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540 points drankl | 41 comments | | HN request time: 2.664s | source | bottom
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parpfish ◴[] No.44485690[source]
Decades ago in my first abnormal psych course, the prof warned us that there was an almost iron-clad law that students will immediately start self diagnosing themselves with “weak” versions of every disorder we learn about. In my years since then, it has absolutely held true and now is supercharged by a whole industry of TikTok self-diagnoses.

But there are a few things we can learn from this:

- if you give people the chance to place a label on themselves that makes them feel unique, they’ll take it.

- if you give people the chance to place a label on themselves to give a name/form to a problem, they’ll take it.

- most mental disorders are an issue of degree and not something qualitatively different from a typical experience. People should use this to gain greater empathy for those who struggle.

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1. zug_zug ◴[] No.44485765[source]
It's interesting because there are two diametrically opposed ways to interpret what you said

One is - everybody thinks they have disorders, so just ignore that feeling it'll mess with you.

The other is - everybody thinks they have minor version of disorders, because we all do, we live on continuums, and therefore we should probably all think about it more

replies(7): >>44485878 #>>44485902 #>>44485910 #>>44486037 #>>44486133 #>>44486252 #>>44487076 #
2. Retric ◴[] No.44485878[source]
Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a label past the point of meaning.
replies(2): >>44486041 #>>44489837 #
3. gg82 ◴[] No.44485902[source]
The other idea is that people who go into the field are screwed up themselves... and are trying to work out how to treat/understand themselves.
4. orn688 ◴[] No.44485910[source]
In my experience the truth is somewhere in the middle. It's helpful to neither completely ignore nor ruminate over one's traits, but just _be aware_ of them.

It's been very helpful for me to pay attention to and think about how my own personality compares to others'. For example, I tend to be a people-pleaser, but I used to think that everyone was just as people-pleasing as me, which only reinforced the people-pleasing because I didn't feel right putting my own needs first when everyone else was already sacrificing their own needs (or so I assumed).

At the same time, medicalizing these things paints them as "abnormal" disorders that need to be "cured", overlooking any of the positives these traits bring. When it comes to my people-pleasing, I like it about myself that I care about others. As long as I recognize that it sometimes comes at my own expense, I can begin to make more conscious decisions about when to allow the people-pleasing to flow versus when to try to subdue it.

replies(1): >>44486212 #
5. rf15 ◴[] No.44486037[source]
there's a third: everyone wants to feel special and also takes any excuse to not have to work on their flawed habits
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6. cheschire ◴[] No.44486041[source]
So it’s a 1 or a 0? The kid is either full autistic or just a socially maladjusted asshole? No room for a middle ground with you then?
replies(2): >>44486113 #>>44486125 #
7. zug_zug ◴[] No.44486107[source]
There's an odd presumption there...

It sounds like you're presuming those who put a label on themselves don't want to change themselves at all; one could also imagine that those who put a label on themselves want to change themselves most of all

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8. Yossarrian22 ◴[] No.44486113{3}[source]
It’s a 1 if it goes above 0.6
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9. Retric ◴[] No.44486125{3}[source]
That’t not it, what many disorders are describing isn’t just the obvious symptoms.

ICE engines heat up because they burn fuel, but if it’s overheating in normal operation that’s from something else breaking down.

Not that people are so simple, but that transition point to disorder often represents a meaningful transition.

replies(2): >>44486174 #>>44486181 #
10. ◴[] No.44486133[source]
11. wredcoll ◴[] No.44486174{4}[source]
Much like addiction, a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life.

As the guy said, if you think you hear voices but they tell you to go to sleep on time and do a good job at work, you probably don't need treatment.

replies(1): >>44488228 #
12. Mtinie ◴[] No.44486181{4}[source]
An engine is an assembly of parts. When an engine breaks down it does so because it broke down. An engine does not exist without its cylinders, fuel system, gaskets, lubricants, etc.

I believe your analogy is flawed. Can you restate your first statement in any other way?

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13. Mtinie ◴[] No.44486187[source]
Alternatively, society is broken.
replies(1): >>44487934 #
14. Spivak ◴[] No.44486209{4}[source]
You just invented 0,1 again but gave a weird label to the 1.
15. ◴[] No.44486212[source]
16. Retric ◴[] No.44486249{5}[source]
Someone who is clinically depressed isn’t just sad, they are unable to return to normal. Things that help normal people feel better simply fail, it’s a meaningfully different situation. Similarly treatments for depression like electroconvulsive therapy shouldn’t be applied to normal people.

