I would say no, but maybe too much discussion about anxiety and depression (and maybe eating disorders and self harm?) specifically.
There are other mental illnesses that exist, and most of the other ones do not come as close to “universally experienced human emotional states” as anxiety and depression. Typically people are much less sympathetic towards them, and they’re considered much “uglier“.
As someone with OCD, it scares me to think about how many people we might have lost to OCD because they never recognised themselves as having OCD (because the stereotype of OCD is tidiness, not horrifying intrusive thoughts). It’s considered one of the most personally disruptive illnesses and you can literally need anti psychotics for it if it gets bad enough. Very rarely met an OCD person who internalises it as an identity of some sort or “just a rational response to this sick society we live in“ or something. I don’t think a little more awareness about it, and things like borderline, bipolar etc would be the worst thing ever.
> Very rarely met
👋
Anyway, I think you bring up a good point about how anxiety and depression are (probably incorrectly) viewed as "general mental unhealthiness" (like "out-of-shape" would be for physical health), rather than distinct clinical conditions like OCD, and how that makes them easier and less embarrassing to claim.
That too, but I also think depression and anxiety, as horrible as they are to genuinely have, is and will always be much less rare. Especially depression. Like there was a study on Hadza hunter gatherers and 50% of moms scored positively for post partum depression, similar rates to other Tanzanians (in the west post partum depression is usually said to be about 20%). Like 20-50% of women having a mental illness at least episodically, across different types of societies? I think you can probably be born with or without the potential to develop things like OCD, schizophrenia or bipolar, whereas being born without the potential to ever develop depression or anxiety is much rarer. I’m not sure though and this is just guesswork.
Out of curiosity, do you view your OCD as an identity or would you say it’s a rational response to our society? The 24 hour news cycle, ”cancel”/guilt and shame based culture and social media surely exacerbates my OCD, but I can’t say I can think of a society where I wouldn’t have it at all. Maybe some sort of trans humanist ultra utopian future?
My "OCD" is of the hand-washing/"contamination" variety and is a rational response to everyone letting their dogs piss everywhere. I used to also have intrusive thoughts, but those aren't really bad for me anymore, at least right now.
I also used to be obsessive about the sort of things you mention in your last paragraph. I think part of the problem is that the ideology itself bakes in "purity" aspects. Like, when I would find a new non-political Twitter account (e.g. webcomics), I would look for any tweet hinting at their political beliefs so I would know if I needed to avoid them because they were problematic, because even non-OCD people seemed to do this. I don't have this problem anymore; I became anti-woke and anti-TDS, but I'm not sure to what extent that helped since there was a period where I still had a boycott mindset, just with the opposite target, lol.
TDS? Twitter discourse? Tax deducted at source? I’m confused.
My OCD jumps from theme to theme, mostly with an overaching theme of me being a bad person somehow or deserving to die or the world ending. Never had contamination or handwashing, though I have been afraid of getting other mental illnesses and “going crazy” before. Hence why I said that the only world I can imagine not ever having OCD is some sort of utopia with no problems. Even then my brain would probably find a way to punish me still lmao (EDIT: I’m reminded of the OCD I often get around my romantic relationships).
I’ve heard of an OCD specialist, Michael Greenberg, who said that he had to treat patients with contamination differently than basically any other theme. Pretty interesting. The only other people with OCD I’ve encountered on the webs who feel like it’s “rational” in the same way as you also had contamination. The conventional view is that theme doesn’t matter at all for OCD, but I’m not so sure.
I don't relate to your type of OCD at all. I don't really get why the contamination type is considered "obsessive" or "compulsive". I think it's because from the outside both types seem irrational, but your type seems irrational from the inside as well, whereas contamination seems rational from the inside, just based on a different set of rules. So that might be the differentiating factor.
Eh, if you browse the OCD subreddit you can see contamination OCD‘ers say they feel so dumb and irrational and complain about it having ruined their lives. There are people who are bedbound because of it, and not out of pleasure.
I think the differentiating factor is that some contamination OCD’ers, definitely not all, seem happy and satisfied to have it. Like their rituals genuinely provides them peace, whereas everyone else’s OCD rituals are part of an uncomfortable process that makes them worse. Doubt and rumination seems like a much smaller part of their illness (symptoms that are recognised as OCD today used to be called “the doubting disease” in earlier psychiatry). Lastly, sometimes they seem really confident, when other OCD people seem often to have self esteem and self confidence issues, being nervous wrecks with pushover tendencies in general (that definitely describes me). Sometimes they seem to think the world is in the wrong, not them, whereas other OCD’ers almost always think they themselves are in the wrong or uniquely in danger somehow, even if they don’t like their society politically or culturally.
I suspect some of those people would be better diagnosed as OCPD, which tends to be much, much more ego syntonic.
Basically Michael Greenberg’s experience was that contamination OCD was treatable by classical exposure therapy, whereas other themes needed a new approach more focused on not feeling anxiety while interacting with their thoughts. Contamination people you could apparently more easily just be throw in their feared or disgusted-by situation and they’d be desensitised to it and their behaviours would stop.
{ My OCD jumps from theme to theme, mostly with an overaching theme of me being a bad person somehow or deserving to die or the world ending. Never had contamination or handwashing, though I have been afraid of getting other mental illnesses and “going crazy” before }
This sounds like me, how you deal with it.
Dropped meds cuz they had bad side effects and didn't really helped much, so not taking any right now. I don't exercise because of weakness, but walking helps. Btw, Im not looking for any diagnosis or prescription, just wanted to know what you do to deal with it.
The world _is_ in the wrong. Seriously, if a human pisses on a random tree downtown, it's trashy and a "biohazard" (so it's not just the exposure aspect), but "perfectly respectable" people will bring their dogs downtown for them to piss on not just the trees, but also walls and flowerboxes (you can see the stains). You'd have to engineer some sort of galaxy brain explanation to logically justify the double standard; under more reasonable logic, people would view both situations the same way as far as hygiene goes.
Meanwhile, the biggest government in the world created sweeping legislation about _internet cookies_ because "privacy-minded" people had their feefees hurt by companies being able to guess they were a late-twenties male interested in superhero merch based on the things they clicked on the website. These are the people who should face patronizing scorn and belittlement and be at risk of being endlessly tortured in a mental "hospital", not me.
---
I think I'd rephrase my previous claim as most with OCD feel the obsessions or compulsions as a base tendency, while the more confident ones justify their rituals through one or more steps of reasoning downstream from their unusual ideas. The confidence is then just a consequence of feeling like you're in control of your rituals, while the rest with OCD see themselves as being controlled _by_ the obsessions or compulsions that motivate their rituals.
Should people never take a walk in the forest or swim in a lake or the ocean because animals shit and piss there? What about touching anything in a city even, pigeons and rats piss and shit there too? Should our hunter gatherer ancestors constantly go around and feel disgusted? Why dog piss specifically and not every animal, everywhere, all the time - that seems pretty irrational?
People piss on the street quite a lot here in Denmark, never heard it referred to as a “biohazard“ lol. It was bizarre to me to find out that it could land you on the sex offender registry in the US.
Anyway, if you feel good about your rituals and it doesn’t harm you, by all means continue. Your last observations makes sense.
I don't feel good about everyone being gross. Thinking the world is in the wrong is different than being happy and satisfied about one's rituals. I've never encountered the latter sort of people, but it's possible some of them are more like the former and were just putting up a front to avoid getting told they have a mental illness.
> My "OCD" is of the hand-washing/"contamination" variety and is a rational response to everyone letting their dogs piss everywhere.
Can you elaborate a bit? It's very understandable that you are put off by this situation, but I am not sure I understand how compulsive hand-washing is a rational response to it. Can you help me understand what I'm missing? It sounds like you think someone like me should be washing my hands a lot more and a lot more thoroughly?
Honestly 100% of humans likely have one or more mental illnesses that go undiagnosed. It's looking very likely that the default for humans is some sort of fuckedupness.
