We Need To Talk About Depression
techcrunch.com
techcrunch.com
Even publications that dedicated to following mental health (and ostensibly authored by "experts" in the field) tend to do a dubious job of describing what is an extremely complicated problem to which THERE IS NO QUICK FIX. Read that again. Addressing mental healthy problems is very hard work and treatment plans vary by individuals (not even by disease) so even once you find a doctor you like - no easy task - and whether you go into psychotherapy or the psychiatric [aka prescribed] route or both - you have a long, hard road ahead of you which will require a lot of patience from you and those that you maintain relationships with whether they are work or personal.
There are lots of mental health disorders of which depression is a common symptom. It's important to work with a doctor you feel comfortable with to figure out if you suffer from depression, or if the root cause is some other disorder (OCD, bi-polar, anxiety are common amongst SDE types) which routinely causes you to feel depressed for days or weeks (or god forbid, months) at a time.
Even if you are comfortable going the medication route (and there are many reasons why this choice should not be made lightly, especially if it is via anti-depressants or another - they're all habit forming and bring their own set of side-effects and problems), it is a long an arduous process to find the right one/right dosage/etc. that will work for you (if there even is one). Each one takes weeks to see results typically.
Anti-depressants help some people greatly. Others will struggle with them and find them counter-productive to their treatment. There is no one-size-fits-all treatment plan. Mental health is a subject that doesn't get attention in any facet of American culture.
PS. There is no evidence to suggest that the software industry suffers disproportionately from mental health issues compared to any other.
The main message is "If you're feeling these things, please talk to someone you trust. If someone talks to you about these issues, please don't dismiss them." I think it's a good message, even if presented at Techcrunch. The more we as a culture talk about mental health issues in a constructive way the better.
I'd be interested to see a study on this
Why should she have written this for TechCrunch? Why not? The tech industry exerts enormous pressure to signal that one is a rockstar, that everything is better than fine, and that you're not just keeping up with the Joneses; you're lapping them. It's about time the tech press talked about depression as it really is, and not "depression" as a neutered buzzword for stress. And it's about time someone -- anyone -- restarted the national dialogue regoing about clinical depression and mental health.
In 2014, the stigma surrounding depression is every bit as harsh as it was in 1998, when I was diagnosed. In some ways it's even harsher. That really sucks. We need people to talk about it, and to be honest, the more people talking about it, the better. If one of those places happens to be TC, and so long as TC isn't peddling a watered-down version of the topic, I'm all for it. By the same token, if Sam Altman wants to talk about depression and wants to do his part to alleviate the stigma, I'm all for it. None of these articles is ever going to be perfect, or capture 100% of the issue. But I'm glad we're getting these articles, nonetheless. For decades, this was something people just didn't talk about or admit to in public. I'll take public.
I think it's worse. People are more aware of the illness itself, but there's more conformity, which means that it's harder to find accommodation for symptoms that are mild but embarrassing (e.g. needing a quiet room, instead of an open-plan hell, to recover from a panic attack).
What's new and upsetting is the competitive conformity of the Millennial generation (or maybe I'm just biased against my won age group). Gen Xers in 1995 may have had to show up for work at 9:00 and wear slacks, but they didn't rat each other out. They knew it was them against the system. The rising generation seems to have more house-slave types who'll rat each other out. I don't mind conforming (to a reasonable degree) and I don't mind competing, but when people compete to conform I just want to punch everyone in the face.
In fact I turned down an offer purely because of an office plan which would put me between a Ping pong table and a room full of people (in an open office plan).
You're talking about the third step, which is ensuring an environment where people can get the correct treatments and address the issues in a helpful way. I think this is vital to ensure that most people who suffer from anxiety, recurring depressive episodes or other symptoms that are triggered by a hard-and-fast lifestyle, get lasting benefit from treatment.
The problem is, most Americans (and Hacker News is in no way an exception to this) are stuck somewhere before point 1 and 2. So just opening the discussion up a little, is in fact moving in the right direction.
Although I do agree that someone should point out that "just be cheerful", "just talk to somebody", "just take a holiday" is dangerous advice which only serves to sometimes reduce the pressure a little. Doing things like these rarely addresses the underlying issues (unlucky genetics, unrealistic ambitions, unhealthy lifestyle, self-destructive thought patterns, unresolved relationship to traumatic memories, etc).
