AIBU to think we over-pathologise very nomal human behaviour?

[Breakawaygirl]

Other threads have got me thinking about this....

We all know that diagnosis of anxiety, depression, autism and other emotional/mental health/neurological conditions are on the rise.

My question is, is it true that we are just paying more attention to conditions that were swept under the rug, or are we over-diagnosing very natural human behaviour.

I've often thought depression, anxiety and other conditions are very natural reactions to our modern world.

Many people wake up early only to be overworked, fed bad food, underpaid, come home to more work, unable to foster connections with loved ones and children, feel lonely, cut off (no community), big uncertainty in the future, pollution, overpopulation, extinction of animals, little nature in some animals and a very aggressive media that seems to have an agenda - surely to feel bad is NORMAL in these circumstances.

I often think the diagnosis is a way of saying it's the PERSON who has the problem rather than the way we conduct our society/culture as a whole.

That is not to minimise that many conditions are the result of neurology and genetics, but a huge component is nurture and lifestyle.

I've often felt that we live in human zoos and are behaviour and neurosis stems from that.

For instance exercise is a natural anti-depressant but most of us don't get enough.

Anxiety is proven to be exaggerated by social media and the idea that everyone is doing better.

Is it that people individually are sicker, or is society sicker?

Curious for people's thoughts.

Interesting comment re obesity.

Many people say they are predisposed to obesity the same way they say they are predisposed to depression, but we know that obesity is purely lifestyle. VERY few people are genetically prone to obesity. With depression, I wonder if it's similar. There are people who inherit depression due to different neurological wiring, but for many people, it's not that they simply are born to be depressed, but that their lifestyle has contributed to it.

I think you're drawing a false distinction between "natural" and "pathological". I wouldn't think it was unnatural for someone to have autism. I do think that autism/depression/anxiety can have a negative impact on people's lives in a way that can be mitigated with help. In order to access that help it's helpful to be able to characterise what the issue is. It also helps other people to understand why someone with autism for example might behave in a different way and allows us to interact with them better.

If someone's depression is sufficiently mild that they can resolve it with a bit of exercise and fresh air they may well not seek out a diagnosis. For many people that is going to be woefully insufficient at solving the problem.

I think you're probably just assuming that everybody feels as you do. You might feel down or anxious sometimes but with a bit of effort can overcome it. That isn't because you've come up with a very clever system no one else has thought of it's because you don't suffer from depression or anxiety.

I think young people in particular are now confusing 'feelings of anxiety' which are normal and to be worked through with actual anxiety disorders which require medical treatment and support.

It's a symptom of more awareness of mental health issues - I do think it's a worthwhile downside of awareness for people who truly need help though.

However in the meantime, I think we should be more open about how you can have a 'bout of anxiety or depression' which is a bit like having a cold, you'll feel shit for a few days/weeks but do the right things and it will pass. The young people I encounter seem to panic now at the first hint of something anxiety inducing - like an assignment deadline.

@Snuggly - yes, I could have accepted my diagnosis as a lifelong 'fact.' I'm just an anxious person. But I understand now that it was a bad time in my life and everything about my lifestyle was wrong and incompatible for me. This is obviously just my own experience, but why I think over-diagnosing can be dangerous.

I thoroughly agree with you and think about this a lot myself
Society needs to change.
People commuting further and further. Leaving in the dark getting home in the dark. Where’s the time to do anything?
Stressful jobs drive sugar consumption and boozing
People barely move nowadays

I totally agree. I felt so stressed by having to get up when it was still dark, travel to work on a crowded train full of strangers and be isolated in a stuffy office all day. It’s not natural. I wanted to wake when it got light, do some physical activity outdoors and interact with people. Forcing myself into unnatural behaviour made me unwell. I’m so much poorer but happier as a SAHM because I have more of a natural schedule.

@Breakawaygirl

You're entire comment is inaccurate.

Many people say they are predisposed to obesity the same way they say they are predisposed to depression, but we know that obesity is purely lifestyle.

That is total rubbish. The natural variation in peoples appetite and craving for food is massively dependent on both genetics, epigenetics and in particular the environment you grew up in. Obesity very much runs in families. As does depression and anxiety and are also heavily related to other neurological issues.

