Mental illnesses such as depression and anxiety disorders have become more prevalent, especially among young people. The demand for treatment is increasing and prescriptions for some psychiatric drugs have increased.
These increasing trends in prevalence are paralleled by increased public attention to mental illness. Mental health messages saturate traditional and social media. Organizations and governments are developing awareness, prevention and treatment initiatives with increasing urgency.
The growing cultural focus on mental health has obvious benefits. It raises awareness, reduces stigma and promotes help-seeking.
However, there can also be costs. Critics worry that social media sites are incubating mental illness and that commonplace discontent is being pathologized by the overuse of diagnostic concepts and “talk therapy.”
British psychologist Lucy Foulkes argues that trends for increased attention and prevalence are linked.
Her “prevalence inflation hypothesis” proposes that increased awareness of mental illness may lead some people to misdiagnose themselves when they are experiencing relatively mild or transient problems.
Foulkes’ hypothesis implies that some people develop overly broad concepts 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 vary in the breadth of their concepts of mental illness.
Why do people self-diagnose mental illness?
In our new study, we examined whether people with broad concepts of mental illness are, in fact, more likely to self-diagnose.
We defined self-diagnosis as a person’s belief that they have a disease, whether or not they received the diagnosis from a professional. We rated people as having a “broad concept of mental illness” if they judged a wide variety of experiences and behaviors to be disordered, including relatively mild conditions.
We asked a nationally representative sample of 474 US adults whether they believed they had a mental disorder and whether they had received a diagnosis from a health professional. We also asked about other possible contributing factors and demographics.
Mental illness was common in our sample: 42% reported having a current self-diagnosed condition, most of whom received it from a health professional.
(Mental Health America/Pexels)
Surprisingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.
The second most important factor after worry was having a broad concept of mental illness. When their levels of concern were the same, people with broad concepts were more likely to report a current diagnosis.
The graph below illustrates this effect. It divides the sample by levels of concern and shows the percentage of people at each level who report a current diagnosis.
People with broad concepts of mental illness (the highest quartile of the sample) are represented by the dark blue line. People with narrow concepts of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad concepts were significantly more likely to report having a mental illness, especially when their distress was relatively high.
People with greater mental health education and less stigmatizing attitudes were also more likely to report a diagnosis.
Two further interesting findings emerged from our study. People who self-diagnosed but did not receive a professional diagnosis tended to have broader concepts of illness than those who did.
In addition, younger and politically progressive people were more likely to report a diagnosis, consistent with some previous research, and had broader concepts of mental illness. Their tendency to hold these concepts more broadly explained in part their higher rates of diagnosis.
Why does it matter?
Our findings support the idea that expanded concepts of mental illness promote self-diagnosis and thereby may increase the apparent prevalence of mental ill health. People who have a lower threshold for defining distress as a disorder are more likely to self-identify as mentally ill.
Our findings do not directly indicate that people with broad concepts over-diagnose or those with narrow concepts under-diagnose. Nor do they prove it by having broad concepts the causes self-diagnosis or results in CURRENT increases in mental illness. However, the findings raise important concerns.
First, they suggest that increasing mental health awareness may come at a cost. In addition to increasing mental health literacy, it may increase the likelihood that people will misidentify their problems as pathology.
Inappropriate self-diagnosis can have negative effects. Diagnostic labels can become identity-defining and self-limiting, as people believe that their problems are stable and difficult to control.
Second, unwarranted self-diagnosis may lead people experiencing relatively mild levels of distress to seek help that is unnecessary, inappropriate, and ineffective. Recent Australian research found that people with relatively mild anxiety who received psychotherapy got worse more often than they got better.
Third, these effects may be particularly problematic for young people. They are more likely to hold broad concepts of mental illness, in part due to social media consumption, and they experience mental illness at relatively high and increasing rates.
Whether widespread concepts of illness play a role in the youth mental health crisis remains to be seen.
Ongoing cultural changes are driving ever-broader definitions of mental illness. These shifts are likely to have mixed blessings. By normalizing mental illness, they can help remove its stigma. However, by pathologizing certain forms of everyday distress, they may have an unintended downside.
As we grapple with the mental health crisis, it is essential that we find ways to raise awareness of ill mental health without inadvertently inflating it.
Jesse Tse, PhD candidate at the Melbourne School of Psychological Sciences, University of Melbourne and Nick Haslam, Professor of Psychology, University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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