I’ve noticed a trend on the internet in the last decade and perhaps it may indeed confirm the stigma of mental illness.
It seems that people firmly believe in mental illness when it comes to someone making any changes to their body via plastic surgery or gender reassignment yet when it comes to illnesses like Depression or ADHD, people say “This doesn’t exist, it’s just an excuse to be lazy/selfish”.
Why the stark difference? Is mental illness in most cases reduced to an ad hominem attack? It’s very common to hear in politics that Liberalism is a mental disorder.
I think people are more likely to doubt the validity of spectrum disorders or disorders that can present in a myriad of different ways. Which is pretty much all of.them. For instance, most people have experienced a depressive spell or two, so many folks believe that gives them the right to evaluate other people’s claims. “She says she is depressed, but I just saw her smiling. When I was depressed, I never smiled. So she is a big ole liar.”
Or maybe they know someone who has a severe anxiety disorder and they use that person as a benchmark. “You can still work and run errands without having panic attacks, unlike my friend. Thus, you have no right to call yourself sick.”
Finally, people have a tendency to think common diagnoses are “fads”. And if something is a fad, that means it ain’t real…you are just jumping on a bandwagon.
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I would say that the difficulty is that it’s difficult to see the harm in depression or adhd. They both present as symptoms that in moderation are very normal. Most people feel sad and having moments of inattention or hyperactivity are not uncommon. They then apply their experience with that and assume that people with depression or adhd are experiencing the same thing. So the thought process is “What is depression?” “Depression is being sad.” “Well, I’ve been sad and I don’t just sit around in my room.” “Therefore, they’re not actually ‘ill’ they just need to get out more.” I think though that people do get depression when it reaches levels of self-harm, they just don’t understand it when it doesn’t.
I don’t think the differences are all that stark, mostly because there is a large gray area between mental illness and personality flaws. Am I mentally ill if I am 40 years old, jobless, and living in my mother’s basement, or am I just lazy? You can answer Yes to both without necessarily being wrong. If I need my support peacock in order to get on a plane, am I mentally ill?
Perhaps part of it is the M’Naghten rule, which is used in law to determine “guilty/not guilty by reason of insanity”. If you genuinely don’t know, because you are crazy, that what you are doing is wrong, and can’t stop yourself, then you are legally insane. OTOH if I am a serial killer, I am not likely to grab my victim off a busy street standing next to a cop. Therefore, on some level, I can control myself, even if only to the extent that I will plan not to get caught. Thus I am legally insane - but most serial killers are not mentally normal. But they are still held accountable for their actions. That’s a standard applicable in the courts, but does it work the rest of the time?
Freud said that work and love were the ways to determine if someone is ill or not. If I can hold down a job, or otherwise support myself, and form relationships with other people, maybe I am mentally ill but not crazy. If that makes any sense.
People are messy, and don’t always lend themselves well to bright lines. But bright lines are what we need when dealing with strangers - nobody’s got time to hear a detailed explanation of why you aren’t behaving the same way as everyone else.
Mental illness is certainly real, in general. In specific, it is nothing like clear-cut, a lot of the time.
I don’t know a single person that thinks depression or ADHD are not real.
Now, I do know people that conflate ADHD with hyperactivity and think ritalin is overprescribed to kids, which I agree to some extent, but non-existent? Nah.
My friend “says” he has arthritis, but yesterday he fixed his back deck.
It’s very attractive to apply the M’Naghten Rule (or something resembling it) in situations where it definitely doesn’t apply. The fact that my friend can, with a lot of pain and extra effort, do physical work - once - (he sure won’t be able to do it again today) doesn’t show that his arthritis doesn’t exist.
Similarly, the fact that I can, with a lot of pain and extra effort, organize my belongings once, or once sit through a whole class quietly without interrupting, doesn’t show that I don’t have ADHD.
And similarly again for a depressed person who has a good day or an anxious person who makes an effort to go out and talk to people or whatever.
As someone with a mental disorder, there are indeed some times when people will use a mental disorder (or “mental disorder”) as an excuse. I’ve heard of people using “Asperger’s” to excuse their jerk behavior when in fact they probably did not have Asperger’s at all.
but as monstro mentioned, there are also people who will claim that someone does not have a mental illness because that person’s symptoms doesn’t fit their preconceived notions of mental illness.