We discussed how is it possible that he was only diagnosed now. His response was striking and ming opening: "I had never experienced not having ADHD. How could I know that my experience is not normal ?".
I completely agree with your response. We must talk about mental health and raise awareness to mental health problems.
THERE IS NO QUICK FIX.
Sure, and I think that's well-acknowledged. Yes, we need to beat the stigma. However, that's not going to cure these illnesses. It'll just give people who have them a fair chance to recover. It's just one step, but it's an important one. For people in the mild-moderate stretch of the spectrum, the worst thing about these diseases (I'm bipolar) is that people kick you when you're down.
There is no evidence to suggest that the software industry suffers disproportionately from mental health issues compared to any other.
I don't know if we have a higher incidence of these problems (although it wouldn't surprise me) but we suffer in some unique ways. First, many of us work in open-plan offices. That's already unhealthy. But consider further that it takes a bit of an obsessive nature to get good at what we do. We genuinely want to do our jobs well, and get frustrated (and measurably anxious) when impeded. An open-plan environment that makes concentration impossible can be hell for a person like that.
Then add the "Agile" micromanagement, which is really just designed to put people on a treadmill and shoot the people who (for whatever reason) can't keep pace. Now, added to the existing risk of having a bad week is anxiety about having a bad week.
We've let The Business treat us like garbage, and the result is that we're constantly insulted with bad working conditions, micromanagement, low autonomy and deeply punitive environments. Some people can laugh this off, and many more of us get cynical with time, but the obsessively inclined people who tend to become programmers don't do so as easily, because they care deeply about doing their jobs well and then get handed an environment that makes it impossible.
Then:
> Mental health is a subject that doesn't get attention in any facet of American culture.
???
Worse still, some people I know are aware and accepting of the fact that they have issues, but they refuse to treat them because they fear antidepressants or mood stabilizers will impact productivity. One person I know explicitly refrains from treating his bipolar disorder because he thinks manic episodes make him productive. :-/
No one treatment is appropriate for everyone, but far too many people are willing to throw away their health in order to chase after the startup dream, despite the fact that it can hurt everyone around them in addition to shortening their own life.
> Worse still, some people I know are aware and accepting of the fact that they have issues, but they
> refuse to treat them because they fear antidepressants or mood stabilizers will impact productivity.
> One person I know explicitly refrains from treating his bipolar disorder because he thinks
> manic episodes make him productive. :-/
I would add more so much more, as I hope you can understand, and as the article alludes to, these aren't issues easily discussed, especially not with relative strangers on the Internet and I'm not interested in hiding my opinions behind a throwaway. Suffice it to say that my own experiences have led to similar choices to the person you described, and whilst I've never experienced mania, I too believe myself to be better off for those choices. I can categorically say that the opinions shared by those closest to me, the effect on my creativity, productivity and my sense of "self", corroborate that. In my case, the choice wasn't to refuse all treatment or therapy, but only to refuse specific types of treatments which were drastically over-powered and negatively impacted me beyond any perceptible benefit. Subsequent consultations corroborated that decision, and criticised the treatment I was initially suggested as being so heavy handed, that it's analogous to treating a cut finger with amputation of the entire arm.
One size does not fit all, and until approaches to treatment reflect that, we will keep repeating the same mistakes to the detriment of the afflicted. If you're lucky enough to have a supportive network of family and friends around you, I can only reiterate the article's salient point: "talk about it" and add the suggestion that you educate yourself to the best of your ability, to help making the best possible decision.
I'd echo the suggestion of educating yourself to the best of your ability. Most people from HN are pretty intelligent: learning about one disease and the treatments for it is not difficult to do at a basic level. Generally those who've spent years studying it (say, doctors) are going to know more and be able to better contextualize that information, but it helps to know what the evidence is for a particular treatment, if it's considered responsible, what side effects to expect, etc., as it helps you better evaluate the doctor and makes you aware of your options.
This is anon48191, I apologize for using yet another anonymous user. As outlined in my, unfortunately dead, comment I have reasons to stay anonymous (check shadowdead if you're interested in my original comment).
