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461 points LaurenSerino | 3 comments | | HN request time: 0.682s | source
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aeturnum ◴[] No.45290780[source]
> We medicalize grief because we fear it.

I think this is just incorrect. You are not obligated to seek treatment for most medical problems[1]. The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in and when people enter a situation where they may need external help. One of the diagnostic criteria, which this article mentions, is that your grief is disrupting your life - but despite what this article claims they have misunderstood that criteria. Of course grief changes your routines and life. That change only becomes "disruptive" if you feel the change has somehow gone too far or you are struggling to undo it. This writer is doing neither and therefor does not meet the diagnostic criteria for disordered grief. They are grieving normally and the medical literate supports that understanding.

There are of course medical professionals who use diagnostic criteria as cudgels. Trying to force people to become patients in order to enforce their idea of what someone "should" want. This is a problem but it is a problem that the official diagnostic guidelines try to avoid. For those who are interested in this kind of problem with our medical system might look into the professional philosophy of doctors (generally arrayed around identifying and curing disease) and nursing (generally arrayed around making the patient comfortable as possible). I tend to think the nursing model is the more useful and sensible of the two - even though, of course, if one wants to cure a disease a doctor is helpful.

[1] There are very few diseases, such as tuberculosis, where you can be forced to treat the disease.

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Aurornis ◴[] No.45290900[source]
> The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in

The problem is that medical diagnoses and therapy speak have spilled over into common language where they’re so diluted that they’re not accurate any more. For many there is no line drawn anywhere because they are self-diagnosing based on flawed understandings as soon as any feeling or symptom arrives.

This is scarily obvious when I’ve worked with college students and early 20s juniors lately: A subset of them speak of everything human nature in medical and therapy speak. Common human experiences like being sad about something or having a tough day are immediately amplified into full-blown medical terms like “I’m having a depressive episode today” (which is gone by tomorrow). Being a little nervous about something is “I’m having a panic attack”. Remembering an unpleasant disagreement at work “gives me PTSD”. When they’re procrastinating a task that is fun “my ADHD is flaring up today”.

This is only a subset of people, but it’s a rapidly growing percentage of younger people I work with. When someone falls into this mindset it only grows: The same people using these terms usually accumulate a lot of different self-diagnoses to cover every element of common human experience: They will claim ADHD, social anxiety, often some variation of Autism despite showing none of the signs, PTSD due to a previous relationship/boss/professor they didn’t get along with, and insomnia or delayed sleep phase syndrome. Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.

I’ve been offered helpful links to TikTok ADHD influencers to help me understand them, because that’s where they think the best information comes from. 20-something engineers confidently tell me they know more than their doctors about ADHD and how to treat it (usually after their doctor refuses to increase their dose of Adderall again or denies them some other controlled substance they think they need like ketamine or perpetual daily Xanax). There’s also a growing culture of casual drug abuse and misuse that gets justified as self-medication, but that’s a topic for another post.

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anal_reactor ◴[] No.45291947[source]
> Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.

The thing is, many people have valid reasons not to trust the medical system. Not so long ago:

1. Homosexuality was considered a mental disease

2. Forced sterilization of minorities was good medical practice

3. FDA ignored warnings about pesticides being potentially harmful because that would be bad for business

4. FDA ignored warnings about pesticides being potentially harmful because that would be bad for international politics

5. Entire field of psychiatry was just basically random shit, it's not until very recently that we have any actual scientific knowledge

6. Pregnant women were presribed medicine that fucked up their fetuses

Not to mention that most likely when you go to a doctor you're not getting state-of-the-art diasgnosis, most likely the doctor is just a random guy doing his job, sometimes better sometimes worse. Personally I don't trust medical system with my mental health because medical system is a product of a society that made me have mental problems in the first place.

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1. cardanome ◴[] No.45295105[source]
I mean I live in Germany where Hans Asperger oversaw the mass killing of autistic children. He decided which one were to be murdered or which had the "right kind of autism" i.e. Asperger syndrome and could serve the fatherland. (Just to be clear, the differentiation between autism and Asperger has not and had never any scientific leg to stand on.)

The term Asperger syndrome was only removed from the DSM in 2013.

For autistic children something called Applied Behavior Therapy is still the most common treatment. It is the same thing they use in gay conversation camps. Yes, literally. It can be super traumatizing to autistic children.

The way we treat neurodivergent people is absolutely abhorrent.

That said, the main issue people don't get a diagnosis is not lack of trust but lack of access. Most people can't afford it or are not able to jump over the bureaucratic hurdles to get it.

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2. autoexec ◴[] No.45295993[source]
Germany is notorious for being shitty to people with mental illness. Even people with something as common as ADHD struggle to get the care they need there!

On the subject of Asperger syndrome, after learning about the history I was surprised that there are people previously diagnosed with Asperger's syndrome who were (and still are) very angry about the term being removed resulting in them being lumped in with everyone else diagnosed as autistic.

Being labeled as "autistic" could mean anything from seeming a bit strange but being highly intelligent and perfectly capable, to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care. Some "Aspies" saw Asperger's as a very convenient way to differentiate their particular flavor of autism. Convenient enough that the usefulness of that distinction far outweighed the shadow of the terrible origin of the name itself and also the fact that it hilariously sounds like "ass burgers".

Personally, I'm glad that Asperger's was removed but I have to agree with the Aspie crowd that they got screwed over when no new term was given to replace what they had. The still grossly overbroad "3 level" system is trash. The spectrum of autism is so wide that the term is nearly useless.

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3. cardanome ◴[] No.45299252[source]
> could mean anything from seeming a bit strange but being highly intelligent and perfectly capable

No, everyone that is diagnosed under ASD has some sort of care needs. If you are just a bit strange and it is not disabling in any form, then you are just strange.

People see autistic people on the internet and seem to miss that video editing exists and that the they are seeing just a very specific and carefully chosen part of this person. They are seeing the highlight reel not daily life that can look very differently.

One of the fears with removing Aspergers was indeed that some people diagnosed under Asperger might not be diagnose under ASD as it is arguably stricter.

> to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care.

The problem is that many people see things as single line from low care needs to high care when in reality it is multi dimensional. Just being non-verbal does not mean that one is not intelligent, that is a huge stigma that non-verbal autistic people suffer. Many autistic people struggle with sensory issues but some don't. You might struggle heavily in one area but not so much in another.

If you know one autistic person, you know one autistic person.

> The still grossly overbroad "3 level" system is trash.

It is a step in the right direction because it realizes that care needs can change over the course of a persons life. You are born autistic but how disabling it is for you can change depending on how much help you get. It can get better or worse depending on your life situation.

Otherwise you have a current situation where people assume it isn't worth giving a non-verbal autistic child a proper education because they they think that they will never be able to life on their own anyway, acting like their outcomes are already predetermined. Or when someone with Asperger is assumed to never have serious care needs.

That said, people that have been diagnosed as Asperger, I don't correct them if they cling to their diagnosis. It is the diagnosis they have identified with for years or decades and if it what works for them then that is fine.

Still the new system is a good step in the right direction. Not perfect but better.