“I have problems of my own, but I feel obligated to minimize/hide/ignore/push through them. Therefore everyone should, and if they don’t they’re just lazy.”
So do I. Mainly from people who in fact don’t have any significant problems to deal with, beyond the ones that everyone has as a consequence of being human.
The existence of the internet has dramatically increased the incidence of self-diagnosis, including self-diagnosis of mental disorders. Although I try to give people the benefit of the doubt, on the internet I tend to be skeptical of mental illness diagnoses the are not accompanied by discussion of seeking treatment from mental health professionals. It’s just too easy for people to blame their problems on the diagnosis du jour. I say this as someone who has been diagnosed with anxiety and been treated. I believe that the diagnoses are real, but not everyone who makes them is doing so legitimately.
There are still people who claim to be “giving me the benefit of the doubt” after diagnosis. (I never suspected anything before the diagnosis I was given - I just figured I was messed up.) I recognize that you’re legitimately saying what you’re saying, yet at the same time too many people think about “the benefit of the doubt” when in fact a doubt doesn’t exist.
People accept things that conform to their worldview and reject the things that don’t, always. I used to hear “God made Adam and Eve, not Adam and Steve” and right there is a enough of a foundation for believing that liberals (or gays or transpeople) are mentally ill, but people with major depression aren’t. As the public health community deals with anti-vaxxers who are self-styled health experts, so does the mental health community deal with people who think there’s nothing that can’t be solved with a prayer or an ass-kicking.
“Liberalism is a mental disorder” was pushed heavily by Michael Weiner, aka Michael Savage, on his RWNJ talk show. I believe he still denies the validity of autism, PTSD, etc., and he’s a natural medicine kind of guy, so there again is the requirement that mental illness conform to established beliefs, or it can’t exist. Try not to be led astray by “what about service iguanas, what about safe spaces at college…” The root of the problem, as you’ve presented it, is the pervasive belief that depression and ADHD and the like are mere inventions.
Unless someone is out of touch with reality, it takes no effort to acknowledge many physical illnesses and disabilities. If I talk to someone who is missing a hand, can’t see, or can’t walk, it’s obvious. If I’m speaking to someone with ADHD or a learning disorder, I might literally have no idea if they don’t tell me. I’m not a psychologist, so when people told me this I was surprised. I don’t have the tools to diagnose people, obviously. (In both cases, they did not make a big deal about it, and did not try to gain social benefits. I met both at work.) So people are more conscious about more “obvious” illnesses; you don’t need any sort of expertise to spot those.
I think high diagnosis rates, especially ones that spike, create doubt.
Autism is a great example of this. The rates spiked because more people are getting tested for autism, and also because people who were diagnoses with other issues are getting diagnosed with autism now that the diagnostic criteria have changed. Unfortunately few people talk about the former illness terms being reduced. (We aren’t actually seeing more children with autism. We’re just changing labels, hopefully with the result of getting interventions for autistic children who need it.)
Making matters worse, autism is so “celebrated” and stereotyped. According to the link cited, 1 in 80 American children are autistic. That’s not a very high rate. However, 1 in 80 American children do not act like the stereotype. Probably none of them do. If someone who didn’t do a bit of research was told that 1 in 80 American children are autistic, I don’t think they’ll believe it, since they will have never met a stereotypical autistic child.
It’s even worse for conditions like ADHD that are literally being overdiagnosed. It might not take much for someone who thinks it’s overdiagnosed to think it doesn’t actually exist. If doctors get it wrong some of the time, perhaps they get it wrong all of the time. I don’t think it’s true, but I’m sure many people think that.
Faking It: Sadly, some people fake illnesses and conditions, and of course not just mental ones. Many people hurt their backs and can’t work in their former occupation. And there’s a few who just pretend they did, since proving that someone is suffering from pain isn’t easy. There are a lot of illnesses that are difficult to diagnose. Every once in a blue moon we’ll hear a news story about someone who claimed they had a back injury or were injured in a car accident being caught playing soccer, moving furniture, etc. It’s hopefully not common, but it happens, which ruins it for people who actually have a condition.
Sometimes it’s obvious. An emotional support peacock? There’s no registry or diagnosis for one (despite the certifications you can buy online and show to the airline). This creates doubt.