I would also like to quickly address the comment by Flow:
It might very well be that people around me already know. However, there's a big issue between knowing and officially knowing. Further, I never talked about medication. I personally don't believe much in medication. The steps I was considering were talking to a psychiatrist and take it from there. However as soon as I do this, it is bound to become public, as in public within my circles.
I will not question Flows intention in their comment, their knowledge or familiarity of the issue. However, and you'll have to take the word from an anonymous commenter on the internet for this, I am most definitely depressed, if not worse, and outright claiming my (however anecdotal) comment is wrong, seems a bit harsh.
From what I've read and learnt during these years, is that exercise seems to be the most effective treatment. This is the only thing I've not tried seriously yet.
Medication has helped a bit. I can say they are no quick fix, you have to give them at least 3-4 months before you stabilize and can start to reason about how you feel and how to proceed. I hesitated before I tried them, and feel that it was quite dumb and a waste of time to not take them earlier.
The last thing I'd like to mention, is Cognitive Behavioral Therapy, CBT. It worked really well for me. I managed to do several things I wanted to do for years, and the feeling was incredible to finally get out of the catch-22.
Here in (Nordic Country), CBT is not a crazy sign. I know a lot of people that go and have CBT sessions for things like to reason about how to unstuck their life, solve issues at work.
It's no more weird than having a personal trainer at the gym.
From your wording it seems you really feel you need to do something. I don't think your mental health will get better without you changing or doing something about it.
Perhaps you could take a few CBT sessions for your depression, but officially say it's because you want to accelerate your career? Soften your friend and coworkers by sending them links to articles about becoming more efficient at work via CBT?
It's really unproductive and shameful that mental health issues are so stigmatic.
Thank your for replying to me instead of just drive-by down-voting. I wish you luck finding a solution that fits you.
(Please don't post like this in the threads, though. As the guidelines ask, email us instead at hn@ycombinator.com. In addition to everything else, it guarantees that we'll see it.)
Does he have hypomania or actual mania?
True mania (not hypomania, which is sometimes benign) is a hot mess and I'd be surprised if he's employed 12 months down the road. It's pretty devastating, and I can't see why anyone would want it.
You're correct that true mania is a whole lot worse than hypomania. My perspective is that you should at least be getting regular guidance and treatment from a qualified psych, even if you aren't on mood stabilizers, to make sure you don't end up in the grips of a manic episode.
I like your shrink idea (though probably once a week is enough). If it was me, I'd also encourage daily 1-hour exercise (gym, soccer, walking, whatever). It really helps.
Oddly enough, the "old-style" corporations that have gone out of style, did. At many investment banks, you can still schedule a confidential appointment with an on-site doctor or therapist.
The depression stigma isn't as strong at the banks as it is in technology companies and in startups. I'm basically unfundable (cyclothymia, aka "bipolar 3") by VCs, but my condition, because it's well-treated, would be a non-issue at most financial firms (even at high levels).
Lifestyle changes, self-care techniques, antidepressants, dietary supplements, etc. are all things a medical professional will recommend to you - and the antidepressants are often the last thing they'll suggest. Did you try all of those, find them unhelpful, and resort to psychedelics?
If you have a personal or family history of psychotic episodes though, including delusional thinking, be extremely cautious, and either only take lower doses or abstain entirely for your own safety and well-being.
Is there any evidence against the following hypothesis:
What we call mental illnesses are (with possible exception of Schizophrenia and Bipolar disorder), not qualitatively different from ordinary experience. But in order to provide treatment (e.g. various kinds of therapy) it is useful to assign labels to people. But this usefulness doesn't make mental illness as "real as cancer", in the sense that it is a discrete category that we can definitively assign people too.
One reason people prefer a diagnosis is that they prefer a label (even if it does come with some social stigma) to the greater social stigma associated with the same symptoms absent a "mental illness". Assigning such a label allows people (both the individual with the mental illness, and people around them) to view their symptoms in a different and more compassionate light. Most importantly, it allows people to think rationally about the best course of action for the person.
My claim is that if society could be more compassionate, without needing to first assign a label in order to remove "blame" for people's symptoms, we wouldn't need the category of mental illness as much. E.g. instead of saying "I thought I was just a loser, but then I found out I suffered from depression", a person might say "I thought I was a loser, but then I realized that what society calls a loser is a person with certain characteristics, thought patterns, and patterns of behavior, and I decided that instead of judging myself for having these things, I would find the best approach to changing them".