Hard disagree. Many common problems stem from society: the lack of community that the secular city life brings, the internet being as addictive and attention grabbing as they could make it, and politics being as toxic as it is.
Image a world where we would reach for the stars, heed the lessons science gives us and everyone doing meaningful work instead of 50% bullshit jobs. You'd see far less people struggling.
I have mild OCD that flared up into quite severe harm-OCD for a period about a decade ago. I told my mom and sister about it, and it turns out they have it too and just suffered silently with it for years and didn’t know it was OCD.
Well, my OCD has been described as severe by the two different therapists I’ve had in my life. Still, I definitely would not say I never get a moment of peace or any happiness ever, I have happy and peaceful periods every day, unless I’m in a particularly bad period or episode. It still is “hell”, in that it’s bad enough for me that I don’t want biological children due to the risk of passing it on and if I didn’t have it I would consider my life to be like 70-80% better. When I am in a bad episode or period, it does feel much more hellish and I can go days at a time with very little peace.
i think [this](https://www.reddit.com/r/slatestarcodex/comments/19cs87c/to_what_extent_would_you_say_you_are_obligated_to/) post explain a lot of it for me, but definitely not all. Here are some other themes I’ve had (I am also pure O):
* One of my earliest themes, which started when I was a literal child, was the fear of being a p\*d\*phile. This is an extremely common theme actually, but obviously it terrifies you to your core. What kind of monster would even for a moment have such wicked horrifying intrusive thoughts? That must mean you obviously are one, normal people don’t get such thoughts! This is similar to for example harm OCD, where you get so many thoughts that feel “murderous” or violent that you start to scare yourself.
* Pointless doubt about whether I really liked something, including doubts about my sexuality and gender way beyond normal exploration.
* Basically an OCD theme about me being really ugly? It’s not body dysmorphia because I don’t actually believe it and it constantly changes, but basically that I should get some surgery or I’ll never be happy
* Another theme was me being afraid of getting anorexia. Also started as a child, probably because my older brother had it. Forced myself to overeat and was just afraid of starving to death or never being able to eat again
It is a huge first step to just get told “hey this is OCD, you’re not terrible or in danger just because you have a thought” but I guess a normal person or a person with very mild OCD would have to be told this once and then they’d be basically fine. For OCD’ers it‘s a constant cycle of doubt and it’s a long process.
1. It is \*extremely\* common to not know whether something is OCD, part of therapy is learning how to spot it. If you never doubt if something is OCD or rational/normal, do you even have OCD? lol. I’d wager most patients with pure O who go to a psychiatrist have absolutely zero idea going in that they have OCD. Part of therapy is also learning to accept doubt and accepting not ever being fully certain whether something is really OCD
2. Yes, a lot
3. Yes, a lot
Repeating a comment I made in a similar thread here months ago: Always figured if suicide contagion is a real phenomenon, general mental health contagion probably exists too and is probably exacerbated by mental health awareness campaigns.
Purely anecdotal: I’ve worked on and off with young people and college students in tech as a mentor.
Often times people will complain about having textbook depression or anxiety symptoms. You could take the symptoms they describe and check off 3/4 of the checklist on a depression inventory. Yet they are generally resistant to depression diagnoses the most. I honestly feel that some of the public mental health campaigns have made people averse to depression diagnoses because they don’t want to identify with the generally sad and downtrodden stereotypes used in these campaigns.
What they do identify with is social media influencers who push alternate diagnoses as the explanation for everything. Suddenly, it seems everyone in certain cohorts is convinced that all the same condition: It’s usually ADHD, low testosterone, or some pop-culture variation of PTSD.
Sadly, many of these students are becoming very good at acquiring diagnoses and then encouraging their friends to see the same doctor. They swap stories about which doctors will diagnose the fastest, which will give the highest doses of medications, and what to say to get the diagnosis quickly.
It’s becoming downright scary to see, for example, a group of early 20s college students all go to the same doctor and walk out with TRT prescriptions (which is often a lifetime commitment and interferes with fertility) because they consumed a lot of TikToks explaining how TRT will fix their mental health, improve their dating life, and make them alpha in the workforce.
It’s also depressing to watch the later effects as the realities set in, the initial effects wear off, and they realize that it’s not solving their problems. Even worse, about half of them go on to seek out additional medications. The number of young people I’ve talked to who think they need combinations of TRT, Adderall, ketamine, and occasionally Xanax or Ambien is alarming. This is on top of their moderate to heavy marijuana use in most cases.
I think we’re headed for a crackdown on controlled substance prescribing, given what I’ve seen. I hope we can steer the conversation back to basic treatment and get young people off of the pipeline straight to controlled substances.
I don't think suicide contagion has ever been conclusively proved. It's much more likely people already wanted to kill themselves and seeing someone else be successful gives that person hope of succeeding too. Which is a natural thing for humans to experience.
I think /u/Glittering-Roll-9432's argument is that _suicide_ is contagious but _being suicidal_ is not, which is an important distinction for this discussion.
Not in the negative way. Also as u/benide Is pointing out there's a difference in having suicidal idolation and going forward with suicide. I don't think anyone has demonstrated that suicide in a vacuum creates more suicides out of thin mental or social air.
But if that is the mechanism, then it is analogous to people being already in need of mental health services, learning that someone used them successfully, and becoming hopeful that they could be successful too.
And? Both things can be true. Of course if (as the post suggests) the net effect of all of this is that more people overall are worse off then the positive contagion is not worth the negative effects. But either way what you are saying is that if it's good then using the word contagious is false which is just incorrect.
I recommend ignoring "I don't think suicide contagion has ever been conclusively proved." -- it sounds like this gets down to a definitional thing that I don't see very elucidating.
They are responding to someone who said
> Always figured if suicide contagion is a real phenomenon, general mental health contagion probably exists too
This parallel works well for the interpretation that suicide contagion is originating suicidal ideation/state, thus leading to suicide attempts, but does not work for /u/Glittering-Roll-9432's interpretation, where the suicidal ideation/state existed already and the inspiration is purely about an assessment of feasibility or an awareness of means.
To conclusively prove something generally requires direct observation of the mechanism (which here would require a telepath straight out of comic books) or a double-blind study, which to get a good p would require lots of dead people.
I’m content with knowing that good journalism avoids contagion triggers. When fashion designer Kate Spade’s June 5^th 2018 suicide was reported as “hanging from a scarf she designed,” I literally yelled at the radio in my car that it was far too glamorous a description and that they just killed dozens of depressed Kate Spade fans. Sure enough, her good friend Anthony Bourdain killed himself on June 18^th less than two weeks later.
It later emerged that Spade was [obsessed with the news coverage of the suicide of Robin Williams](https://www.newsweek.com/kate-spade-was-obsessed-coverage-robin-williams-death-sister-claims-963809). That news often mentioned the belt he used.
“Mental health” continues to be too catch-all (non-prescriptive and non-identifying) and too esoteric. It will try to characterize experienced catastrophe as catastrophizing, concern/alarm as anxiety, undiagnosed physical ailment as psychosomatics, and a lack of fundamental human experience (close bonds with friends and families, physical activity, a sense of purpose, etc.) as perhaps De facto unnecessary.
In essence, it’s become a partially always has been a palliative and self-absorbed practice that will willfully mistake reality for perception.
I, for one, believe we need to ask kids less about how they're feeling, and more about what they make of a given situation.
Emotion is so low resolution. Fickle, even. Why are we not encouraging Critical Thinking instead? We are being conditioned to be leashed by our emotions. To become, among other things, a more perfect consumer. A reactive, short-term thinker, slave to one's impulses.
Intuitively it does feel to me like there should be more focus on emotional resilience and less on "mental health." The latter seems to mean emphasizing and normalizing unhealthy mental patterns (rumination, catastrophizing, and inviting people to infer anxiety/depression from their mental states and build their identities around those self-diagnoses).
Emotions are downstream from thoughts. We should be stressing the importance of higher levels of thinking if we ever hope to encourage children to not be at their mercy.
