I was recently asked this question in an interview about mental health:
“Half of all young people in their 20s are labeled with (or label themselves with) a mental disorder (anxiety, depression, etc.). How did we get here? Are these diagnoses accurate?”
It was a great question, and I wonder about the answer to that question myself as a professional treating mental health conditions day-to-day. I don’t know if “half” our young people label themselves, but definitely more than in the past.
It has become common to see a young person in her twenties bounce in to clinic, plop down, and energetically report that she feels terrible. She says she is anxious. But she doesn’t look anxious. She says she is depressed. But she doesn’t look depressed. And while it is possible for someone to feel terrible and hide her feelings, I’m conducting a clinical examination as a trained physician specializing in mental health. Some of the young people coming in telling me they are in bad mental health shape appear mostly normal.
Sure, they have stress. They feel down. They get overwhelmed with some of the responsibilities of growing up. But if I compare the young people I’m seeing today to the ones I was seeing 15 years ago, the young adults today are coming with milder symptoms, and heightened concern about the symptoms they are experiencing.
So, how did we get here?
1. It may be a side effect of raising public awareness about mental health conditions like depression and anxiety. We have brought mental illness to the front of people’s minds. And we have inadvertently created a side effect of pathologizing some aspects of normal experience. Everybody has anxiety and sadness, and now by raising awareness, we have encouraged young impressionable people to believe their feelings are something abnormal- that worry and sadness are equivalent to clinical anxiety and depression.
2. The written criteria for mental disorders can be easily misused to label almost anyone with a mental disorder. Now that mental health criteria can be searched up online, it’s easy to see oneself in the list of experiences that add up to an illness.
3. Our kids are reaching adulthood without the kinds of life skills previous generations had. They have been overscheduled, overprotected, and had little time to make decisions on their own. When they arrive to adult roles, they may feel completely overwhelmed.
4. Substance abuse is soaring. Research shows that young people drink a lot. Cannabis use is extremely prevalent. Using substances may interfere with learning healthy coping skills.
5. Social media use has increased, and it may make us all miserable. A lot of studies support this idea.
These theories on how we got here point to some obvious solutions:
- Normalize the parts of the human experience that can be normalized, while still compassionately caring for the people suffering with mental illness.
- Leave the labeling to the experts, and train the experts to use the criteria correctly. Or in some cases, re-write the criteria to clearly exclude normal experiences.
- Teach kids adult skills so they feel ready for adulthood. Focus on skills for those who arrived to adulthood without them, and don’t encourage the idea that feeling overwhelmed by a lack of life skills is a mental disorder.
- Encourage miserable young people to try a period of full sobriety and a social media break to see if those changes make things better.
- Encourage exercise, healthy diet, mindfulness skills, spirituality, community, and healthy outlets.
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