I have to reiterate for some reasons who are misunderstanding me, I'm not talking about GENUINE cases of mental illness, which I completely believe to be real.

I am just saying of all diagnoses that are made, how many fall into the category of neurological or inherited depression, and how many are the result of lifestyle/modern world/learned behaviours? I would argue that fewer cases are inherited and most are simply natural human behaviour.

This is NOT to take away from anyone who suffers with depression, anxiety or any other mental illness, it is just a discussion.

@AIIMY

Obesity is not usually inherited through family genes, but through family lifestyle. If grandma was obese and taught her daughter bad eating habits, she might be obese and carry that on with her own children.

Very few people will be obese if they are starved or given rations. Obesity is PRIMARILY a lifestyle illness. To say a person is born to be obese robs them of the power to take their health in their own hands.

I agree with you, OP. Johann Hari makes similar points in his book Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions (a good read).

@AIIMY food craving is also largely psychological and learned - learning to comfort with food is something that often begins in childhood. This is more an engrained habit that an inherited trait.

I would argue that fewer cases are inherited and most are simply natural human behaviour

I’m confused, do you think people with things like situational depression shouldn’t get medical help?

@Fission, no, I definitely think people should reach out and get help if they are struggling with their mental health, but I also think a healthy distinction needs to be made between a normal and natural mental health blip (which help can and should still be sought for) and an ongoing mental health condition that warrants an actual diagnosis.

To have stages of depression and anxiety is very normal for most people. To have a chronic, ongoing mental illness is different.

I agree, most of 'minor' mental illness (anxiety, depression) is fairly normal and part of many peoples lives. However, one doesn't always recognise it as such, or necessarily know methods of dealing with it, hence may be a good idea to see a doctor/therapist etc. It is after all easy to stay in bed because you feel bad, without knowing you would feel better if you got up and did something.

I confess to lacking sympathy for those that know, have been told this and/or use it as an excuse to access benefits/miss work and generally clog up the system. But also know that to genuinely suffer seriously from such conditions is horrible and know help is not easy to find. Have also known of several people faking/exaggerating as well

I think poor mental health is very similar to type 2 diabetes. It runs in families, it can be a side effect of many medications, it can be contributed to by many other illnesses, medical invention can be necessary, it disproportionately affects lower socio-economic classes, it suits the government/media to blame individual responsibility rather than recognise societal effects, and a healthy lifestyle helps!

Both depression and type 2 diabetes can be cured by positive lifestyle changes, but some can't and needs medication.

But I wouldn't say we're "over-pathologising" how people process insulin. I'd say we're recognising a problem, but maybe over medicalising the solution.

i disagree that we over diagnose these days, there is nothing wrong with a diagnosis as a gateway to understanding yourself and tailored solutions, some of the treatment however often amounts to getting yourself to do things you find hard (stick to an eating plan if you are a disordered eater such as me, learn social behaviour like a school topic if you have poor social skills and lack natural intuition in this area like me etc.

the diagnosis backlash about labels relates to the fact that they only help so far, mostly in helping you find relevant solutions.

I look back on MH and LDs we've had in our families for generations, I expect, and if those people had been helped, they might have understood themselves and had a chance at happier lives.

But I wouldn't say we're "over-pathologising" how people process insulin. I'd say we're recognising a problem, but maybe over medicalising the solution.

^^

I like this comment a lot and think it's very true. Medication is great for many sufferers, but longstanding lifestyle changes are often the way forward as well. I've known a few people who have had meds for depression (what I would call situational for all but one) but the side effects did not help (weight gain, feeling despondent, very tired and lethargic.) Medicine works differently for different people, but I think medication in tandem with lifestyle change is MOST effective (and again gives more power to the patient.)

So, I disagree that there is "real" and not real mental illness. But I don't disagree that our threshold for diagnosing and treating medically rather than changing society may be in the wrong place. Very like type 2 diabetes.