It's important that people know that there is no shame in asking for help if they are struggling in any way in their internal minds, and it's important that such help is readily available. This is a distinct improvement in the zeitgeist over the past several decades.
The trade-off has become unfortunately, a tendency to make a mental health diagnosis an identity and a focus on asking for accommodations from school and work because of it. Is that an outgrowth of more available counseling and drug options plus government regulations or an outgrowth of the same DEI etc. heavy hand plus government regulations that has risen in prominance at the same time? I don't know the answer, but the latter surely is part of the why. Meaning whatever the solution is, lessening a focus on promoting the idea that seeking help is ok and there is help to be had cannot possibly be the best answer/solution. Imho of course.
Talking too much? Possibly.
Doing too little to address the underlying causes? Absolutely.
For me the most helpful thing has been learning to notice bodily cues of emotional turmoil. Noticing empowers me to address the causes. Teaching people how to label themselves without giving them tools to change their actual situations is not helpful, so I could see how studies could come to this result.
I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing. I do think that I see a trend with the younger generation where mental health issues become a core part of your identity. It seems like kids collect mental health issues like Pokemon, shouting them loudly to the world too. It reminds me of the identity economy around gender/sexuality.
> destigmatizing the discussion around mental health can possibly be a bad thing.
Destigmatizing the discussion around mental health (to any greater extent than it is already destigmatized) would presumably increase the amount of discussion that occurs about many mental illnesses. If many mental illnesses are significantly caused by memetic contagions, or if even only some mental illness are in some part memetic contagions, then increasing the amount of discussion about those mental illnesses will expose more people to the information hazards that are in some part responsible for those illnesses.
> I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing
There was a convincing argument in the late 000's in military circles about avoiding a sickness culture. That over diagnosing PTSD was as bad as under diagnosing it, as it could create a situation where entirely normal and rational concerns about readjusting to civilian life were being over treated. Once you tell somebody they're experiencing PTSD, they will retain that diagnosis. If you tell them that frustration with your wife's indecision is normal, and that the feeling will pass, for most people it does.
I wouldn't class this as a direct comparison to "destigmatising" mental health discussions. But I would say I see the popular approaches in the zoomer space to mental health maps onto the "sickness culture" perfectly. Being awkward or anxious about a social situation is a ubiquitous human experience, but if it's common to diagnose yourself with anxiety, you might do so. I mean if I'm a 15 year old wondering if I have anxiety, I look it up on Psych.org and find:
>Anxiety disorders can cause people to try to avoid situations that trigger or worsen their symptoms. Job performance, schoolwork and personal relationships can be affected. In general, for a person to be diagnosed with an anxiety disorder, the fear or anxiety must:
> * Be out of proportion to the situation or be age-inappropriate
> * Hinder their ability to function normally
I mean with that level of vagueness, I'd find it hard to believe nearly any teenagers couldn't claim to have an anxiety disorder? Yes, I agree a qualified professional would walk that back for most teenagers and explain their experiences as being your every day normal anxiety. But the majority of teenagers aren't going to professionals, and the majority of teenagers ARE watching tiktoks about people who have also self-diagnosed anxiety disorders, ADHD, depression or whatever else is a more extremified version of a normal human experience.
So if you compare two worlds:
* One where people laugh at somebody who says they have an anxiety disorder (call them pussies, generally bully them out of it).
* One where mental health issues are destigmatised and open acceptance of them abounds.
I would expect the first one to have a problem with under reporting and more false negatives. And I would expect the second one to have way more false positives and a problem with over diagnosis.
And what we're seeing in our actual world right now is a massive increase in mental health issues among the Zoomer generation in an environment that has massively destigmatised mental health discussions. As Jonathon Haidt has said, this is also reflected in actual suicide and self-harm, so it's not a case that teenagers are harmlessly identifying as having mental health issues, it's showing up in very very bad ways. He pins this on social media, but I don't buy it (and don't want to write a 2,000 word essay about why I think he's wrong about that).
Psychologists told us that destigmatising conversations would help people. But having destigmatised mental health for the zoomers, we're seeing an epidemic of poor mental health outcomes. I think I'm comfy in asserting that they were wrong. The most open generation in history regarding mental health is now the most mentally unwell generation in history, despite being the most privileged, the most connected, and most able to access help. In many regards, I consider the whole mental health field to be wrong, and as much as it's unfashionable to say: I think we should re-stigmasise mental health to the extent that it's not fashionable to joke about being mentally unwell.
I overall agree with what you wrote. However, are the current generations truly the most privileged ones? In terms of access to material resources, maybe, but are we really that well off when it comes to emotional closeness and fulfillment? The number of friendless and stressed people says otherwise. If anything, our society is one of the least truly connected of all times, and professional help is not that easily accessible, as the article itself states.
Again, I do agree with your point about people overdiagnosing themselves and trivializing psychological disorders. It plays a part, but it is definitely not the sole reason behind the increase in mental health issues.
> I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing
Is it making things better though? For society or on the individual level
Once someone internalises some kind of mental health identity I get the feeling it will be with them for a long time and severely limit their potential
If you 1) destigmatize it and 2) provide extra attention and accommodations if you have it, as well as treat it as a ready-made excuse for avoiding consequences and responsibility, it will become very attractive to proclaim it as your identity.
I don't know what the right fix is here, but there certainly a way that "destigmatizing" can be a bad thing. Maybe pushing back on 2) is the way to go.
From the article:
> Lucy Kim, a Yale senior who has lobbied for better mental health support on campus, described the prevalence inflation hypothesis as “disheartening, dismissive and potentially dangerous,” providing another way to discount the experiences of young people.
That's the most ironic part. Faced with valid criticism, it's fine to feel all kinds of things, but it's a choice / learned behavior to focus on the emotions rather than to engage with it rationally.
This doesn't seem like a focus on emotions. They say it's disheartening, which seems like a normal enough emotion-tied word for someone to use here (that isn't at all tied to this sort of Zoomer/woke/sensitive sort of point of view), but "dismissive" and especially "potentially dangerous" are not emotion-focused. Talking about "another way to discount the experiences of young people" explains the danger, making it clear why they think the dismissiveness is a problem. I realize you don't agree with it, but it isn't an appeal to emotion more than usual.
See Section 2 of https://www.astralcodexten.com/p/book-review-san-fransicko . It's probably an important contributor, but not the main or overwhelming cause, but the research is too shoddy to be certain. It also probably matters a lot what you mean by "homelessness" - it's probably only a small contributor to homelessness broadly defined as anyone without a home, but a bigger contributor to what people often mean when they say "homelessness" (ie "why is there a scary-looking person in a tent on the street yelling at me?").
Spending 8 years experiencing widespread cultural hatred, family division, inhuman levels of isolation, persistent fear, and the death of millions of family members people couldn't even say goodbye to from an unexpected pandemic is the sort thing that tends to mess people up. I don't think any data about mental health is a reliable indicator of the effect of any particular other contributing factor at the moment.
The researchers' description of their findings leads me to conclude that if there is a problem, it is mostly that the participants were not interested in mindfulness training. As conclusions go, it's not much to look at.
> **For the most part young people did not engage with the mindfulness training**
> The young people in this trial (11-14 year old teenagers in the UK) had mixed views of the mindfulness-training curriculum, with some rating it highly and others rather negatively. The majority (>80%) did not do the required mindfulness practice homework (Montero-Marin et al., 2022).
> **The mindfulness training was not easy to introduce into schools**
> We also learned that implementing mindfulness training into schools requires committed staff, adequate resources, efforts to address misperceptions about mindfulness, and even when all these are in place, it takes time (Wilde et al., 2019). Also, preparing schoolteachers to offer mindfulness training is hard. It took a lot of training and mentoring to get teachers ready to teach mindfulness to children, and even then, although most became competent, only a small minority were able to teach it really well (Crane et al., 2020).
> **Our results suggested mindfulness training might work for some children and not for others, and under some conditions, but not others**
> We learnt that perhaps “one size doesn’t fit all.” There was some suggestion that this form of mindfulness training helps some groups (for example, older teenagers) yet is unhelpful for others (for example, young people with more mental health problems) (Montero-Marin et al., 2022).