This is what Healthline says about Chronic Fatigue Disorder:
Emphasis added.
Furthermore some doctors are treating it as if it were a psychological condition. Since we don’t know what causes it, they could be right. (I think it’s not one condition, but several that share symptoms. Sort of like trying to treat many kinds of headaches headaches. So many things can cause them, you just give up on the diagnosis and take aspirin. Unfortunately, there doesn’t seem to be a “make CFS go away” pill, so actually finding out what is causing it is more important.)
We’re already conditioned to believe lots of people go on welfare because they’re too lazy to work, so it comes across as a “convenient” illness for “lazy” people who want an “excuse” to go on welfare and not work. Between the difficulty of diagnosing CFS and the stereotypes about “lazy welfare bums”, you have doubt. A person on disability for CFS can’t even fend off inquisition with the diagnosis, because the inquisitor might not believe the condition even exists.
Social Cachet: It’s something I don’t understand, but some people who have a condition make a big deal out of it. They can talk endlessly about how the condition affects them, or if they’re a parent, how much effort it takes to take care of a child with X. They may put that information all over Facebook or other social media.
How many times have people pretended to have cancer to garner sympathy or money on the Internet? Could they do the same thing with a mental illness? That creates doubt.
“Fake” Health Advice: I am nauseated by all the health advice you can get. “This diet! That diet! Eggs are healthy, they have protein! Eggs are unhealthy, they have cholesterol! This study promoted by Company A. That study promoted by Company B. This “study” written on Facebook who just typed what they wanted to believe. My doctor told me to take vitamin X pills, so you should too. If your doctor didn’t tell you that, they just want you to get sick, since they get paid every time you see them. A porn star told me not to vaccinate my kids, and I listened to her. 90% of what you eat has an impact on your risk of cancer, one way or the other.”
I pretty much close my ears to all health advice unless I get it from a doctor.
I’ll use gluten intolerance as an example of potential fakery. According to Wikipedia’s gluten-related disorders page:
So I did a quick search for “gluten intolerance rates” and that was the first link. Right underneath I saw “People also ask”
11 Ways Gluten Can Damage Your Health | Paleo Leap
Naturally they imply that everyone is gluten-intolerant (since gluten inevitably damages your gut, apparently), it’s just worse if you have celiac. Is the website trying to sell me gluten-free food? Well, they’re a diet website, so probably.
Of course, that’s a small sample size, but it was the first one I got off a quick Google search (linked from an article that appeared on the first page of the Google search).
So when I hear someone say they are gluten-free, I find myself wondering if it’s just a lifestyle thing, rather than an illness, in their case.
With this kind of health claim marketplace, it’s easy to believe that certain mental illnesses are overdiagnosed, or even don’t exist.
First off, ALL diagnoses of mental illness are political. Every. Single. One. They aren’t all necessarily political in the ways that most people think of political, but let me spell it out for you: it is a designation of a person’s thought processes as being due to brain static, meaningless gibberish generated by neurochemical or neuroelectrical misbehaviors. Now think about that. Keep on thinking about that. Got it? Yeah, it’s even more dismissive than your typical political ad hominem that categorizes your opponent’s thinking as the thinking of an immature jerk or a zealot or a foaming-at-the-mouth loon, even. Let’s grab that last one for particular comparisons. Even when we conceptualize a foaming-at-the-mouth loon, we still sort of attribute the thoughts to the batshit-insane drooling person who voices them. They get to own their thoughts, such as they are. But the clinical def of mental illness essentially says there’s no human author there. They can’t help it – their brain has been hijacked by a mental illness and this is the verbal effluent spilling out, not making any sense to the author let alone the audience.
Second, since it is political, you should not be surprised to see it used politically. The allegation of mental illness works both as an excuse for not expecting the same things of a person that would be expected of the “default citizen” (responsibility) and as a mechanism for depriving a person of adult rights as far as acting and behaving and then being held liable only for those things that are violations of law (authority).
(Authority and responsibility are the same thing, by the way. So is freedom).
Conservatives do not like people evading responsibility so they do not like the idea that someone can plead mentally ill as a way to say “expect less of me”. But they’re more often onboard with stripping people of the authority to make disruptive social statements.