There is one more corollary to this, which is that "professional" help, in the form of drugs or therapy, may not be the only or best approach for such people.
I would be much easier to have a discussion if you did this, since otherwise people who don't have time to watch a 1 hour video will have to take it on faith that this video really addresses the questions I asked. And assuming it did, it would probably be useful to have the points summarized here so we could discuss them.
Labels do serve some use. But many people hate having the label and they hide it. Stigma is still very strong. For all the people who are open about their diagnosis there are many who keep it secret -- or who do not seek treatment because they are scared of the stigma.
And some labels have worse problems than others. A diagnosis of Personality Disorder (eg Bordeline PD) can be catastrophic. There isn't really any medication for it, and therapy options are limited. And people will often respond to anything you do through the lens of the diagnosis -- you did that because you have BPD and one of the symptoms of BPD is X and so that's why people like you do things like that. Even if that wasn't one of the diagnosing symptoms.
Depression is not just sadness. Imagine your favourite show going off TV. You may be sad for a while. You probably won't feel as if it's your fault it's come off air, nor that there is never going to be anything else worth watching, and the feelings won't be constantly with you throughout the day and probably won't last long.
Depression affects appetite, sleep, motivation, and cognition. There's some feedback loops in there. Sometimes these create someone who can function but at a reduced level. Sometimes it kills people.
I find it vaguely offensive when people suggest that feeling bad enough to overcome the human inante desire for self-preservation is somehow a normal part of the human experience. A broken leg is not shameful, happens to many people, but is not normal.
You also call cancer "real". That kind of attitude (here's a list of real illnesses, and here's a list of psychological illnesses) is really harmful. There are many people who reject any psychological interventions in their illnesses because they feel that it means people are saying their illness is not real. People with severe RSI pain reject cognitive behaviour therapy treatment because they feel as if they are being told they are making it up. People with long term farigue reject CHT for similar reasons; so much so there are now two forms of chronic fatigue in the online community - one the responds to CBT and real fatigue.
The link to cancer is that CBT is sucessfully used to treat pain in some people with cancer.
>Labels do serve some use. But many people hate having the label and they hide it. Stigma is still very strong. For all the people who are open about their diagnosis there are many who keep it secret -- or who do not seek treatment because they are scared of the stigma.
You've ignored my argument regarding why people seek out labels, apart from their therapeutic usefulness. I did also state that these labels have a stigma associated with them, but I made a claim, that you haven't addressed, that the stigma of the symptoms in the absence of diagnosis, may be greater than the stigma of the label.
>Depression is not just sadness. Imagine your favourite show going off TV. You may be sad for a while. You probably won't feel as if it's your fault it's come off air, nor that there is never going to be anything else worth watching, and the feelings won't be constantly with you throughout the day and probably won't last long.
It is this sort of claim, that I was asking for evidence for. I agree that a person might feel all these things, and that it might be reasonable to label this cluster of symptoms as "depression". But you are taking it much much further, and claiming that this is in contrast to ordinary experience, and not an extreme part of a spectrum. I can guarantee you one things: every person on earth has experienced much more significant sadness than their favorite TV show going off the air, and when they experience these things, the result is going to be much closer to the symptoms you associate with depression, than to "being sad for a while".
>I find it vaguely offensive when people suggest that feeling bad enough to overcome the human inante desire for self-preservation is somehow a normal part of the human experience. A broken leg is not shameful, happens to many people, but is not normal.
If you are offended because you thought that I was implying that nothing should be done to help people who were in a state of mind that was so terrible to be in, that they preferred suicide, then you misread my post. If you are offended because I didn't draw a line in the sand separating such people from everyone else, because you find it offensive to the human spirit to suggest that, absent a very specific disease, a person would ever find themself in this state of mind, or anything resembling it, then I would answer that human nature is what it is, not what we want it to be.
>You also call cancer "real". That kind of attitude (here's a list of real illnesses, and here's a list of psychological illnesses) is really harmful.
That is not what I said. I never claimed that people should not seek help, or otherwise try to address the symptoms of mental illness. What I said is that cancer is different from depression because cancer is a discrete category. People don't fall on a spectrum of having cancer, and whether or not a person has cancer is not at all subjective.
http://www.ted.com/talks/brene_brown_on_vulnerability
You are vulnerable, but you are not weak.