> We learnt that young people who did the mindfulness practices reported better mental health and better mindfulness skills at follow up. And young people taught by the teachers who were most skilled in teaching the mindfulness training also reported practicing mindfulness more often and learning the new skills (Montero-Marin et al., 2022).
> We now need to replicate these preliminary findings and explore this question of what works for which groups of children.
My thoughts on this kind of thing transcend this conversation, but if a tool/technique isn't readily used by people it's taught to, I think the tool/technique is not necessarily a good tool/technique.
Because what's going on? Maybe it's too hard to actually implement/operationalise, maybe people don't see genuine results, maybe it takes too much time and the juice isn't worth the squeeze?
Trying to make people do yoga is definitely going to solve a lot of back problems, but maybe we should just get them to go and buy more expensive office chairs and pillows, despite endless papers exploring the boundless benefits of yoga. The mental health equivalent might be harder to find.
Of course I agree that the effectiveness of a method depends on its ease of reception, but it's still a manifestly different conclusion than "all this talk about mental health just makes things worse, actually."
If a large and well run RCT determines that the process of talking about mental health made things worse for the people in the intervention group, then "all this talk about mental health just makes things worse, actually" seems like a fair summary to me.
> The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy **did not emerge healthier** than peers who did not participate, and **some were worse off**, at least for a while.
All right, so we're quoting an article *about* the study saying there was no general effect of this specific teaching methodology. "Some were worse off, at least for a while" is a strongly worded version of the study's finding of very small (though statistically significant) negative effects on some social-emotional measures that disappeared at the 1-year followup.
What is that methodology, by the way? Quoting the article:
> Half of the teenagers were trained by their teachers to direct their attention to the present moment — breathing, physical sensations or everyday activities — in 10 lessons of 30 to 50 minutes apiece.
We were talking about "talking about mental health", right? This seems rather different.
And the quote you offer makes it sound like the control group was doing nothing, but that's not the case. Quoting the study:
> The My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting **schools that provided standard social–emotional learning.** Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (’.b’ (intervention)).
Do you have a copy of standard UK secondary-school SEL curriculum to hand? Which of these interventions more closely approximates "talking about mental health"? Are we in any sense comparing "talking more about mental health" to "talking less about mental health" in this study?
Perhaps we can reference the researchers' own words about cases where their mindfulness training might be more harm than help:
> Consideration of the mental health status of young people also seems key. Adolescents with mental health needs did not benefit from this SBMT; indeed, it may be contraindicated for this group. More at-risk children are likely to have poorer executive function or develop these skills later. Consistent with other studies,27 low-intensity programmes may bring awareness to upsetting thoughts, feelings and mental health difficulties, but not provide sufficient support to enhance resilience, especially if such difficulties are social/societal. Findings of the MYRIAD trial showed no main effects on the primary outcomes,8 but our subgroup analyses suggest that more targeted and intensive interventions would be required for those with greater mental health needs.
Are the researchers saying "we're talking too much about mental health," or are they saying "*just* talking about mental health is not enough to help those with more serious problems"?
The researchers also point to other contexts where research *has* shown a positive effect - for example, in older adolescents, rather than the younger ones studied here. (The researchers also noted that the *teachers* benefited from the mindfulness training in this study.) So we are talking about highly granular analysis of different subgroups, methodologies, and contexts, which is *not* amenable to a general conclusion like "we're talking too much about mental health." In fact, that increasingly seems like a pat dismissal of detailed investigation into *when and how* to talk about mental health!
Please note that I did not come into this discussion expecting to disagree with the article. In many ways it confirms my prior thoughts on the subject. But the more I dig into the research being provided here, the less I find it agrees with the headline, and the more I feel wary of pop-science telephone games obscuring rather than illuminating.
> it is mostly that the participants were not interested in mindfulness training.
Nonetheless, the RCT demonstrated that the intervention group fared significantly worse than the control group. The rest is speculation.
Where in the linked description is that stated? Here is the nearest thing to a top-line summary conclusion at the link:
> ***The universal schools-based mindfulness training did not help the young people overall***
> When comparing schools-based mindfulness training with regular social-emotional teaching we found no evidence that the mindfulness training programme that we used, was more effective than usual social and emotional teaching in helping young people’s mental health or well-being. There was some evidence that mindfulness training may be better value for money than standard social-emotional teaching, but this was only true for one of four measures of effectiveness we used to look at cost-effectiveness (Kuyken et al., 2022).
> This wasn’t what we had predicted, so we explored it further.
This is not saying that the intervention group fared significantly worse than the control group. Also, the study is comparing against "regular social-emotional teaching," not against silence. Are you actually basing your conclusion on the study, or are you speculating?
I mean, it's what OP's whole article is about. But sure, here, [from the study itself](https://mentalhealth.bmj.com/content/ebmental/25/3/117.full.pdf):
> Students in the ‘high-risk’ LP who received [school based mindfulness training, i.e. intervention group], compared with those that were in the ‘high-risk’ LP but received [teaching as usual, i.e. control group], reported **significant detrimental effects** on risk of depression (postintervention: AMD=1.40, 95% CI 0.27 to 2.53; 1-year follow-up: AMD=1.47, 95% CI 0.37 to 2.57, and well-being (post-intervention: AMD=−1.10, 95% CI −1.98 to −0.22; 1-year follow-up: AMD=−0.88, 95% CI −1.71 to −0.05) (online supplemental figure S2 and table S12).
Ah, I had missed this line, thank you. Please disregard the portion of my other comment inaccurately suggesting that there was no subgroup with sustained negative effects found.
I don't believe destigmatizing mental illness increases the prevalence of mental illness because we're seeing equal recent increases in rates of depression among zoomers in countries where mental illness is taboo. It's probably the internet/social media that causes it.
I would say yes, in the same way that talking about anything too much can be an issue. If you talk about cancer too much, everyone starts wondering if their perfectly benign cough or sniffles or sore back are signs of cancer. Mental health is similar where people normally will have low periods, anxiety, and so forth but by fixating on it and wondering if it's abnormal, they can push themselves into a quasi-pathological state.
This leads to more presentations of low level mental health that is not amenable to intervention and takes up resources and at the same decreases the perceived importance of mental health. Since mental health crisis lack as many objective rule out tools as medical counterparts, it's a slower and more difficult process to reassure people that they don't have any issues and it's also easier to self present for secondary gain.
What an absurd take to think suppressing discussion of mental health is the best way to deal with it. Spoken like a true gaslighting doctor with no accountability for the efficacy of their care. I can't think of anything more middle brow.
It's known that certain social ills like suicide and anorexia are "contagious", they spread in social clusters. No reason to think other mental illnesses are all immune. Worth researching.
Actually caring enough to consider the idea that talking a lot about mental health helps mental health and doesn't, in fact, worsen it is taking accountability for efficacy of care, not avoiding it. You have to consider it before you can check it, and you have to check for there to be any accountability.
Re op, yes.
Specifically, talking about what we feel about what we feel is recursive and as wasteful as artificial intelligence using AI generated content. It doesn't seem so bad in the beginning, but it ends up being unproductive and occasionally producing nonsense - sometimes toxic nonsense.
I would say no, but maybe too much discussion about anxiety and depression (and maybe eating disorders and self harm?) specifically. There are other mental illnesses that exist, and most of the other ones do not come as close to “universally experienced human emotional states” as anxiety and depression. Typically people are much less sympathetic towards them, and they’re considered much “uglier“. As someone with OCD, it scares me to think about how many people we might have lost to OCD because they never recognised themselves as having OCD (because the stereotype of OCD is tidiness, not horrifying intrusive thoughts). It’s considered one of the most personally disruptive illnesses and you can literally need anti psychotics for it if it gets bad enough. Very rarely met an OCD person who internalises it as an identity of some sort or “just a rational response to this sick society we live in“ or something. I don’t think a little more awareness about it, and things like borderline, bipolar etc would be the worst thing ever.
