Sunday, October 10, 2021

Mental Health, Respectful Dialogue, and The Urge to Diagnose Someone

 

Today is World Mental Health Day, where countries across the globe are taking the opportunity to spotlight the struggles, hope, and lives of those who live with a mental health diagnosis.  Organized by the World Health Organization, this year they are focusing on the effects that COVID-19 has had on mental health.  Sadly, things like depression, anxiety, and substance abuse have skyrocketed during the pandemic, with good reason.  People have been isolated, millions have lost jobs, millions of people lost a loved one, friend, or colleague during the pandemic.  All those things take a heavy toll on the lives of people across the globe.  Here in the United States, we have always had trouble with proper access to mental health treatment.  Long waits for providers, difficulties with finding a provider who accepts certain insurances, a lack of providers in certain areas, have all contributed to the problem.  When people cannot freely access treatment in a timely manner, their problems are only made worse.  In addition, we have seen a very sad and unfortunate rise in substance abuse disorders over the last 15-20 years.  All of these things are a crisis, and we need to continue to be vigilant about advocating for those who need treatment.  As someone who previously worked in the field of mental health, this is always a topic which means a lot to me and I will always use my voice to promote. 

There is also a stigma about mental health issues, and while we are doing much better, there is still a long way to go.  Past generations did not believe in therapists or seeking treatment.  Some believed that mental health problems did not exist.  Even today, people are not recognized as having an illness, they are deemed “emotionally weak” or “too sensitive.”  You are told to “get over it” or “pull yourself up by the bootstraps.”  Tune into any sitcom and you will hear jokes about mothers being blamed for everyone’s problems.  That is the perception of mental health to many people.  Some religions such as fundamentalist Christianity and Scientology deny the existence of mental health problems.  You are told that you have a “spiritual problem” and are discouraged from seeking or flat out denied access to mental health treatment.  There is still a lack of understanding about what mental health disorders really mean.  Some people do not understand the difference between normal human emotions and an actual diagnosis in which an individual is struggling so much that it affects their ability to function properly. 

And then there are also the unconscious stigmas.  One of those stigmas is language.  Increasingly, we are using terms in our daily language which are insensitive to those who genuinely do suffer from a mental health disorder. Using these terms do not properly describe a diagnosis and lead to misunderstanding.  This is nothing new, I have heard this language my entire adult life.  People use the words “bipolar” and “schizophrenic” on a regular basis to describe others’ behavior.  To the best of my knowledge, when non-clinicians are using the world “bipolar” it means that someone is having a mood swing.  The reality is that bipolar people do have mood swings, but they are longer and more pronounced than someone without it.  There is a build up to what is called a “manic” state, where an individual can engage in high-risk behavior, go on binges where they spend exorbitant amounts of money, speak rapidly, not sleep, and have a sense of invincibility.  Individuals do not immediately move out of this state; someone can be in a manic state for a week or more.  If they are not treated with medication, it can last over several months.  When that individual does come down from the episode, then extreme depression does set in.  People with bipolar disorder cycle back and forth between these two extremes.  As you can see, it is not just someone with a passing mood swing.  As far as the term “schizophrenic,” I have heard that used when someone is changing their minds about something, acting similar to someone being described as bipolar in which their moods are shifting, unpredictability, and any other unexplained behavior.  Schizophrenia is, in my opinion, one of the most severe and tragic of all mental health disorders.  Those who live with schizophrenia can experience hearing voices, seeing things or people who are not there, and have trouble distinguishing between actual reality versus what is occurring inside of their minds. Individuals diagnosed with schizophrenia can become extremely paranoid as well.  In severe cases, it can lead people to act out in ways up to and including physically harming themselves or someone else.  As severe as this illness is, it is not anything to use in casual conversation.  More importantly, it is not a good idea to label people’s behavior with their diagnosis.  Imagine if you had a conversation with someone and they said, “I saw John today, and he was acting very cancer.”  Or “I ran into Mary at the grocery store, and she was acting diabetic.”  Even though there are certain behaviors associated with a mental health diagnosis, it is important not to personally label people with those terms.  An individual should be defined by who they are, and not their diagnosis. 