It is a sign of weakness to avoid showing signs of
weakness.
- Nassim TalebI still need to learn this.
28c3: Geeks and depression panel
This is from a very popular commencement speech this year at UT. Im curious to HN's opinion of this attitude in the light of the OP. I think that the scenarios are different, as the SEALs training is specifically against something, but the founder's depression arises from the against yourself. Possibly some of the lessons in the struggle for a good life and doing a good job that the SEALs have can be used to the benefit of founders and other tech workers. I think the quote I had there is a great one. When you are really in the dumps, go out and sing as a reflex.
Possibly a good way to overcome the depression that many feel is to develop a better sense of yourself, so as to recognize when to just reflexively start singing.
[0]http://www.artofmanliness.com/2014/05/24/manvotional-want-to...
For me, It is encouraging to see that people in the same insane positions of starting their own company are facing similar problems with me and I am Not the only crazy person around! Starting your own company and fighting the unknown lonely steps of success is undeniably hard,scary and depressing but with some weird manner also extremely rewarding! The high risk always comes with the high satisfaction.
people like me and many others, need to hear it get encouragement and an indirect form of support so useful and valuable to keep you going! I found great pleasure watching silicon valey series for this exact reason; and listening to real people having similar issues is even better x
http://www.ted.com/talks/andrew_solomon_depression_the_secre...
Especially if frequent tiredness and exhaustion are strong components, you could be experiencing a change in endocrine function, particularly thyroid, a sleep disorder, or any number of other medical conditions.
Sleep disorders especially are often underdiagnosed, and can go untreated for years in lieu of just treating psychiatric symptoms instead (I know this from personal experience). Conditions such as hypothyroidism are often similarly underdiagnosed. So if you're feeling extraordinarily tired all the time, and anemia and other nutritional and medical causes have been ruled out, get your thyroid levels checked and a sleep study done too, or at least bring it up with your doctor.
But also don't hesitate to seek out treatment for mental health problems even if a known medical cause can't be found or has yet to be identified. It's all physiological causes really, but there's a lot we still don't know about the human brain and body, and treating symptoms, especially if they are having a significant negative impact on your quality of life, is just as important as trying to find a cause.
And last but not least since we are talking about depression and depression-related conditions (such as bipolar, etc.), I just wanted to raise a little awareness for borderline (BPD) too. For those of you that have strong emotions, maybe a little impulsive, and/or a troubled childhood and suicidal tendencies, or have people in your life like that, you should find it really worthwhile to read up a bit on BPD:
http://en.wikipedia.org/wiki/Borderline_personality_disorder
It's a diagnosis which has gotten a bad but undeserved stigma over the years, that needs better awareness and understanding.
Whether you identify strongly with a BPD profile or not, if you struggle with strong emotions and/or suicidal tendencies in your life, a lot of Dialectical Behavioral Therapy (DBT) coping strategies and methods might be particularly helpful to you in dealing with those feelings:
http://en.wikipedia.org/wiki/Dialectical_behavioral_therapy
Stay healthy and happy hackers, but don't be afraid to ask friends, family, and professionals for help when you need it either!
The catch here is that talking with people who don't actually know much about depression (e.g. the "just cheer up" crowd) can be a problem.
I'm not suggesting that these symptoms don't exist, but rather that they've been a perfectly normal part of human life since the dawn of man.
It's perfectly natural for people to go through periods where they have less energy than other periods, overeat or under-eat, have difficulty concentrating or making decisions, feel anxious. This is normal stuff depending on the life circumstances especially if you're drinking any amount of coffee because that will lead to periods of highs and lows. It does not mean you "have depression" as if there was some flu virus that you became infected with it simply means you're a human being.
I would argue that legitimate diagnosis should be reserved for people who are either suicidal or who's symptoms strongly suggest elements of self-harming or harming others.
Some conditions are overdiagnosed, and there is a too-cozy relationship between medicine and pharma that is disturbing to many of us.
However, to make a diagnosis based on Diagnostic and Statistical Manual (DSM) criteria almost without exception (one exception is for bipolar II disorder) require that symptoms (and several symptoms are required usually for any given disorder) must cause significant impact on one's lives, eg,
"...sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features."
or
"...symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."