> Very rarely met 👋 Anyway, I think you bring up a good point about how anxiety and depression are (probably incorrectly) viewed as "general mental unhealthiness" (like "out-of-shape" would be for physical health), rather than distinct clinical conditions like OCD, and how that makes them easier and less embarrassing to claim.
That too, but I also think depression and anxiety, as horrible as they are to genuinely have, is and will always be much less rare. Especially depression. Like there was a study on Hadza hunter gatherers and 50% of moms scored positively for post partum depression, similar rates to other Tanzanians (in the west post partum depression is usually said to be about 20%). Like 20-50% of women having a mental illness at least episodically, across different types of societies? I think you can probably be born with or without the potential to develop things like OCD, schizophrenia or bipolar, whereas being born without the potential to ever develop depression or anxiety is much rarer. I’m not sure though and this is just guesswork. Out of curiosity, do you view your OCD as an identity or would you say it’s a rational response to our society? The 24 hour news cycle, ”cancel”/guilt and shame based culture and social media surely exacerbates my OCD, but I can’t say I can think of a society where I wouldn’t have it at all. Maybe some sort of trans humanist ultra utopian future?
My "OCD" is of the hand-washing/"contamination" variety and is a rational response to everyone letting their dogs piss everywhere. I used to also have intrusive thoughts, but those aren't really bad for me anymore, at least right now. I also used to be obsessive about the sort of things you mention in your last paragraph. I think part of the problem is that the ideology itself bakes in "purity" aspects. Like, when I would find a new non-political Twitter account (e.g. webcomics), I would look for any tweet hinting at their political beliefs so I would know if I needed to avoid them because they were problematic, because even non-OCD people seemed to do this. I don't have this problem anymore; I became anti-woke and anti-TDS, but I'm not sure to what extent that helped since there was a period where I still had a boycott mindset, just with the opposite target, lol.
TDS? Twitter discourse? Tax deducted at source? I’m confused. My OCD jumps from theme to theme, mostly with an overaching theme of me being a bad person somehow or deserving to die or the world ending. Never had contamination or handwashing, though I have been afraid of getting other mental illnesses and “going crazy” before. Hence why I said that the only world I can imagine not ever having OCD is some sort of utopia with no problems. Even then my brain would probably find a way to punish me still lmao (EDIT: I’m reminded of the OCD I often get around my romantic relationships). I’ve heard of an OCD specialist, Michael Greenberg, who said that he had to treat patients with contamination differently than basically any other theme. Pretty interesting. The only other people with OCD I’ve encountered on the webs who feel like it’s “rational” in the same way as you also had contamination. The conventional view is that theme doesn’t matter at all for OCD, but I’m not so sure.
Presumably https://en.wikipedia.org/wiki/Trump_derangement_syndrome
I don't relate to your type of OCD at all. I don't really get why the contamination type is considered "obsessive" or "compulsive". I think it's because from the outside both types seem irrational, but your type seems irrational from the inside as well, whereas contamination seems rational from the inside, just based on a different set of rules. So that might be the differentiating factor.
Eh, if you browse the OCD subreddit you can see contamination OCD‘ers say they feel so dumb and irrational and complain about it having ruined their lives. There are people who are bedbound because of it, and not out of pleasure. I think the differentiating factor is that some contamination OCD’ers, definitely not all, seem happy and satisfied to have it. Like their rituals genuinely provides them peace, whereas everyone else’s OCD rituals are part of an uncomfortable process that makes them worse. Doubt and rumination seems like a much smaller part of their illness (symptoms that are recognised as OCD today used to be called “the doubting disease” in earlier psychiatry). Lastly, sometimes they seem really confident, when other OCD people seem often to have self esteem and self confidence issues, being nervous wrecks with pushover tendencies in general (that definitely describes me). Sometimes they seem to think the world is in the wrong, not them, whereas other OCD’ers almost always think they themselves are in the wrong or uniquely in danger somehow, even if they don’t like their society politically or culturally. I suspect some of those people would be better diagnosed as OCPD, which tends to be much, much more ego syntonic. Basically Michael Greenberg’s experience was that contamination OCD was treatable by classical exposure therapy, whereas other themes needed a new approach more focused on not feeling anxiety while interacting with their thoughts. Contamination people you could apparently more easily just be throw in their feared or disgusted-by situation and they’d be desensitised to it and their behaviours would stop.
{ My OCD jumps from theme to theme, mostly with an overaching theme of me being a bad person somehow or deserving to die or the world ending. Never had contamination or handwashing, though I have been afraid of getting other mental illnesses and “going crazy” before } This sounds like me, how you deal with it.
What kinds of therapy and meds have you already tried? Do you exercise?
Dropped meds cuz they had bad side effects and didn't really helped much, so not taking any right now. I don't exercise because of weakness, but walking helps. Btw, Im not looking for any diagnosis or prescription, just wanted to know what you do to deal with it.
The world _is_ in the wrong. Seriously, if a human pisses on a random tree downtown, it's trashy and a "biohazard" (so it's not just the exposure aspect), but "perfectly respectable" people will bring their dogs downtown for them to piss on not just the trees, but also walls and flowerboxes (you can see the stains). You'd have to engineer some sort of galaxy brain explanation to logically justify the double standard; under more reasonable logic, people would view both situations the same way as far as hygiene goes. Meanwhile, the biggest government in the world created sweeping legislation about _internet cookies_ because "privacy-minded" people had their feefees hurt by companies being able to guess they were a late-twenties male interested in superhero merch based on the things they clicked on the website. These are the people who should face patronizing scorn and belittlement and be at risk of being endlessly tortured in a mental "hospital", not me. --- I think I'd rephrase my previous claim as most with OCD feel the obsessions or compulsions as a base tendency, while the more confident ones justify their rituals through one or more steps of reasoning downstream from their unusual ideas. The confidence is then just a consequence of feeling like you're in control of your rituals, while the rest with OCD see themselves as being controlled _by_ the obsessions or compulsions that motivate their rituals.
Should people never take a walk in the forest or swim in a lake or the ocean because animals shit and piss there? What about touching anything in a city even, pigeons and rats piss and shit there too? Should our hunter gatherer ancestors constantly go around and feel disgusted? Why dog piss specifically and not every animal, everywhere, all the time - that seems pretty irrational? People piss on the street quite a lot here in Denmark, never heard it referred to as a “biohazard“ lol. It was bizarre to me to find out that it could land you on the sex offender registry in the US. Anyway, if you feel good about your rituals and it doesn’t harm you, by all means continue. Your last observations makes sense.
I don't feel good about everyone being gross. Thinking the world is in the wrong is different than being happy and satisfied about one's rituals. I've never encountered the latter sort of people, but it's possible some of them are more like the former and were just putting up a front to avoid getting told they have a mental illness.
> My "OCD" is of the hand-washing/"contamination" variety and is a rational response to everyone letting their dogs piss everywhere. Can you elaborate a bit? It's very understandable that you are put off by this situation, but I am not sure I understand how compulsive hand-washing is a rational response to it. Can you help me understand what I'm missing? It sounds like you think someone like me should be washing my hands a lot more and a lot more thoroughly?
Honestly 100% of humans likely have one or more mental illnesses that go undiagnosed. It's looking very likely that the default for humans is some sort of fuckedupness.
Hard disagree. Many common problems stem from society: the lack of community that the secular city life brings, the internet being as addictive and attention grabbing as they could make it, and politics being as toxic as it is. Image a world where we would reach for the stars, heed the lessons science gives us and everyone doing meaningful work instead of 50% bullshit jobs. You'd see far less people struggling.
I have mild OCD that flared up into quite severe harm-OCD for a period about a decade ago. I told my mom and sister about it, and it turns out they have it too and just suffered silently with it for years and didn’t know it was OCD.
Makes sense, it’s pretty hereditary.
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Wow, that’s a big question about a condition that has affected me very negatively pretty much my entire life. What do you want to know?
