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The authors hypothesize that for some children, framing their struggles as mental health disorders that require treatment can actually worsen their situation by

The authors hypothesize that for some children, framing their struggles as mental health disorders that require treatment can actually worsen their situation by causing them to ruminate on it. Anecdotally, this isn’t limited to adolescents. There is a weird trend toward over-diagnosing common life struggles as major clinical health issues requiring intervention. I think this comes from a place of good intentions, where people don’t want to miss anyone who might have a major mental health issue that will benefit from treatment. However, over-diagnosing mental health conditions and convincing kids they even common struggles are actually mental health issues that require advanced treatment techniques has the opposite effect of amplifying common struggles into something much bigger. There’s a secondary phenomenon in some demographics wherein having a mental health diagnosis is perceived as providing some social advantage, as weird as that sounds. This isn’t just conjecture, it’s actual policy in some schools. It’s well-known among kids that having an ADHD diagnosis will grant people extra time to take tests in some schools, which becomes a cheat code for getting a leg up. I’ve also witnessed young adults swapping tips on how to say the right things to get certain mental health diagnoses and get specific drugs: Xanax for anxiety, etc. They were even swapping names of doctors and notes about who was more lenient about prescribing certain drugs in a Slack community. Coming up with rules to stop that behavior without triggering complaints about stigmatizing mental illness was a challenge.

naasking 4y ago
> The authors hypothesize that for some children, framing their struggles as mental health disorders that require treatment can actually worsen their situation by causing them to ruminate on it. Not just to children, just in general, the narratives we use to interpret the things that happen to us can actually cause more harm than the event itself. Simplistic example, but take a culture where scars are a mark of pride, say from surviving battle, compared to one where they are seen as ugly and so shameful. The physical harm in each case is the same, but the mental impact is very different. We even see this in trauma, like with sexual assault. Being pitied and told something that happened to you was the worst thing that can possibly happen to someone, it makes a far worse mental impact than it otherwise might have made without that framing. There are a number of reasons for this, but I think in general, disempowering people by removing their sense of control and the notion that they're resilient becomes something of a self-fulfilling prophecy. Sometimes, some people really are less resilient or lose their sense of control in some circumstances, and then they do need that help, but that should probably not be the default approach. We've had a bit too much of an over correction to the old, "suck it up and walk it off" mentality.
- TedDoesntTalk 4y ago
  I wish I understood this many years ago.
Spooky23 4y ago
When I was in college in the 90s some of the fraternities had systemized this. You’d get a diagnosis, get a drug that had value for sale or you could take it, and the reasonable accommodation for ADHD was taking a test in a private room with open book. I was pissed when I found out as tests were usually graded in a curve, and these idiots broke the curve for the rest of us.
- kofejnik 4y ago
  Not idiots, though
bawolff 4y ago
I would argue that any test which is a race against the clock is a bad test. Whatever you are trying to test you are almost certainly not measuring (i suppose reality doesn't care and people still have to deal with bad tests).
- ryan93 4y ago
  Basically every test has a time limit in school. No one save a small number of learning disabled kids struggles to finish in time. If it takes you the whole time you don't know it!
  - quacked 4y ago
    The fact that nearly every test has a time limit isn't proof that time limits are useful. Furthermore the majority of tests taken in school are completely forgotten even a year later, meaning that students didn't "know" the information in the first place, they were just able to regurgitate it for a useless exercise in stress and make-work.
    - naasking 4y ago
      Tests are useful as spaced repetition, and spaced repetition is good for remembering. That students may not remember a specific test a year later doesn't seem relevant. Time limits are necessary because everything is time limited, even when applying this knowledge in a job, and if you're struggling to finish in time, then that indicates areas that need work.
      - bawolff 4y ago
        Most (tech) jobs put a premium on being right over being fast. Nobody cares if you get the wrong answer quickly. Person who takes longer but gets a better answer will usually do better in their career.
        naasking 4y ago
nerdponx 4y ago
> There is a weird trend toward over-diagnosing common life struggles as major clinical health issues requiring intervention. I think this comes from a place of good intentions, where people don’t want to miss anyone who might have a major mental health issue that will benefit from treatment. However, over-diagnosing mental health conditions and convincing kids they even common struggles are actually mental health issues that require advanced treatment techniques has the opposite effect of amplifying common struggles into something much bigger. My subjective unprofessional opinion is that this tendency is also an over-compensation in trying to destigmatize mental illness, and to treat mental illness as illness and sufferers thereof as victims, rather than blaming them for lacking motivation or whatever unempathetic BS people used to think. Hopefully this is a short-lived trend and things will balance somewhere a little more sensible. > There’s a secondary phenomenon in some demographics wherein having a mental health diagnosis is perceived as providing some social advantage, Mental illness had some degree of social gravity (not necessarily clout or advantage) when I was a teenager back in the "emo" and "scene" days of the 00s. The phenomenon has clearly evolved somewhat, but I don't think it's entirely new. What is new is its reach.
PuppyTailWags 4y ago
I would take the "tips on how to say the right things" in a more favorable light. It can be extremely difficult to get proper help or diagnosis, especially if you're marginalized (gay, black, female, transgender, poor, bad at speaking...) I've definitely seen shit like black boys not being diagnosed with autism or young girls not getting diagnosed with adhd
BurningFrog 4y ago
There is also profit in diagnoses. For the diagnoser.

