Mental illnesses such as depression and anxiety disorders are becoming increasingly common, especially among young people. Demand for treatment is soaring and prescriptions for some psychiatric medications have increased.
These rising prevalence trends are paralleled by growing public attention to mental illness. Mental health messages are pervading traditional and social media. Organizations and governments are developing awareness, prevention, and treatment initiatives with increasing urgency.
The increasing attention to mental health in today’s culture has clear benefits: it increases awareness, reduces stigma, and encourages help-seeking.
But it can also come at a cost. Critics worry that social media is a breeding ground for mental illness, and that ordinary misery is pathologized through the overuse of diagnostic concepts and “therapeutic discourses.”
British psychologist Lucy Foulkes argues that the trends of increasing attention and prevalence are linked. Her “prevalence inflation hypothesis” suggests that increased awareness of mental illness may lead some people to misdiagnose themselves when they suffer from relatively mild or transient problems.
Foulkes’ hypothesis implies that some people develop overly broad conceptions of mental illness. Our research supports this view. In a new study, we show that concepts of mental illness have broadened in recent years—a phenomenon we call “concept creep”—and that people differ in the breadth of their conceptions of mental illness.
Why do people self-diagnose mental illnesses?
In our new study, we examined whether people with a broad conception of mental illness are, in fact, more likely to self-diagnose.
We defined self-diagnosis as a person’s belief that they have an illness, whether or not they have received a diagnosis from a professional. We assessed people as having a “broad conception of mental illness” if they considered a wide variety of experiences and behaviors to be disorders, including relatively mild conditions.
We asked a representative sample of 474 U.S. adults whether they thought they had a mental disorder and whether they had received a diagnosis from a health professional. We also asked about other possible contributing and demographic factors.
Mental illness was common in our sample: 42% of respondents reported having a self-diagnosed health condition, the majority of which had been diagnosed by a healthcare professional.
Unsurprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.
The second most important factor after distress was having a broad conception of mental illness. When their level of distress was the same, people with a broad conception were significantly more likely to report a current diagnosis.
The graph below illustrates this effect. It divides the sample by distress levels and shows the proportion of people at each level who report having a current diagnosis. People with a broad conception of mental illness (the highest quarter of the sample) are represented by the dark blue line. People with a narrow conception of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with a broad conception were much more likely to report having a mental illness, particularly when their distress was relatively high.
People with greater knowledge of mental health and less stigmatizing attitudes were also more likely to report a diagnosis.
Two other interesting findings emerge from our study. People who self-diagnosed but did not receive a professional diagnosis tended to have a broader conception of the disease than those who received one.
Additionally, younger and politically progressive people were more likely to report a diagnosis, consistent with some previous research, and had broader conceptions of mental illness. Their tendency to endorse these broader concepts partly explained their higher rates of diagnosis.
Why is it important?
Our findings support the idea that broad concepts of mental illness promote self-diagnosis and may thus increase the apparent prevalence of poor mental health. Individuals who have a lower threshold for defining distress as a disorder are more likely to self-identify as having a mental illness.
Our results do not directly demonstrate that people with broad concepts overdiagnose or that those with narrow concepts underdiagnose. Nor do they prove that having broad concepts causes self-diagnosis or results in real Mental illness is increasing. Nevertheless, these findings raise significant concerns.
First, they suggest that greater awareness of mental health could come at a cost. In addition to improving mental health knowledge, it could increase the likelihood that people will misidentify their problems as pathologies.
Inappropriate self-diagnosis can have adverse effects. Diagnostic labels can become identity-defining and self-limiting, as people come to believe that their problems are enduring, hard-to-control aspects of their personality.
Second, unwarranted self-diagnosis can lead people experiencing relatively mild levels of distress to seek unnecessary, inappropriate, and ineffective help. A recent Australian study showed that people with relatively mild distress who received psychotherapy experienced worsening more often than improvement.
Third, these effects may be particularly problematic for young people. They are more likely to hold broad conceptions of mental illness, in part because of their social media consumption, and they suffer from mental health problems at relatively high and increasing rates. Whether broad conceptions of illness play a role in the youth mental health crisis remains to be determined.
Ongoing cultural shifts are promoting increasingly expansive definitions of mental illness. These changes are likely to have mixed positive effects. By normalizing mental illness, they may help eliminate its stigma. However, by pathologizing some forms of everyday distress, they may have unintended negative effects.
As we grapple with the mental health crisis, it is essential that we find ways to raise awareness of mental health issues without inadvertently making them worse.
This article is republished from The Conversation under a Creative Commons license. Read the original article.