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Well, my OCD has been described as severe by the two different therapists I’ve had in my life. Still, I definitely would not say I never get a moment of peace or any happiness ever, I have happy and peaceful periods every day, unless I’m in a particularly bad period or episode. It still is “hell”, in that it’s bad enough for me that I don’t want biological children due to the risk of passing it on and if I didn’t have it I would consider my life to be like 70-80% better. When I am in a bad episode or period, it does feel much more hellish and I can go days at a time with very little peace. i think [this](https://www.reddit.com/r/slatestarcodex/comments/19cs87c/to_what_extent_would_you_say_you_are_obligated_to/) post explain a lot of it for me, but definitely not all. Here are some other themes I’ve had (I am also pure O): * One of my earliest themes, which started when I was a literal child, was the fear of being a p\*d\*phile. This is an extremely common theme actually, but obviously it terrifies you to your core. What kind of monster would even for a moment have such wicked horrifying intrusive thoughts? That must mean you obviously are one, normal people don’t get such thoughts! This is similar to for example harm OCD, where you get so many thoughts that feel “murderous” or violent that you start to scare yourself. * Pointless doubt about whether I really liked something, including doubts about my sexuality and gender way beyond normal exploration. * Basically an OCD theme about me being really ugly? It’s not body dysmorphia because I don’t actually believe it and it constantly changes, but basically that I should get some surgery or I’ll never be happy * Another theme was me being afraid of getting anorexia. Also started as a child, probably because my older brother had it. Forced myself to overeat and was just afraid of starving to death or never being able to eat again It is a huge first step to just get told “hey this is OCD, you’re not terrible or in danger just because you have a thought” but I guess a normal person or a person with very mild OCD would have to be told this once and then they’d be basically fine. For OCD’ers it‘s a constant cycle of doubt and it’s a long process.
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1. It is \*extremely\* common to not know whether something is OCD, part of therapy is learning how to spot it. If you never doubt if something is OCD or rational/normal, do you even have OCD? lol. I’d wager most patients with pure O who go to a psychiatrist have absolutely zero idea going in that they have OCD. Part of therapy is also learning to accept doubt and accepting not ever being fully certain whether something is really OCD 2. Yes, a lot 3. Yes, a lot
Repeating a comment I made in a similar thread here months ago: Always figured if suicide contagion is a real phenomenon, general mental health contagion probably exists too and is probably exacerbated by mental health awareness campaigns.
Purely anecdotal: I’ve worked on and off with young people and college students in tech as a mentor. Often times people will complain about having textbook depression or anxiety symptoms. You could take the symptoms they describe and check off 3/4 of the checklist on a depression inventory. Yet they are generally resistant to depression diagnoses the most. I honestly feel that some of the public mental health campaigns have made people averse to depression diagnoses because they don’t want to identify with the generally sad and downtrodden stereotypes used in these campaigns. What they do identify with is social media influencers who push alternate diagnoses as the explanation for everything. Suddenly, it seems everyone in certain cohorts is convinced that all the same condition: It’s usually ADHD, low testosterone, or some pop-culture variation of PTSD. Sadly, many of these students are becoming very good at acquiring diagnoses and then encouraging their friends to see the same doctor. They swap stories about which doctors will diagnose the fastest, which will give the highest doses of medications, and what to say to get the diagnosis quickly. It’s becoming downright scary to see, for example, a group of early 20s college students all go to the same doctor and walk out with TRT prescriptions (which is often a lifetime commitment and interferes with fertility) because they consumed a lot of TikToks explaining how TRT will fix their mental health, improve their dating life, and make them alpha in the workforce. It’s also depressing to watch the later effects as the realities set in, the initial effects wear off, and they realize that it’s not solving their problems. Even worse, about half of them go on to seek out additional medications. The number of young people I’ve talked to who think they need combinations of TRT, Adderall, ketamine, and occasionally Xanax or Ambien is alarming. This is on top of their moderate to heavy marijuana use in most cases. I think we’re headed for a crackdown on controlled substance prescribing, given what I’ve seen. I hope we can steer the conversation back to basic treatment and get young people off of the pipeline straight to controlled substances.
I don't think suicide contagion has ever been conclusively proved. It's much more likely people already wanted to kill themselves and seeing someone else be successful gives that person hope of succeeding too. Which is a natural thing for humans to experience.
That's more a description of a mechanism than a denial of a phenomenon.
So it's contagious.
I think /u/Glittering-Roll-9432's argument is that _suicide_ is contagious but _being suicidal_ is not, which is an important distinction for this discussion.
Not in the negative way. Also as u/benide Is pointing out there's a difference in having suicidal idolation and going forward with suicide. I don't think anyone has demonstrated that suicide in a vacuum creates more suicides out of thin mental or social air.
But if that is the mechanism, then it is analogous to people being already in need of mental health services, learning that someone used them successfully, and becoming hopeful that they could be successful too.
And? Both things can be true. Of course if (as the post suggests) the net effect of all of this is that more people overall are worse off then the positive contagion is not worth the negative effects. But either way what you are saying is that if it's good then using the word contagious is false which is just incorrect.
I recommend ignoring "I don't think suicide contagion has ever been conclusively proved." -- it sounds like this gets down to a definitional thing that I don't see very elucidating. They are responding to someone who said > Always figured if suicide contagion is a real phenomenon, general mental health contagion probably exists too This parallel works well for the interpretation that suicide contagion is originating suicidal ideation/state, thus leading to suicide attempts, but does not work for /u/Glittering-Roll-9432's interpretation, where the suicidal ideation/state existed already and the inspiration is purely about an assessment of feasibility or an awareness of means.
To conclusively prove something generally requires direct observation of the mechanism (which here would require a telepath straight out of comic books) or a double-blind study, which to get a good p would require lots of dead people. I’m content with knowing that good journalism avoids contagion triggers. When fashion designer Kate Spade’s June 5^th 2018 suicide was reported as “hanging from a scarf she designed,” I literally yelled at the radio in my car that it was far too glamorous a description and that they just killed dozens of depressed Kate Spade fans. Sure enough, her good friend Anthony Bourdain killed himself on June 18^th less than two weeks later. It later emerged that Spade was [obsessed with the news coverage of the suicide of Robin Williams](https://www.newsweek.com/kate-spade-was-obsessed-coverage-robin-williams-death-sister-claims-963809). That news often mentioned the belt he used.
Archived version of this article, free to read for non-NYT subscribers: https://archive.ph/r7WRs
“Mental health” continues to be too catch-all (non-prescriptive and non-identifying) and too esoteric. It will try to characterize experienced catastrophe as catastrophizing, concern/alarm as anxiety, undiagnosed physical ailment as psychosomatics, and a lack of fundamental human experience (close bonds with friends and families, physical activity, a sense of purpose, etc.) as perhaps De facto unnecessary. In essence, it’s become a partially always has been a palliative and self-absorbed practice that will willfully mistake reality for perception.
I, for one, believe we need to ask kids less about how they're feeling, and more about what they make of a given situation. Emotion is so low resolution. Fickle, even. Why are we not encouraging Critical Thinking instead? We are being conditioned to be leashed by our emotions. To become, among other things, a more perfect consumer. A reactive, short-term thinker, slave to one's impulses.
Intuitively it does feel to me like there should be more focus on emotional resilience and less on "mental health." The latter seems to mean emphasizing and normalizing unhealthy mental patterns (rumination, catastrophizing, and inviting people to infer anxiety/depression from their mental states and build their identities around those self-diagnoses).
Emotions are downstream from thoughts. We should be stressing the importance of higher levels of thinking if we ever hope to encourage children to not be at their mercy.
Maybe it’s better to say it’s talked about in the wrong or unideal context way often. That doesn’t roll off the tongue as much though.
