| ▲ | aeturnum 5 days ago |
| > 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 5 days ago | parent | next [-] |
| > 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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| ▲ | swores 5 days ago | parent | next [-] | | I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that. Similar to how some people look at raw stats of autism diagnoses and think hugely more people are becoming autistic when in reality it's that we've got better at diagnosing autism; I think we (society, in at least some countries) have got better at being honest about mental health conditions. Meaning that more people, especially younger people who've grown up around less mental health stigma, will talk about having an actual genuine problem even without more diagnoses or more exaggeration. I think studies would be needed (that I'm not aware of) to figure out how many more people are using labels that don't really fit, vs how many more people are being honest about actual serious conditions. When I was in my 20s, if I needed a day off work because of depression I would always use a bullshit excuse to avoid mentioning the actual reason. I don't any more, most of my colleagues know what issues I do or don't have. And the younger generations are starting from that place, rather than having to grow into it. | | |
| ▲ | djoldman 4 days ago | parent [-] | | Assuming the days you took off from work because of depression were unexpected and not planned in advance, why did you feel you had to explain anything? Why couldn't you say: "I'm sick and won't be at work today." |
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| ▲ | mnky9800n 5 days ago | parent | prev | next [-] | | This is a very american trend in my experience. Americans are quite happy to tell you their long list of diagnoses, how that some how gives them some kind of exception to the rule, and how this is some how part of their identity. This kind of oversharing is common across topics from Americans but in particular oversharing of and obsession with psychological conditions seem to be a common modern stereotype of americans amongst my friends who interact with americans regularly. | | |
| ▲ | ToucanLoucan 5 days ago | parent [-] | | I mean, I have no data for this, but I think it's a combination of two factors: - Access to mental healthcare here is HEAVILY gate-kept by a combination of it often costing quite a lot of money, generally having longer waits than most healthcare services, heavy variability in availability by location, and insurance coverage runs the gamut between great or utterly absent, sometimes even in the same policy depending on what you need. Self-diagnosis is for many people the only diagnosis they have access to, and even if it's wrong, you can often use whatever diagnosis it is to find coping mechanisms that help you, or substances that will help you self medicate. - Naming something medically is the only way to get institutions to pay attention to it, which can mean a number of things by itself, from getting appropriate accommodations at work or school, to getting certain kinds of coworkers or authority figures to treat you in a way that's more amenable to your mental state. And I don't think its wrong to make it part of your identity either. Some definitely take it to a weird, unhealthy place, and also most of those people are teenagers. Teenagers do tons of stupid shit, I did tons of stupid shit. It's just part of growing up. But ultimately... it is part of you that you're going to be dealing with probably forever, so, some amount of identifying with it is probably healthy. Edit: Also not sure how to read you calling this "oversharing?" Like I guess it could be depending what it is, but I dunno, my wife has BPD and a touch of Autism, she doesn't announce it when we meet someone but it isn't a secret either. |
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| ▲ | ryandrake 5 days ago | parent | prev | next [-] | | I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet. I guess we'll know when they turn 40 and are still saying things like "I had a panic attack" and "I'm literally shaking rn". | | |
| ▲ | portaouflop 5 days ago | parent | next [-] | | Unc “I'm literally shaking rn” is only ever used ironically.
