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Anthony Yeung, MD's avatar

This is an excellent commentary on current society's overzealousness of focusing on "mental health" and the false equivalency with mental illness. To build on Foulke's prevalence inflation hypothesis, I might add that the overdiagnosis of certain disorders (e.g., anxiety disorders, depressive disorders, and ADHD) is actually exacerbating stigma for individuals who have the most severe phenotypes of these disorders. Those who have the most severe phenotypes of these disorders will be the most deprived of limited psychiatric resources and also have their diagnosis potentially trivialized. If everyone and their grandmother has ADHD ("if everyone has ADHD, then no one has ADHD"), then the value and meaning of the diagnosis effectively becomes watered down. It may be easy for said diagnoses to be met with a shrug if it seems everyone can get a diagnosis. I have seen this phenomenon in clinical practice, but have yet to come across a term that succinctly describes this. I am curious if you have come across any terms? My best attempt is to call it a "paradoxical stigma due to prevalence inflation."

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JustAnOgre's avatar

As a patient I like this shift. Let me explain. The words health/illness, are too binary. We need something between health and illness, neither healthy or ill.

In physical health, we would call it lack of fitness. Someone very obese, or emaciated from starvation, walking with small shuffling steps, is not healthy, not fit, but also not necessarily ill.

That is where I am mentally. Unfit, not ill. Getting an anxiety attack from taking the bus, spending whole weekends in bed. But it is not at the illness level. I am basically functional, I drag my carcass to the office, work, do every second week parenting, and not thinking of any kind of self-harm. It sucks, but it is not serious suffering.

My mind needs to get fitter. Tried a couple of things that did not work, Quiteapin, magnesium, l-theanine, l-tryptophan, GABA. I will have a two month job gap and will try to get back into exercise, surely it will help but somehow I don't feel it will be a 100% fix. I don't even have any anxious or negative thoughts, not consciously.

At any rate, what my mind needs is not the mental equivalent of a hospital, as is the case of true illness, but the mental equivalent of the fitness coach.

BTW merging Asperger Syndrome with autism was a terrible idea. The Sperg is mostly just like being Mr. Spock from Star Trek, quite functional for an engineering job.

Similarly, my kind of not-ill-but-not-healthy depression and anxiety needs to be separated from the clinical one. If that was your point, I agree. But in that case we need both, not either-or, a concept of clinical illness and a concept of lack of health.

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