We most certainly are over diagnosing. It does little to help and there is a national obsession with 'wellbeing'

My grandparents agree with this. They were labourers who lived in a tiny two-room cottage they built themselves and worked endless days growing flowers and vegetables to sell. It was a hand-to mouth existence. But I asked them once if they were unhappy in those days, and they said they didn’t have time to think about it. Everyone they knew was in the same boat and they were so busy that their only thought was survival and making sure their children got to school. They had no hobbies - no time for them. Daily life was all-consuming. And there were no gadgets or home furnishings or clothes in the shops as we have today, so they didn’t feel they were missing out on anything.

It’s not necessarily helpful to think we should be happy all the time. It’s not viable. Life is tough. Happiness shouldn’t be the goal, and it’s often fleeting anyway, so we have to enjoy those moments when we are!

i know with ASD behaviour, the earlier you can start learning social interactions, the better the outcomes are in terms of being able to fit in, learning the script. So the 'over diagnosing' is beneficial if it leads to earlier support.

Well I think there is a difference between mental health and mental illness.

A person can have a well brain, but suffer depression or anxiety, much like a person can have a healthy body and break a leg.

Or a person can have an unwell brain from the start that will always need medication or CBT to function well.

My concern is putting the people in column A in column B.

In the past people with mental health problems were removed from society and sent to asylums, in Victorian times a visit to the asylum to view the so called idiots was considered entertainment. I think some of these were probably people who today might be considered to have some of the conditions you mention and now they would be treated and function fine in todays society.
I have an interest in ASD as I have a family member with the condition, and I have sometimes wondered how he would have been treated 100+ years ago, badly I suspect.
In the past many physical problems were not recognised which today are treated as common conditions, I think mental health and disabilities are similar but the diagnosis and treatment is still not as advanced as with physical ailments.

@Snuggybuggy

I do think we can sometimes be too quick to stick a diagnostic label on something. I went through a grim period for several years a while back and had so many people telling me to see my GP because I must have depression, I didn't, I was just in a really shit situation.

I do think there's something in that - I lost my mum in a horrible way this year and struggled very hard. I knew the reason, I knew why my brain was foing what it was doing. But knowing it didn't help me get through it; i struggled at home and at work. And in the end I went to the GP not because I wanted treatment or pills so much as, simply, I wanted someone to say it was OK to stop working for a little while. I needed a few days off work so badly (days that were not taken up with organising and attending the funeral and probate matters, which is what ate up the generous 5 day alocation of compassionate leave). I needed some time to cry, and I needed not to be at work supposedly getting on with things but actually just staring at my screen as horrible things played out behind my eyes, and then the anxiety of knowing another day of work had piled up in front of me. It was a vicious circle and I needed to be let out. And the only way that could be accommodated was with a doctor's note.

I wasn't sick; I was sad. But the sadness was totally debilitating FOR THAT PERIOD OF TIME. And the only way the machine could process that need for a bit of time to be sad in was 'depression'.

So I do think a more compassionate society might result in lower diagnosis of depression, but not for the reasons the OP states perhaps. Same as at school, if your kid is a bit idiosyncratic often the only way to get ANY allowance made for that is to get them 'certifcated'. Schools should be more open to children that need different things just as part of the human condition.

I agree, there is both over diagnosing and over-medicating. A friend of mine was dumped by her boyfriend and after two days her GP had put her on antidepressants. Of course it's normal to feel sad after a break up, but does sadness need medicaton? I close colleague of mine died, and I cried for three days. Isn't this a normal human reaction to death...called grieving? My "depressed" friend said I should get antidepressants for this!

I went through a grim period for several years a while back and had so many people telling me to see my GP because I must have depression, I didn't, I was just in a really shit situation.

That works both ways. I had some serious trauma in life and chuntered on. About 6 years later I started to experience when I thought were panic attacks and they got BAD. I was waking up several times a night gasping and heart racing, unable to settle, I'd lie back and it would start again. I tried everything - herbs, OTC meds, yoga and meditation, exercise (I was already doing loads of that), sleep hygiene, etc - and experiencing them multiple times a day. I finally went to the GP, thinking I'd get anti-depressants, maybe some beta blockers or maybe HRT (it was that time of life).

First thing he did after speaking to me for a bit, getting some history─ was take my blood pressure.

My blood pressure was staggeringly high. I also had diabetes. It took months of meds and doctors to get everything stable.

If it had been the 'good ole days' of the past I'd have dodged along and probably had a heart attack and died before I was 50.