EDIT: (based on your own edit) - reserving diagnosis and treatment just to those at risk for self- or other-harm is going to harm many suffering people. I don't think you understand what depression really is. It's not caffeine withdrawal or the flu. Even when no suicidal ideation is present, it's a serious disease with real costs to the individual and to society, just as real as cancer.
Beyond depression, I think you'd agree that even in the absence of harmful behavior or ideation, people who experience auditory hallucinations in the course of depression, or OCD sufferers who are unable to work because they must wash their hands hundreds of times a day, or who have PTSD triggered simply by backfiring engines, or who have dozens of other DSM diagnoses, all have legitimate illnesses that deserve much more than the terrible, stigmatizing suggestion that their illnesses somehow are not real.
My argument is that it's not an "epidemic of depression" that we're dealing with but rather an "epidemic of over-diagnosis". I would argue that the industry is in practice being far too loose with the definition of "significant impact on one's lives". I think articles like this one blur the line even further by making it sound like everyone who has experienced a few of these symptoms suffers from depression. People read stuff like this and then start telling themselves "I'm depressed" and because of this mistaken belief many of them wind up being medicated inappropriately.
This epidemic of over-diagnosis has reached such vast proportions that I imagine the majority of people in the tech industry have been prescribed some kind of psychotropic drug to treat some form of mental illness at some point in their life. I wish I could get accurate statistics on this to prove my point.
As a side note I do think that caffeine induced psychosis is 100% real (because it's a very powerful drug) and the symptoms often mimic that of depression or bi-polar and can even be inclusive of phenomena such as hallucination. I don't have any credentials but my opinion as a layperson is that I think it's incredibly irresponsible to write a prescription or to give a diagnosis for any mental illness to a patient who has not first completely cut caffeine out of their lives.
When you say 'it's perfectly natural for people to experience X', what you may actually mean is 'many people suffer from mild depression and/or bipolar disorder symptoms without ever being treated', which is absolutely true.
When people say 'clinical depression' or 'bipolar disorder', they're generally referring to natural biological mechanisms that have gotten out of hand (due to negative feedback loops, or other problems) and are so profound that they clearly require medical assistance.
Lots of people deal with clinical depression, bipolar depression, or mania by 'riding it out', sometimes using self-care techniques, lifestyle changes, or self-medicating. It's important to take this into account when considering whether something is 'natural' just because it's common.
I would argue that what people call "mild depression" IE symptoms that do not warrant a diagnosis.. is actually not depression at all but rather part of the normal human range of emotion and feeling. Many people latch on to the advertising concept of "mild depression" but that doesn't mean it actually exists
Otherwise, you're agreeing that there is a spectrum of symptoms, but somehow the symptoms on the milder end of the spectrum 'don't actually exist'?
A diagnosis is different from a prescription. Just because you have a diagnosis of depression doesn't mean you automatically need to take antidepressants; the diagnosis is used as a tool to understand the general set of symptoms you might experience and what the treatment methods are.
Again, depression is not 'abnormal' emotion or 'abnormal' feelings. Neither are the effects of bipolar. They are both 'normal' and entirely natural biological mechanisms, the problem is that those mechanisms are acting to an atypical degree and causing negative side-effects. In many cases the treatment methods are also entirely 'natural', not involving any pharmaceuticals.
Another way to put this: It is normal for someone to become depressed in response to tough circumstances or disappointment. It's normal for someone to get amped up and slightly manic in response to stress or an immediate threat. Those are natural mechanisms.
When the depression or stress response lasts for days or weeks, that is where it starts to enter into territory where a physician might diagnose it as clinical depression, or hypomania, or mania. Again, the problem is not the feelings, it's the duration and magnitude of the feelings - the feelings and physical effects lasting well after the initial triggers are gone.
For example flu-like symptoms do not necessarily mean that you have early onset AIDS or ebola virus even though those diseases do produce flu-like symptoms. Therefor people shouldn't refer to those common symtoms as "mild ebola" or "mild AIDS". The same principle applies to mental health and words like "depression".
