‘High-Functioning Anxiety Isn’t a Medical Diagnosis. It’s a Hashtag.’ | NYT Opinion

Soaring rates of anxiety and depression among adolescents. Medical groups declaring a “national emergency.” The surgeon general calling for an “all of society” response to a “devastating” mental health crisis among young people.

By all indications, kids these days are in rough shape, giving additional urgency to Mental Health Awareness Month, which began on May 1. But in the Opinion video above, Lucy Foulkes, an academic psychologist at Oxford University, argues that the problem may not be a lack of awareness but rather too much.

Amid an enormous societal push to destigmatize mental illness and encourage more conversation about emotions, young people have been flooded with mental health information on social media and elsewhere. But much of it is unreliable and counterproductive.

“I’m deeply concerned that this awareness craze,” Foulkes says, “is ironically making their mental health worse.”

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[apexnext]

One of the things my psychologist really drilled into my head when he was giving my diagnosis, was that this diagnosis is *NOT* a personality.

[jackwheeler]

I worry that many young people implicitly believe that unless their experience constitutes a medical condition, it isn’t worthy of attention. In some ways, I think reaching for psychiatric terminology is a way of trying to signal to oneself that one’s feelings are real and matter.

[brantheprate]

As someone who has had dreadful depression in the past that destroyed entire years of my life, I get really annoyed whenever people try to out-depress each other for social clout when it's trending to be unwell.

[jthoma]

I just finished my psych degree, I've been part of research team and presented our findings at the SPSP conference and I start grad school for clinical mental health counseling in the fall. This video is absolutely spot on. What's worse about these arm chair diagnostics is the 3rd order effects it's creating. People are using a self diagnosis to shield themselves from accountability or to avoid addressing an underlying issue that would normally lead to strengthening their well being. Look at how many relationships are ending because their ex partner was a "narcissist", which let's them conveniently avoid any accountability for their own actions while putting all of the blame on their partner.

Stop pathologizing normal feelings and behaviors. Being sad doesn't mean you're depressed. Anxiety is a normal response to the unknown or difficult challenges. Seeing a situation in a different way from your partner doesn't mean you're gaslighting them. Instead, just speak YOUR feelings and what's going through YOUR mind as you're feeling it.

[sergio.ssantos]

"Are you consuming too much social media?"

[AvocadoPear]

It isn’t a surprise to me that young people struggle more to function and find their way in the world as it is today. Social media is one aspect of the problem, but also just look at how much more difficult it is to establish yourself in the world as you become an adult. Post-secondary education is more expensive than ever, wages are lower than ever (relative to inflation), the cost of living has become astronomical, and the deleterious effects of climate change are becoming more and more apparent in many people’s lives.

Rather than point out flaws in society, it’s much easier to point to flaws in individuals and pathologize feelings of discomfort, discontentedness and stress that are absolutely reasonable for a young person to have when living in a difficult environment. It’s easier to commodify mental health disorders to tell kids, “you’re the problem because your brain is sick” than it is to take a long hard look at the messed up world that kids are being handed today.

And it’s especially sad because many kids fully believe it. They feel so disempowered to change the environment they exist in that it feels more reasonable to say “I must have a problem.”

[farinizam]

Love this take on anxiety, for a while I have been feeling like there are more and more people that have been rising to talking about anxiety but also self-diagnosing anxiety.

[rach]

I am a young person and hate how people in my age group self diagnose. Literally all my family members in my age group are self diagnosing themselves with autism and anxiety. They will even claim going to the doctor is stupid. They look down on me who went to the doctor and got a proper diagnosis rather than self diagnose. I have actually been diagnosed with depression, anxiety and bipolar disorder. My mental struggles are not a joke and are not self diagnosable. This is insanity at the highest level and belittles the struggles of actual sufferers of mental illness

[ice]

I 100% agree..and as a teenager its really getting out of hand, almost everyone in my class / school somehow has anxiety or depression or something else without even visiting a psychologist

[heylisten]

A couple things:
- Nocebo really resonates with me. I’ve been doing a lot of research on some of my bad mental patterns recently, and it definitely helps to be aware of nocebo.
- I think it’s hard because these things all exist on a spectrum. I saw a therapist for the first time a few months ago, and he wrote generalized anxiety disorder down on my profile, but I don’t know if my anxiety is that bad. But I also have a lot of friends on anti anxiety / depression medication who don’t seem to have it any worse than I do.
- As you mention, I think people are just looking for labels, and most mental health labels come from quite severe conditions.