In a culture of ever increasing extremes language follows, that’s all that is to this | |
| ▲ | giantg2 5 days ago | parent | prev [-] | | I think it will continue as it's been turned into socially acceptable and even expected behavior now. |
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| ▲ | anal_reactor 5 days ago | parent | prev | next [-] | | > 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. | |
| ▲ | isk517 5 days ago | parent | prev | next [-] | | The dilution by people with no formal diagnosis become more common is scary because of how it normalizes not seeking help, which is the hardest part of actually having these issues. It creates this illusion that one should be able to treat themselves and that things like sitting at your desk all day thinking it wouldn't be that bad if you died in a car accident, or having your heartrate spike and sweating profusely while you thoughts are paralyzed are normal things that happens regularly to everyone so your inability to deal with them is a personal failing. They are not and if you do feel this way try and seek assistance from a experienced professional. | |
| ▲ | aeturnum 5 days ago | parent | prev | next [-] | | What you're describing is a big problem [edit: for the people who get sucked into it] and, to me, is kind of the "other side" of the overmedicalization issue that this blog is complaining about. One way medicalization harms is is when people are forced into conditions they don't agree with (as the author feels they have been). The other way is when people who aren't medical professionals (and wouldn't be in a position to diagnose even if they were) adopt medical language to describe experiences. I guess my thoughts on the trend you're critiquing is that it happens almost entirely outside of the medical community. As you describe the people who are most impacted by this often find actual medical treatment unhelpful and un-validating and turn to self-medication or other "medically inspired" coping techniques. I think the people who actually don't have these conditions and are applying medicalized treatments and explanations are opportunistically drawing on medical language because people often respect it socially. But also there are lots of people who engage in self-deception (or just normal deception) for social advantage and I don't know that people who use medical language are better or worse? A word is just a word and unless that word is actually on a medical record somewhere it only has the power you give it. The flip side of this is of course that the medical establishment has many well-studied and documented biases. They offer poor treatment to overweight people, black people, people with mental health diagnoses, basically every vulnerable population that's been studied gets worse service from medical professionals. That very reasonably leads to people distrusting "the system" and searching for coping mechanism outside of it. I think that is generally pretty harmless and helpful - as long as it doesn't get into the realm of serious self-medication like you describe. Basically if you like using a medical term to describe your experience ("I'm being really OCD today") I don't think there's much harm in it and you may find coping mechanisms for people with ODC helpful as a bonus. | |
| ▲ | retrac 5 days ago | parent | prev | next [-] | | I'm not sure if this is "human nature" or if it's a specific cultural problem in the modern west. It's certainly true here in Canada too -- everyone uses terms that are really quite heavy duty to describe quite minor things. I'm deaf. When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too." Now not to go policing people on their identities but -- no you're not. Like what do I need to say? Clinically deaf. Severe-profoundly deaf. Cannot hear a fire alarm without hearing aids? It's one thing when it's an elderly person. Yes maybe they are in fact a bit deaf too. But for all the people in their 30s or 40s who have said it to me -- the odds they all have moderate or worse hearing loss is nil! Most of the people who are saying it presumably have normal hearing. I understand that they're trying to identify with and not alienate me. But it's such a strange dynamic. | |
| ▲ | margalabargala 5 days ago | parent | prev | next [-] | | > I’ve been offered helpful links to TikTok ADHD influencers to help me understand them To be fair, giving you an example of someone else who performatively pretends to have a mental illness is a great way to understand them. | |
| ▲ | thatfrenchguy 5 days ago | parent | prev | next [-] | | > When they’re procrastinating a task that is fun “my ADHD is flaring up today”. I mean, our industry is filled with people of all ages with ADHD (arguably because it’s one of the few industries where you can succeed while having severe ADHD), GenZ folks are just more likely to admit it in public where older millennials are more likely to either be quiet about it or ignore the fact that they are subject to it. | |
| ▲ | mlsu 4 days ago | parent | prev | next [-] | | You’re right and it’s actually wild how many people lack the ability to just deal with it. I think they do it because having a medicalized identity gives you a kind of framework or structure to lean on in social situations. You don’t need to learn the complex social rules to get grace from other people, instead you can do this easy thing and demand it. I think it is downstream of social media displacing face-to-face social interactions. | |
| ▲ | parpfish 5 days ago | parent | prev | next [-] | | another therapy-speak term that has spilled over is "masking". apparently, any time that you need to politely smile when you dont feel like it is "masking" | |
| ▲ | squigz 5 days ago | parent | prev | next [-] | | I know people like to blame social media and just "the kids these days" in general - but I think there's another reasonable, far more charitable explanation: it's a sort of overcorrection after those illnesses being very heavily stigmatized for practically ever. It's perhaps not ideal, but if a symptom of more people who truly have those illnesses being able to get help is a small portion of people using it as a fashion statement, that's a price I think we can pay. And I'm confident it will correct itself over time. | |
| ▲ | AdmiralAsshat 4 days ago | parent | prev | next [-] | | > 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”. Somewhat unrelated, but I complain about the same thing in software parlance. Our work gets divided up into "sprints". A SPRINT is traditionally something you do a handful of times in your life, like when you're fleeing for your life, pursued by a bear. And then when you're a safe distance away and the adrenaline wears off, you collapse from exhaustion and rest. The idea that your employer would use that term to describe how they envision their employees structuring every day of the rest of their lives is either painfully tone-deaf, or even worse, is a brutally honest view of how they regard employee burnout. | |