naasking 4y ago

> The authors hypothesize that for some children, framing their struggles as mental health disorders that require treatment can actually worsen their situation by causing them to ruminate on it. Not just to children, just in general, the narratives we use to interpret the things that happen to us can actually cause more harm than the event itself. Simplistic example, but take a culture where scars are a mark of pride, say from surviving battle, compared to one where they are seen as ugly and so shameful. The physical harm in each case is the same, but the mental impact is very different. We even see this in trauma, like with sexual assault. Being pitied and told something that happened to you was the worst thing that can possibly happen to someone, it makes a far worse mental impact than it otherwise might have made without that framing. There are a number of reasons for this, but I think in general, disempowering people by removing their sense of control and the notion that they're resilient becomes something of a self-fulfilling prophecy. Sometimes, some people really are less resilient or lose their sense of control in some circumstances, and then they do need that help, but that should probably not be the default approach. We've had a bit too much of an over correction to the old, "suck it up and walk it off" mentality.

TedDoesntTalk 4y ago
I wish I understood this many years ago.

Spooky23 4y ago

When I was in college in the 90s some of the fraternities had systemized this. You’d get a diagnosis, get a drug that had value for sale or you could take it, and the reasonable accommodation for ADHD was taking a test in a private room with open book. I was pissed when I found out as tests were usually graded in a curve, and these idiots broke the curve for the rest of us.

kofejnik 4y ago
Not idiots, though

bawolff 4y ago

I would argue that any test which is a race against the clock is a bad test. Whatever you are trying to test you are almost certainly not measuring (i suppose reality doesn't care and people still have to deal with bad tests).

ryan93 4y ago
Basically every test has a time limit in school. No one save a small number of learning disabled kids struggles to finish in time. If it takes you the whole time you don't know it!
- quacked 4y ago
  The fact that nearly every test has a time limit isn't proof that time limits are useful. Furthermore the majority of tests taken in school are completely forgotten even a year later, meaning that students didn't "know" the information in the first place, they were just able to regurgitate it for a useless exercise in stress and make-work.
  - naasking 4y ago
    Tests are useful as spaced repetition, and spaced repetition is good for remembering. That students may not remember a specific test a year later doesn't seem relevant. Time limits are necessary because everything is time limited, even when applying this knowledge in a job, and if you're struggling to finish in time, then that indicates areas that need work.
    - bawolff 4y ago
      Most (tech) jobs put a premium on being right over being fast. Nobody cares if you get the wrong answer quickly. Person who takes longer but gets a better answer will usually do better in their career.
      - naasking 4y ago

nerdponx 4y ago

> There is a weird trend toward over-diagnosing common life struggles as major clinical health issues requiring intervention. I think this comes from a place of good intentions, where people don’t want to miss anyone who might have a major mental health issue that will benefit from treatment. However, over-diagnosing mental health conditions and convincing kids they even common struggles are actually mental health issues that require advanced treatment techniques has the opposite effect of amplifying common struggles into something much bigger. My subjective unprofessional opinion is that this tendency is also an over-compensation in trying to destigmatize mental illness, and to treat mental illness as illness and sufferers thereof as victims, rather than blaming them for lacking motivation or whatever unempathetic BS people used to think. Hopefully this is a short-lived trend and things will balance somewhere a little more sensible. > There’s a secondary phenomenon in some demographics wherein having a mental health diagnosis is perceived as providing some social advantage, Mental illness had some degree of social gravity (not necessarily clout or advantage) when I was a teenager back in the "emo" and "scene" days of the 00s. The phenomenon has clearly evolved somewhat, but I don't think it's entirely new. What is new is its reach.

PuppyTailWags 4y ago

I would take the "tips on how to say the right things" in a more favorable light. It can be extremely difficult to get proper help or diagnosis, especially if you're marginalized (gay, black, female, transgender, poor, bad at speaking...) I've definitely seen shit like black boys not being diagnosed with autism or young girls not getting diagnosed with adhd

BurningFrog 4y ago

There is also profit in diagnoses. For the diagnoser.