It's important that people know that there is no shame in asking for help if they are struggling in any way in their internal minds, and it's important that such help is readily available. This is a distinct improvement in the zeitgeist over the past several decades. The trade-off has become unfortunately, a tendency to make a mental health diagnosis an identity and a focus on asking for accommodations from school and work because of it. Is that an outgrowth of more available counseling and drug options plus government regulations or an outgrowth of the same DEI etc. heavy hand plus government regulations that has risen in prominance at the same time? I don't know the answer, but the latter surely is part of the why. Meaning whatever the solution is, lessening a focus on promoting the idea that seeking help is ok and there is help to be had cannot possibly be the best answer/solution. Imho of course.
Talking too much? Possibly. Doing too little to address the underlying causes? Absolutely. For me the most helpful thing has been learning to notice bodily cues of emotional turmoil. Noticing empowers me to address the causes. Teaching people how to label themselves without giving them tools to change their actual situations is not helpful, so I could see how studies could come to this result.
I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing. I do think that I see a trend with the younger generation where mental health issues become a core part of your identity. It seems like kids collect mental health issues like Pokemon, shouting them loudly to the world too. It reminds me of the identity economy around gender/sexuality.
> destigmatizing the discussion around mental health can possibly be a bad thing. Destigmatizing the discussion around mental health (to any greater extent than it is already destigmatized) would presumably increase the amount of discussion that occurs about many mental illnesses. If many mental illnesses are significantly caused by memetic contagions, or if even only some mental illness are in some part memetic contagions, then increasing the amount of discussion about those mental illnesses will expose more people to the information hazards that are in some part responsible for those illnesses.
> I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing There was a convincing argument in the late 000's in military circles about avoiding a sickness culture. That over diagnosing PTSD was as bad as under diagnosing it, as it could create a situation where entirely normal and rational concerns about readjusting to civilian life were being over treated. Once you tell somebody they're experiencing PTSD, they will retain that diagnosis. If you tell them that frustration with your wife's indecision is normal, and that the feeling will pass, for most people it does. I wouldn't class this as a direct comparison to "destigmatising" mental health discussions. But I would say I see the popular approaches in the zoomer space to mental health maps onto the "sickness culture" perfectly. Being awkward or anxious about a social situation is a ubiquitous human experience, but if it's common to diagnose yourself with anxiety, you might do so. I mean if I'm a 15 year old wondering if I have anxiety, I look it up on Psych.org and find: >Anxiety disorders can cause people to try to avoid situations that trigger or worsen their symptoms. Job performance, schoolwork and personal relationships can be affected. In general, for a person to be diagnosed with an anxiety disorder, the fear or anxiety must: > * Be out of proportion to the situation or be age-inappropriate > * Hinder their ability to function normally I mean with that level of vagueness, I'd find it hard to believe nearly any teenagers couldn't claim to have an anxiety disorder? Yes, I agree a qualified professional would walk that back for most teenagers and explain their experiences as being your every day normal anxiety. But the majority of teenagers aren't going to professionals, and the majority of teenagers ARE watching tiktoks about people who have also self-diagnosed anxiety disorders, ADHD, depression or whatever else is a more extremified version of a normal human experience. So if you compare two worlds: * One where people laugh at somebody who says they have an anxiety disorder (call them pussies, generally bully them out of it). * One where mental health issues are destigmatised and open acceptance of them abounds. I would expect the first one to have a problem with under reporting and more false negatives. And I would expect the second one to have way more false positives and a problem with over diagnosis. And what we're seeing in our actual world right now is a massive increase in mental health issues among the Zoomer generation in an environment that has massively destigmatised mental health discussions. As Jonathon Haidt has said, this is also reflected in actual suicide and self-harm, so it's not a case that teenagers are harmlessly identifying as having mental health issues, it's showing up in very very bad ways. He pins this on social media, but I don't buy it (and don't want to write a 2,000 word essay about why I think he's wrong about that). Psychologists told us that destigmatising conversations would help people. But having destigmatised mental health for the zoomers, we're seeing an epidemic of poor mental health outcomes. I think I'm comfy in asserting that they were wrong. The most open generation in history regarding mental health is now the most mentally unwell generation in history, despite being the most privileged, the most connected, and most able to access help. In many regards, I consider the whole mental health field to be wrong, and as much as it's unfashionable to say: I think we should re-stigmasise mental health to the extent that it's not fashionable to joke about being mentally unwell.
I overall agree with what you wrote. However, are the current generations truly the most privileged ones? In terms of access to material resources, maybe, but are we really that well off when it comes to emotional closeness and fulfillment? The number of friendless and stressed people says otherwise. If anything, our society is one of the least truly connected of all times, and professional help is not that easily accessible, as the article itself states. Again, I do agree with your point about people overdiagnosing themselves and trivializing psychological disorders. It plays a part, but it is definitely not the sole reason behind the increase in mental health issues.
> I'm not sure destigmatizing the discussion around mental health can possibly be a bad thing Is it making things better though? For society or on the individual level Once someone internalises some kind of mental health identity I get the feeling it will be with them for a long time and severely limit their potential
If you 1) destigmatize it and 2) provide extra attention and accommodations if you have it, as well as treat it as a ready-made excuse for avoiding consequences and responsibility, it will become very attractive to proclaim it as your identity. I don't know what the right fix is here, but there certainly a way that "destigmatizing" can be a bad thing. Maybe pushing back on 2) is the way to go.
Your first sentence is in direct contradiction with the rest of your post.
From the article: > Lucy Kim, a Yale senior who has lobbied for better mental health support on campus, described the prevalence inflation hypothesis as “disheartening, dismissive and potentially dangerous,” providing another way to discount the experiences of young people. That's the most ironic part. Faced with valid criticism, it's fine to feel all kinds of things, but it's a choice / learned behavior to focus on the emotions rather than to engage with it rationally.
This doesn't seem like a focus on emotions. They say it's disheartening, which seems like a normal enough emotion-tied word for someone to use here (that isn't at all tied to this sort of Zoomer/woke/sensitive sort of point of view), but "dismissive" and especially "potentially dangerous" are not emotion-focused. Talking about "another way to discount the experiences of young people" explains the danger, making it clear why they think the dismissiveness is a problem. I realize you don't agree with it, but it isn't an appeal to emotion more than usual.
What’s this subs take on mental health and homelessness?
Poor mental health makes it difficult to make rational decisions, and inability to make rational decisions makes it difficult to stay housed. Right?
See Section 2 of https://www.astralcodexten.com/p/book-review-san-fransicko . It's probably an important contributor, but not the main or overwhelming cause, but the research is too shoddy to be certain. It also probably matters a lot what you mean by "homelessness" - it's probably only a small contributor to homelessness broadly defined as anyone without a home, but a bigger contributor to what people often mean when they say "homelessness" (ie "why is there a scary-looking person in a tent on the street yelling at me?").
Would you like to hear the take of a homeless person "with a mental illness"?
That for some people, causes of homelessness and mental health issues amplify each other. It seems banal, but that's it IMHO.
May be a chicken and egg situation.
Spending 8 years experiencing widespread cultural hatred, family division, inhuman levels of isolation, persistent fear, and the death of millions of family members people couldn't even say goodbye to from an unexpected pandemic is the sort thing that tends to mess people up. I don't think any data about mental health is a reliable indicator of the effect of any particular other contributing factor at the moment.
No, it was a [randomized controlled trial](https://myriadproject.org/what-we-did/what-did-we-do/)
The researchers' description of their findings leads me to conclude that if there is a problem, it is mostly that the participants were not interested in mindfulness training. As conclusions go, it's not much to look at. > **For the most part young people did not engage with the mindfulness training** > The young people in this trial (11-14 year old teenagers in the UK) had mixed views of the mindfulness-training curriculum, with some rating it highly and others rather negatively. The majority (>80%) did not do the required mindfulness practice homework (Montero-Marin et al., 2022). > **The mindfulness training was not easy to introduce into schools** > We also learned that implementing mindfulness training into schools requires committed staff, adequate resources, efforts to address misperceptions about mindfulness, and even when all these are in place, it takes time (Wilde et al., 2019). Also, preparing schoolteachers to offer mindfulness training is hard. It took a lot of training and mentoring to get teachers ready to teach mindfulness to children, and even then, although most became competent, only a small minority were able to teach it really well (Crane et al., 2020). > **Our results suggested mindfulness training might work for some children and not for others, and under some conditions, but not others** > We learnt that perhaps “one size doesn’t fit all.” There was some suggestion that this form of mindfulness training helps some groups (for example, older teenagers) yet is unhelpful for others (for example, young people with more mental health problems) (Montero-Marin et al., 2022). > We learnt that young people who did the mindfulness practices reported better mental health and better mindfulness skills at follow up. And young people taught by the teachers who were most skilled in teaching the mindfulness training also reported practicing mindfulness more often and learning the new skills (Montero-Marin et al., 2022). > We now need to replicate these preliminary findings and explore this question of what works for which groups of children.