[emmaponymous]

About ten years ago a YouTuber noted that mental illness wasn't stigmatized, it was romanticised, afterall it had its own merch proclaiming the buyer's struggle with depression and/or anxiety. I've never seen Crohn's disease merch, or hypercholesterolemia merch.

[devonnahwoodruff]

I think needs to be treated in a very exceptionally nuanced way. As someone with diagnosed GAD, it's easier to say high functioning anxiety, because I mask that I have it. So well, I didn't know I had it.

I was complaining about all over physical pain at a doctor and she asked had me take a questionnaire and asked if I tried anxiety meds. Oddly enough was going to PT at the time for a tweeked back. Every time I went my PT would ask why my muscles were so tense. After I started the meds I felt physically better. And the first PT visit I had after starting, she asked what I had done because my muscle tone was normal. Also finally figured out one of my physical symptoms I got from time to time (my esophagus trying to choke me) really was anxiety attacks.

When it comes to teenagers, I think we should be more conservative about handing out mental diagnosis. The hormones are wild, the brain is still developing, its an awkward time. Therapy is good to teach how to regulate emotions, but we should be extra sure before handing them drugs to fix the problem.

[bkeisvi]

Thank you! I thought I was the only one who felt this way! Took the words right out of my mouth. I’m someone who actually suffers with a load of real mental health issues and am seeing people around me self diagnose themselves. I have never self diagnosed myself and I never post anything like that. I wish more people spoke up about the glorifying of mental health issues. I have suffered from multiple mental health issues and been diagnosed since I was 5. It wasn’t me who realised I had these problems, but my parents. They effect me so much.

[shethewriter]

Being miserable is largely just part of being human. Some people actually can't function, or have episodes they can't leave their home for weeks or months at a time. It's really awful that those things are being conflated with commonplace misery because it silences those who need actual intervention.

[josephberg]

This was so well put, and I'm glad it came across my feed. It's something I've been noticing the past few years and it's great to see others noticing too.

[dontworryaboutit]

I've felt this way for several years now. I used to have a friend who would describe themselves as having Obsessive-Compulsive Disorder because they liked a clean apartment. No, you don't have OCD! It is normal to enjoy a tidy, uncluttered living space. Are you obsessed with it? Are you compulsively cleaning? No! Sure, you could learn to unwind a little, but you don't have OCD.

We are pathologizing every negative mood, emotion, or behaviour, while in reality we are animals with very complex social lives that have peaks and valleys. Some people have different tendencies and personalities than others too: deeper social wells, a greater tolerance for stress, more comfortable public speaking, more introverted, others more extroverted, etc. Embrace who you are.

I'm not sure where the balance lies, I suppose that is Dr. Foulkes job. I'm glad she is talking about it.

[ianrlack]

I don’t know about the high-functioning part, but I was diagnosed with generalized anxiety disorder a few years ago. Doesn’t feel like it’s treatable, but it’s manageable with the right coping mechanisms: exercise, mental exercises, therapy and time off from work.

[tobynsaunders]

Thank you for that reporting. We need a lot more of that kind of clear thinking in journalism against pernicious but well-intended cultural, viral phenomena.

[aSpectrumofDorky]

I think it’s important for people to note that mental illness and health operates on a spectrum. There are reasons why certain disorders are comorbid. There are also reasons why there are some diagnoses that pretty much say, “your issues fall into this category of disorders but you don’t quite check the boxes for very specific conditions.”

You can have traits that are characteristic to a disorder without having that disorder. I thought I was bipolar for years. Turns out I was adhd, autistic, and VERY burntout (officially diagnosed).

[Shmancyfancy]

I have OCD and it’s been debilitating. I really think 80% o these people claiming they have a “condition” are just looking for attention.

Life in general is pretty stressful. That doesn’t mean you have a mental condition.