> Another way to put this: It is normal for someone to become depressed in response to tough circumstances or disappointment
I would argue that this is incorrect. If a certain human condition is normal then by definition it is not an illness! Therefor to use the word 'depression' to characterize normal circumstances is not only a misnomer but a dangerous charade that downplays the seriousness of the genuine mental illness. A whole generation is confused on this point in my opinion due to advertising campaigns that are designed to confuse them and the doctors don't seem to be motivated to help clear up this confusion and I can only assume that is due to profit incentive.
There was talk of including some limited use of the term spectrum in the planning of the DSM-V but that's all it was, talk.
Part of the diagnosis is that the feelings are not normal and that they interfere with day to day living.
You might have a point about medications for depression: tri-cyclics, MAOIs, SSRIs and NASAs and etc are not well understood but they sometimes seem to work. Luckily meds are not first choice treatment for most people anymore. CBT is.
Suggesting that bi-polar is in anyway a part of the normal human range of experiences is just ignorant. Mania can be incredibly destructive. Some people love the feeling of being up, but full on mania is more than that and is an unproductive giddy high.
Your last para about self harm is also ignorant. Deliberate self harm is incredibly common. Some people with very mild self harm have severe depression and would need treatment. Some people with significant self harm have mild to moderate illness and are just stuck with an un-useful coping mechanism. There's no way of gauging someone's intent to die by the severity of injuries they inflict upon themselves.
Thankfully the system exists whereby one person (you) doesn't get to decide that.
Over-pathologization might be an issue, but isn't really the topic of discussion. Trying to misdirect the argument from "there's widespread depression" to "it's probably something else" is exactly part of the problem.
The OP is putting forward the same, tired arguments that "feeling like this is normal, get over it". Clearly and admittedly he has no experience or qualifications, so how the hell does he know?
http://hyperboleandahalf.blogspot.ca/2011/10/adventures-in-d...
Your assertion that credentials are needed in order to form an opinion about what is and is not normal human experience is in my opinion ridiculous, and it borders on the "appeal to authority" logical fallacy.
The problem is that your argument, even if it is true for a significant portion of people diagnosed with mental illness (which I personally am not convinced of, but also have no hard numbers on hand), makes it more difficult for those people who currently are afraid of how society will react if they attempt to treat their illness. It creates a bar that someone has to be "this sick to get diagnosed". It creates a fear of being told that your problems aren't really problems, and you're just not dealing with them correctly (regardless of the intent of your original argument).
I think that it's not appropriate _right now_ to deal with over-diagnosis as a serious issue in comparison to under-treatment. Maybe, in a future when it's socially acceptable to get help for mental illness, we can deal with over-diagnosis if it's a serious issue. But trying to stamp out over-diagnosis right now contributes to a more dangerous stigma.
You're using incorrect language there. It creates a bar where a person has to show "this many symptoms" in order to be diagnosed with a particular illness. This is how modern medicine works and none of us question this model when it comes to physical illness so why should it be different for mental illness ? For example flu-like symptoms alone should not be enough to diagnose someone with the ebola virus or AIDS and the same principle applies to mental illness.
>It creates a fear of being told that your problems aren't really problems, and you're just not dealing with them correctly (regardless of the intent of your original argument).
No. It creates an expectation that one should refrain from automatically assuming that normal human experiences are indicative of mental illness. It's normal for human beings to experience certain problems (such as fatigue, anxiety, trouble sleeping, weight gain/loss, etc) during the course of their life and it doesn't mean they are necessarily sick.
The view that "almost everyone is sick but most people are hiding it out of fear" is a ridiculous notion that is probably being injected into the cultural conversation for commercial reasons and I doubt many people take it seriously.
It's never been more socially acceptable to start taking drugs for mental illness due to the pervasiveness of drug advertising. I think it's easy to make an increasingly strong argument that it's been over-normalized to the point where misdiagnosis is commonplace
Go read the DSM-V, or the DSM-IV. (In fact, don't, but at least read up on how they work.) They are the diagnosis guides which are used as a baseline across the USA, and in fact for some things across the world.
They quite explicitly list out symptoms, and how many of them one has to have in order to be diagnosed as having a mental illness, and even within those a scale which allows doctors to prioritise care.
I think that one can end up promoting self-diagnosis and over-diagnosis simply by using the term "mildly depressed" to refer to the general idea of "being upset" or "being in a bad mood" which is becoming increasingly common in our vernacular. I would argue that it's becoming increasing common because commercial interests set out to promote it's use in that way.