapping a mental illness label onto that person, you've proven that you have no clue what you're talking about, and you shouldn't be diagnosing anyone.

Our brain is designed through evolution to slap labels, aka engage in hasty generalisation. The world is much more complex than that.

Addiction is a mental disorder within the mental health spectrum, and it matters.

https://pubmed.ncbi.nlm.nih.gov/41449521/

But nice try with the throwaway account and everything. 8/10, pal.

You can have a bad trip on a drug without being addicted, or without having any mental illness whatsoever.

Nice try dismissing something someone said for invalid reasons, "pal".

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