Elizabeth Barrette (ysabetwordsmith) wrote,
Elizabeth Barrette

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The Issue of Diagnosis

I spotted this today:

Why Do We Need A Diagnosis to See Mental Disorders As Real?

We don't. A mental problem is frequently obvious from the inside, though some people don't recognize or try to deny theirs. A diagnosis is needed to make other people see a mental problem as something they are obliged to address.

The issue with this is that it abdicates responsibility and compassion for bystanders, agency and trust for sufferers. If you have a problem, you don't matter. No matter how bad it is -- you could literally be dying of it, that happens a lot -- nothing will be done unless you can convince someone who matters that it's a problem and gain their permission to have it addressed. You don't matter; your problem doesn't matter; only the important people matter. If they say you don't have a problem, you will be treated as if you don't. If they say you have a problem, even if you are perfectly healthy, you will be treated as if you do. The facts are irrelevant; only the power matters.

Except that's all bullshit. Extremely few mental problems have a scientific diagnosis, the way a heart attack or an infection can be measured with objective tests. The vast majority of them are just descriptions of symptoms, many of which appear across multiple diagnoses, and the assessment of whether something is "bad enough" to "count" is highly subjective. It's all about convincing someone that your suffering is worthy of attention. If you belong to a disadvantaged group, the important people are unlikely to believe you or care even if you are indeed dying right in front of them. Conversely if they see an advantage to describing you as sick, they will do so regardless of the truth, no matter how obvious it is. This is an issue regarding prescription drugs in particular, since corporations wish to sell them. Sometimes they're useful, other times not, and they can be very destructive. People who want help can't get it; people who want to be left alone are dragged into "care" and forcibly violated in mind and body. The system is a mess.

Look at the things that have gone in and out of the diagnostic manuals over the decades. Homosexuality used to be considered a mental illness. Now grief is, if you dare to show it more than briefly. So. Much. Bullshit.

Mental problems are real. They can be illnesses or injuries. They can be small or large. They can be fixable or not. We need to understand them and deal with them, preferably when they are small and fixable, not leave them entirely up to experts who have a lot of conflicting interests and are minimally available anyhow. The current system is not serving people well. People made it; people can change it if they choose to do so. Or they can walk away and try some other solution instead.

In the UK and the US, lifetime prevalence rates are estimated to be roughly 1 in 6 and rising. What explains these rates and what ought we to do about them?

Basically, modern life is a shitty environment for human beings. Humans are social, but families are fragmenting and a more mobile population struggles to maintain meaningful ties. Most humans need stability, but job security is long gone and the social safety net is in ribbons. School is typically designed to meet the desires of powerful adults, not the developmental needs of children, which makes it harder to grow up at all. The planet is overheating with dire results, so everyone absolutely has concrete reasons for feeling existential dread. This is not a recipe for healthy, happy people. And "it is no great sign of health to be well adjusted to a profoundly sick society."

"The fact that we require people to be labeled with a disorder to be worthy of care is an indictment of our collective moral community"

No shit. If someone says they're hurting, don't blow them off. Do something about it. And don't be a dick while you're at it.

To stop the rising rates of mental disorders, don’t just ask what’s wrong with people who have one. Ask what’s wrong with our world and what we need to change about ourselves.

So let's get on that.

* Advocate for mental health access if you wish, but don't expect powerful people to respond readily. They benefit from the mess we have now, and they aren't paying attention to the drawbacks. Expect that you will have to do the work yourself.

* Make your environment as healthy as you can with the resources available to you. Connect with it. Build your resilience. Strengthen your support network. Take good care of yourself. These will help you weather the rough spots.

* A quiet room and/or a sunny window ease stress and lift spirits. You can establish these at home, at work, or any other space you control; and encourage people to make them elsewhere by pointing out the advantages or offering to help.

* When you encounter a problem:
- Identify your thoughts and feelings. Are you safe? Are you grieving? Are you looping?
- Search for possible causes.
- Brainstorm solutions.
- Try to solve it yourself.

If that doesn't work:
- Research more about the problem.
- Talk to friends or other confidants.
- Try some new solutions.

If you run out of ideas, consider whether expert help is available, affordable, and likely to be both safe and effective. Sometimes it's very useful, other times useless or downright harmful. If they refuse to help, which is common -- mental care is rarely available until problems get truly dire -- then try to find other people with similar complaints and help each other. For some things this may even be more effective, such as trying to live with a brain that works very differently than the usual. People with typical brains aren't very good at solving atypical challenges, but other atypical people have probably been there before and may know just what to do.

* Don't give up your agency. It's your body, your brain, your mind, your life; you can figure out how to cope with it one way or another.

* When someone else has a problem, listen and validate. That alone will put you ahead of most responses. Offer help, but don't pester. Even if you can't fix anything, which is sometimes true, you can still be there with them. Many support methods work for online friends too.

* Work to reduce violence at school and other places.

* Know emotional first aid. Have a self-soothing kit available for life's inevitable upsets. Promote emotional first aid for adults. This is every bit as necessary as having a physical first aid kit and knowing how to use it so a scratch doesn't cost you a finger.

* You may need to do emotional triage in an emergency.

* Be prepared to cope with stressful situations and emotional drop. Avoid compassion fatigue. Shit happens.

* Anyone can go nonverbal under enough stress, and there are ways to get through it.

* Know how to let go of things. Everyone needs to sometimes, especially shame.

If you don't like the way things are, change them. Reach out and make something happen. Humans are equipped with forebrains and thumbs for a reason. Use them.
Tags: community, family skills, how to, life lessons, networking, safety
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