Another thing that I see on the rise are people who instantly “diagnose” others with a mental health diagnosis.  I am increasingly hearing people say things like, “So-and-so is on the spectrum.”  Autism has exploded in its diagnosis throughout the past 20 years or so.  As our understanding of autism increases, we find that it occurs on a scale.  Some individuals may have mild symptoms, others severe.  The term “spectrum” has been used to describe several different distinct types of autism.  It is impossible for anyone to meet another individual and proclaim five minutes later that the person is “on the spectrum.”  When meeting an individual with autism, they may present themselves as “quiet” or “withdrawn” but those behaviors can be ascribed to millions of other people as well.  That does not necessarily mean they are diagnosed with autism.  Or they may not.  Individuals with autism can present themselves in many ways, including extroversion. Autism is a complex disorder in which an individual has trouble communicating with others, especially about their emotions.  In severe cases, those with autism may rarely speak.  Thus, it is very important to understand the full diagnosis of autism without immediately rushing to judgement about someone’s behavior. 

Narcissism is a word that is freely thrown around in today’s society.  In a sense I can understand that, because there are certain mass behaviors that could be considered “narcissistic.” Generally speaking, narcissism simply means self-love and adulation.  Narcissism also means that someone is so self-consumed that they fail to see the humanity and needs of others.  Sadly, that is a basic human behavior that has existed as long as mankind has.  It will continue.  In today’s society, people’s love of social media, particularly posting pictures of themselves excessively, could be considered narcissistic.  Even though we all have a right to express our opinions, there are countless millions of people who believe that their voice is more important or more informed than others.  They will take to media such as Twitter, Facebook, or YouTube to let everyone know what they think.  Others have full channels devoted to the exploits of their lives and families.  A lot of us feel like other people’s families are not that interesting but apparently, they are, as these channels do enjoy a lot of success.  You give people a camera and a platform to be seen on, and they sure use it.  I believe that because of this, people throw the term narcissism around freely.  There are thousands of YouTube videos devoted to the subject, and it is something where people tend to pronounce someone as narcissistic.  Most times, it is seen with people who are famous.  So many times over I have seen Bachelor contestants, Survivor contestants, other reality show contestants, etc. being described and diagnosed as narcissistic.  Reality television are not proper demonstrations of a person’s complex behaviors and cannot be taken seriously.  And while narcissism can be a behavior which alienates a lot of people, it often does not rise to a clinical level.  There is an actual diagnosis of Narcissistic Personality Disorder. Here is a description of how it is diagnosed:

Narcissistic-Pathology-Quotes-Handout.pdf (drcachildress.org)

 

Because these people have such an inflated sense of self, they will rarely be found in psychotherapy.  It is very difficult to treat for that reason.  There are certain famous individuals who are speculated to have NPD, including Tom Cruise.  While I do think that there is that possibility, it is only conjecture.  I have two individuals in my own life who meet 4 of the 9 criterion for NPD.  Trust me, they are very difficult to deal with, one more than the other.  (How these two are in relationship to one another is something I will not touch with a ten foot pole.)  -foot pole.)  But, I am not proclaiming them “narcissists.”  Realistically, nobody should be diagnosing anyone, either.  Yes, human behavior can get messy and unwanted.  And no, it does not mean that someone with an education in psychology or social work has all of the answers and is on a different plane than others.  But we generally need to be very careful about “diagnosing” others because it is a slippery slope.  It promotes misunderstanding of complex mental health issues.  And it is really not ethical or kind to make snap judgements about people’s behaviors.

In conclusion, how can you best help someone you suspect may have a mental health disorder?  The first and most important thing you can do is treat them with kindness and respect.  When someone is feeling depressed or anxious, they need to feel like others are on their side and care and will respond in kindness and non-judgement.  More importantly, you can encourage them to connect with a therapist or psychiatrist.  If they need you to, go with them to their first visit or babysit their children so that they can go to their first visit and have uninterrupted time.  It can be very fearful or intimidating the first time someone seeks professional help for a suspected mental health disorder.  So, if you can support that person, please do so.  Make sure to follow up with that person and let them know that you are always there to talk to them and will be an ally in their journey towards recovery.  Person by person is how we will create a world in which those who have a mental health diagnosis will thrive. 

 

 

 

 

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