OCD, clinical addiction, etc are all more involved than just feeling the desire to do something. The lack of control is the issue not just the momentary impulse.

Intrusive thoughts are fine, acting on them isn’t.

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17. jaredklewis ◴[] No.44486252[source]
> The other is - everybody thinks they have minor version of disorders, because we all do, we live on continuums, and therefore we should probably all think about it more

What if the first part of this is true (we all have a smattering of disorders), but thinking about them more just makes things worse?

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18. Mtinie ◴[] No.44486282{6}[source]
Are there people who don’t have clinical diagnoses of depression being subjected to electro convulsive therapies?

Addendum: I believe I’m close to figuring out what you are communicating but for me it’s not working.

I’m reasonably sure we’d agree that neurological conditions are complex and that labels only tell part of the story.

replies(1): >>44486455 #
19. zakki ◴[] No.44486325{3}[source]
>>>who put a label on themselves don't want to change themselves at all<<<

Maybe that wasn't the intention but label does shape perception.

20. Retric ◴[] No.44486455{7}[source]
I’m sure ECT is being misused occasionally, but what I’m referring to is the underlying condition such treatments are addressing as well as the research associated with finding what treatments are useful in which situations.

Seasonal affective disorder and bereavement-related depression may have similar symptoms on the surface, but there’s different treatments due to differences in underlying causes.

Some conditions may be a continuum with the same underlying cause taken to different extremes, but that continuum need not be continuous down to normal human behavior.

21. pxoe ◴[] No.44486619{6}[source]
What is normal human behavior though? Is it some combination of things that's gonna end up being so rare that only so many people fall under it, and is it normal if it's so rare? Is it gonna be "what most/average people are", and if so, well then, isn't everybody gonna have something going on, and isn't that just normal then?

With how widespread it is, labeling, self-diagnosing, inquiring about yourself, is kind of normal human behavior. It is everywhere, and has been historically. Putting it like it's just 'labels for significant things' and then 'normal', and that these things would stand far enough apart to actually make a clear distinction without dismissing people in between is pretty much just wishful thinking. There's way too many things and even more combinations of then. It's gotten so complicated and convoluted only because it is that way. Wishing for a binary clarity in a complex world.

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22. rf15 ◴[] No.44486649{3}[source]
Those who see and believe that there's a label to parts of them can easily believe that they're "helpless", and "that's just the way I am"
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23. kelseyfrog ◴[] No.44486974[source]
I don't see how this explanation doesn't also fall victim to wanting to feel special. It looks a lot like projecting in fact :/ cringe
24. Retric ◴[] No.44486977{7}[source]
Normal is the full range of function not some specific set of behaviors.

Deciding not to get a drivers license is fine, being unable to get one because you can’t leave your home is an issue.

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25. pxoe ◴[] No.44487017{8}[source]
Full range is a specific set. What does that range consist of? Also, seems odd to go from going on about "stretching a label past the point of meaning", but then put normal as some range that's just about vaguely everything. Can normal not be defined? Is it somehow more deserving of being afforded to be a vague spectrum or being under less specific definitions? Where is the point of meaning with "normal"?
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26. esperent ◴[] No.44487076[source]
> everybody thinks they have minor version of disorders, because we all do, we live on continuums, and therefore we should probably all think about it more

I think this is subtly incorrect. I would phrase it this way:

> everybody thinks they have minor version of disorders, because we all do... And they think that makes them different and therefore deserving of special treatment.

We all live on continuums of mental health, and reflecting on that is important. But it's unrelated to what's happening here, there's not much reflection, just self labelling and demanding special treatment based on these labels.

Someone strongly on the autism spectrum absolutely needs special treatment, some just a little, some a lot.

But somebody who watches a TikTok about autism and recognizes, or thinks they recognize, similar behaviors in themselves, does not need it (except in the few cases where it is actually undiagnosed autism, of course, but that's a very small minority).

27. Retric ◴[] No.44487107{9}[source]
By specific set I mean the behaviors actually exhibited, someone either grows a beard or doesn’t you can’t be doing both. Meanwhile either choice is normal.

The “full range” is anything that doesn’t cause you or another significant distress, major impairment, or prevent functioning in society. Eating hot sauce is uncomfortable, amputating a limb is several steps beyond uncomfortable.

> Can normal not be defined?

It’s defined by what it isn’t. There’s ~8 billion people in the world and the majority of them are functioning as should be obvious by our societies continuing to function.