| ▲ | ashtakeaway 5 days ago | parent | prev [-] | | Those folks are the ones who refuse to acknowledge and accept the fact that they were abused by family members while growing up, where those personality 'symptoms' are common. It is very well known that ADD and ADHD comes from abusive households. Nobody except psychologists and anyone in the mental health field would ever admit such failures in life. They will not accept the fact, and exaggeration and deflection of character faults into false medical diagnosis is what happens. Not very many doctors want to get screamed at by their patients (which would prove the doctor right) for telling them the truth of their own past, and besides, they're not even paid to tell them. "Truth hurts, don't it" is a very true phrase. It's a very sick trend affecting Millennials and Gen Z alike, and contributes to other worse mental health and criminal outcomes. It's not even new. |
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| ▲ | x3n0n 5 days ago | parent | prev | next [-] |
| Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply). That said, the writing really resonated with me and i wish Bess well. |
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| ▲ | KurSix 5 days ago | parent | prev | next [-] |
| I think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying |
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| ▲ | hebocon 4 days ago | parent | prev | next [-] |
| Agreed. I think the word "disorder" in DSM terminology is commonly misunderstood/trvialized by lay people. Being forgetful, sad, or tired is just part of life. If it becomes your whole life then you likely need help but an orderly life will contain pain, joy, pride, shame, boredom... We are always at risk of medicalizing discomfort. Allowing oneself to be miserable for a while can be therapeutic alongside patience, forgiveness, and compassion. Edit: after a re-read I noticed that she says she feels most of the symptoms daily a year later. That does feel pretty disruptive on its own but the definition is a bit tautological in that case. Regardless, what she's going through sounds really hard. |
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| ▲ | bonoboTP 19 hours ago | parent | prev | next [-] |
| A piece of paper from a medical professional stating that you have some medical need is extremely powerful against the cold machine of corporate and state bureaucracy. You may want to handle grief through general compassion or something but lawyers and managers don't run on that fuel, but medical documents work on them like garlic on Dracula. That's just how it is. |
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| ▲ | comechao 5 days ago | parent | prev | next [-] |
| I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem. |
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| ▲ | ericyd 5 days ago | parent | prev | next [-] |
| I would posit that you are reading this too literally. I didn't get the impression that the author was trying to rail against the medical establishment but rather to process her own experience in relation to professional guidance on the topic. I took it much more as a personal reflective essay than a professional medical critique. |
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| ▲ | aeturnum 4 days ago | parent [-] | | Sure - it's an expansive essay on the authors' experience around their grief. I never said that this was their thesis, but I do think the way they talk about medicalization is worth critiquing. They put their experience in tension with medicalization in a way that I don't quite see. Edit: I specifically think it's wrong to say we medicalize grief because we fear it. We medicalize it because some people would like a medical intervention with their grief. It's great and right that the author does not want that - but also they shouldn't write in a way that suggest that medical interventions in grief are wrongheaded. |
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| ▲ | dredmorbius 4 days ago | parent | prev | next [-] |
| Further: by defining the criteria under which a condition becomes medically treatable, other parts of the healthcare system, such as insurance (private or government-funded), treatment protocols, and the like, come into play. Individuals should they choose to seek treatment are then able to do so within a much larger system. By making the criteria reasonably loose and readily met, such a definition also minimises the number of individuals who would benefit from treatment who are excluded from being able to do so. This would include those who are very much unable to function or face larger grief-related risks. We medicalise grief not because we fear it, but because there are genuinely useful therapies which may be of use to some, and denying them that merely compounds suffering. And yes, absolutely, grief ultimately is a lifelong experience. You never stop missing that which you've lost, so long as you have the capacities of memory, reason, and feeling. That is not what the clinical definition is about. |
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| ▲ | munificent 5 days ago | parent | prev | next [-] |
| I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional". What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc. We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors. I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.) |
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| ▲ | aeturnum 5 days ago | parent [-] | | I think what you are talking about is a problem. Having a medical diagnosis gives personal experience an extra weight in the social realm that's quite problematic. We should all get to say how impactful something for us and the medical folks can have their own standards for when they feel comfortable intervening. That said, if that's what the author was trying to talk about, I think they are doing so in a way that unfairly indicts the medical system for assertions it doesn't make. They say "Apparently, that’s a disease", but as I said I do not think it is. I think they've misunderstood what makes a disease under the diagnostic criteria they list. > We could just as well have a culture that treats grief as a normal part of the human experience. That culture does exist. Even in this article there is an experience of grief that's considered normative in the medical community. Including, I would argue, the authors' grief. I would argue that the medical approach to grief is actually better than other western treatments of grief. I agree that western cultures (and US culture in particular) is horrible about grief. We want people to be robotic and predictable and not make us think about loss and be sad in private and a whole mess of awful, inhuman things. But I don't think that pressure either comes from the medical community or is furthered by how the medical community talks about grief. |
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| ▲ | aogaili 4 days ago | parent | prev [-] |
| Grief is feared and timed because it impacts the velocity in scrum. Closing your Jira tickets on time is the order. Therefore grief by preventing the closure creates disorder. Stop reading HN and work on your next Jira. |