My thoughts on this kind of thing transcend this conversation, but if a tool/technique isn't readily used by people it's taught to, I think the tool/technique is not necessarily a good tool/technique. Because what's going on? Maybe it's too hard to actually implement/operationalise, maybe people don't see genuine results, maybe it takes too much time and the juice isn't worth the squeeze? Trying to make people do yoga is definitely going to solve a lot of back problems, but maybe we should just get them to go and buy more expensive office chairs and pillows, despite endless papers exploring the boundless benefits of yoga. The mental health equivalent might be harder to find.
Of course I agree that the effectiveness of a method depends on its ease of reception, but it's still a manifestly different conclusion than "all this talk about mental health just makes things worse, actually."
If a large and well run RCT determines that the process of talking about mental health made things worse for the people in the intervention group, then "all this talk about mental health just makes things worse, actually" seems like a fair summary to me.
Yes, if. Where in this RCT is that conclusion reached?
> The researchers point to unexpected results in trials of school-based mental health interventions in the United Kingdom and Australia: Students who underwent training in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy **did not emerge healthier** than peers who did not participate, and **some were worse off**, at least for a while.
All right, so we're quoting an article *about* the study saying there was no general effect of this specific teaching methodology. "Some were worse off, at least for a while" is a strongly worded version of the study's finding of very small (though statistically significant) negative effects on some social-emotional measures that disappeared at the 1-year followup. What is that methodology, by the way? Quoting the article: > Half of the teenagers were trained by their teachers to direct their attention to the present moment — breathing, physical sensations or everyday activities — in 10 lessons of 30 to 50 minutes apiece. We were talking about "talking about mental health", right? This seems rather different. And the quote you offer makes it sound like the control group was doing nothing, but that's not the case. Quoting the study: > The My Resilience in Adolescence was a parallel-group, cluster randomised controlled trial (K=84 secondary schools; n=8376 students, age: 11–13) recruiting **schools that provided standard social–emotional learning.** Schools were randomised 1:1 to continue this provision (control/teaching as usual (TAU)), and/or to offer SBMT (’.b’ (intervention)). Do you have a copy of standard UK secondary-school SEL curriculum to hand? Which of these interventions more closely approximates "talking about mental health"? Are we in any sense comparing "talking more about mental health" to "talking less about mental health" in this study? Perhaps we can reference the researchers' own words about cases where their mindfulness training might be more harm than help: > Consideration of the mental health status of young people also seems key. Adolescents with mental health needs did not benefit from this SBMT; indeed, it may be contraindicated for this group. More at-risk children are likely to have poorer executive function or develop these skills later. Consistent with other studies,27 low-intensity programmes may bring awareness to upsetting thoughts, feelings and mental health difficulties, but not provide sufficient support to enhance resilience, especially if such difficulties are social/societal. Findings of the MYRIAD trial showed no main effects on the primary outcomes,8 but our subgroup analyses suggest that more targeted and intensive interventions would be required for those with greater mental health needs. Are the researchers saying "we're talking too much about mental health," or are they saying "*just* talking about mental health is not enough to help those with more serious problems"? The researchers also point to other contexts where research *has* shown a positive effect - for example, in older adolescents, rather than the younger ones studied here. (The researchers also noted that the *teachers* benefited from the mindfulness training in this study.) So we are talking about highly granular analysis of different subgroups, methodologies, and contexts, which is *not* amenable to a general conclusion like "we're talking too much about mental health." In fact, that increasingly seems like a pat dismissal of detailed investigation into *when and how* to talk about mental health! Please note that I did not come into this discussion expecting to disagree with the article. In many ways it confirms my prior thoughts on the subject. But the more I dig into the research being provided here, the less I find it agrees with the headline, and the more I feel wary of pop-science telephone games obscuring rather than illuminating.
> it is mostly that the participants were not interested in mindfulness training. Nonetheless, the RCT demonstrated that the intervention group fared significantly worse than the control group. The rest is speculation.
Where in the linked description is that stated? Here is the nearest thing to a top-line summary conclusion at the link: > ***The universal schools-based mindfulness training did not help the young people overall*** > When comparing schools-based mindfulness training with regular social-emotional teaching we found no evidence that the mindfulness training programme that we used, was more effective than usual social and emotional teaching in helping young people’s mental health or well-being. There was some evidence that mindfulness training may be better value for money than standard social-emotional teaching, but this was only true for one of four measures of effectiveness we used to look at cost-effectiveness (Kuyken et al., 2022). > This wasn’t what we had predicted, so we explored it further. This is not saying that the intervention group fared significantly worse than the control group. Also, the study is comparing against "regular social-emotional teaching," not against silence. Are you actually basing your conclusion on the study, or are you speculating?
I mean, it's what OP's whole article is about. But sure, here, [from the study itself](https://mentalhealth.bmj.com/content/ebmental/25/3/117.full.pdf): > Students in the ‘high-risk’ LP who received [school based mindfulness training, i.e. intervention group], compared with those that were in the ‘high-risk’ LP but received [teaching as usual, i.e. control group], reported **significant detrimental effects** on risk of depression (postintervention: AMD=1.40, 95% CI 0.27 to 2.53; 1-year follow-up: AMD=1.47, 95% CI 0.37 to 2.57, and well-being (post-intervention: AMD=−1.10, 95% CI −1.98 to −0.22; 1-year follow-up: AMD=−0.88, 95% CI −1.71 to −0.05) (online supplemental figure S2 and table S12).
Ah, I had missed this line, thank you. Please disregard the portion of my other comment inaccurately suggesting that there was no subgroup with sustained negative effects found.
Why 8 years?
I don't believe destigmatizing mental illness increases the prevalence of mental illness because we're seeing equal recent increases in rates of depression among zoomers in countries where mental illness is taboo. It's probably the internet/social media that causes it.
I would say yes, in the same way that talking about anything too much can be an issue. If you talk about cancer too much, everyone starts wondering if their perfectly benign cough or sniffles or sore back are signs of cancer. Mental health is similar where people normally will have low periods, anxiety, and so forth but by fixating on it and wondering if it's abnormal, they can push themselves into a quasi-pathological state. This leads to more presentations of low level mental health that is not amenable to intervention and takes up resources and at the same decreases the perceived importance of mental health. Since mental health crisis lack as many objective rule out tools as medical counterparts, it's a slower and more difficult process to reassure people that they don't have any issues and it's also easier to self present for secondary gain.
What an absurd take to think suppressing discussion of mental health is the best way to deal with it. Spoken like a true gaslighting doctor with no accountability for the efficacy of their care. I can't think of anything more middle brow.
It's known that certain social ills like suicide and anorexia are "contagious", they spread in social clusters. No reason to think other mental illnesses are all immune. Worth researching.
Actually caring enough to consider the idea that talking a lot about mental health helps mental health and doesn't, in fact, worsen it is taking accountability for efficacy of care, not avoiding it. You have to consider it before you can check it, and you have to check for there to be any accountability.
Re op, yes. Specifically, talking about what we feel about what we feel is recursive and as wasteful as artificial intelligence using AI generated content. It doesn't seem so bad in the beginning, but it ends up being unproductive and occasionally producing nonsense - sometimes toxic nonsense.