28. tonyedgecombe ◴[] No.44487462[source]
There is even an argument that putting a label on something will allow them to think less about it. They can put it away in a box rather than continually beating themselves up over it.
29. nradov ◴[] No.44487934{3}[source]
Every society has always been broken and always will be broken in certain ways. For most people, recognizing that isn't actionable. But they can change themselves.
30. freehorse ◴[] No.44488228{5}[source]
> a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life.

Which also brings us to an important point that is totally missed in the article and most of the discussion imo: maybe one of the (many) things that have changed is that lives are more negatively affected by stuff nowadays (or more reported to be so). We live in increasingly complex societies, we have to socialise with more and more people and navigate more demanding and fluid social dynamics. Traits that can be advantageous in a certain context can be disadvantageous in another (and affect one's life negatively).

31. zug_zug ◴[] No.44489837[source]
Well, if you're approaching this as a hard-scientist that's not the case (for psychology).

Because "disorder" may be on a spectrum, because "negative" and "impact" may be on a spectrum. Conditions like depression follow a bell-curve, there's no clear line between depressed and not, and we can draw a line in the sand, but statistically there's no justification for where that line falls.

One way to try to draw a line is "the point at which a certain intervention is no longer effective."

For example studies find CBT therapy reduces depression scores for depressed people ~.8 standard deviations (for a while).

But why not try CBT therapy on happy people? Maybe it's even more effective on people who are already happy. Well the reason why not is likely just because of the clumsy nature of healthcare -- interventions are thought of as "treatments" for "conditions", even though that lens doesn't always make sense.

replies(1): >>44490143 #
32. Retric ◴[] No.44490143{3}[source]
> there's no clear line between depressed and not

There’s a meaningful line in the sand for treatments with major side effects. CBT therapy may be “fine” for normal people, but the most effective treatment for depression is ECT which has major side effects. Including a ~1 in 50k chance of death.

Saying something is a bell curve distribution is an approximation, it doesn’t mean there’s actually a continuous function out to infinity and negative infinity.

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33. pseudalopex ◴[] No.44490358{4}[source]
Those who do not see or do not believe a label can easily believe that's just the way they are. Those who see and believe a label can easily use it to identify what they can do to help themselves.
replies(1): >>44492165 #
34. pseudalopex ◴[] No.44491466{4}[source]
When to resort to ECT is a subjective decision of doctor and patient. It is clear it should come after other treatments failed. But there is no clear line.
replies(1): >>44491802 #
35. Retric ◴[] No.44491802{5}[source]
Everything is subjective at the margins, but that’s ignoring the clear cut examples where it’s not going to be considered.
replies(1): >>44492218 #
36. DisruptiveDave ◴[] No.44492165{5}[source]
the ol' "name and tame"
37. pseudalopex ◴[] No.44492218{6}[source]
> that’s ignoring the clear cut examples where it’s not going to be considered

The 2nd sentence outlined when it would be considered and implicitly when it would not.

You seem to believe some cases of depression warrant ECT. Some do not. It's subjective at the margins. But don't call it a spectrum!

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38. Retric ◴[] No.44492504{7}[source]
No that’s not what I just said.

Spectrums extend continuously from normal to disorders. So if you believe depression is a spectrum you must also believe that no treatment is necessary for some people with depression. However if depression is a disorder there may be some cases that are on the margins that aren’t quite depression that still warrant some forms of treatment.

replies(1): >>44492713 #
39. pseudalopex ◴[] No.44492713{8}[source]
Your definition of spectrum is not standard. And the disorder called depression commonly is called major depressive disorder clinically.
replies(1): >>44494928 #
40. const_cast ◴[] No.44493991{4}[source]
> "helpless", and "that's just the way I am"

These don't mean the same thing. You can be the thing you are and not be helpless. For example, if you have ADHD that's just a part of who you are. That doesn't mean you can't take medication or form processes to help yourself and mitigate the effects of ADHD.

Also, in my experience, people who choose to never label themselves are not better off. They typically do have some sort of condition, sometimes multiple, and they actively choose to do nothing about it because they're in extreme denial.

I see this with parents all the time. "My kids doesn't have ADHD! Stop trying to label him!". Okay great, but little Timmy is about to flunk out at fucking third grade. Let's do something about it.

41. Retric ◴[] No.44494928{9}[source]
I could list a bunch of sources supporting what I just said but I’ll just say.

https://www.ifeet.org/files/DSM-5-TR.pdf

DSM V has depression as depressive disorders, but lists “Schizophrenia Spectrum” and “Autism Spectrum” so I invite you to consider what distinction for spectrum is being used.