Mental illnesses like depression and anxiety disorders are becoming more common, especially among young people. The demand for treatment is rising, and prescriptions for some psychiatric medications have increased.
These rising trends in prevalence are mirrored by heightened public attention to mental illness. Mental health messages flood traditional and social media. Organizations and governments are urgently developing awareness, prevention, and treatment initiatives.
The growing cultural focus on mental health has clear benefits. It raises awareness, reduces stigma, and encourages help-seeking.
However, there may also be drawbacks. Critics worry that social media sites are fostering mental illness and that everyday 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 connected.
Her “prevalence inflation hypothesis” suggests that increased awareness of mental illness may lead some people to misdiagnose themselves when 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 widened in recent years—a phenomenon we call “concept creep”—and that people vary in the breadth of their mental illness concepts.
Why do people self-diagnose mental illness?
In our new study, we examined whether people with broad concepts of mental illness are more likely to self-diagnose.
We defined self-diagnosis as a person’s belief that they have a disease, regardless of whether they received a professional diagnosis. We rated people as having a “broad concept of mental illness” if they considered a wide range of experiences and behaviors to be disordered, including relatively mild conditions.
We surveyed a nationally representative sample of 474 US adults about whether they believed they had a mental disorder and whether they had received a professional diagnosis. We also asked about other contributing factors and demographics.
Mental illness was common in our sample: 42% reported having a current self-diagnosed condition, most of whom had received a professional diagnosis.
The man sits on the park bench
People with more mental health education and less stigmatizing attitudes were more likely to report a diagnosis.
(Mental Health America/Pexels)
Interestingly, the strongest predictor of reporting a diagnosis was experiencing relatively severe distress.
The second most important factor after distress was having a broad concept of mental illness. When their distress levels 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 distress levels and shows the percentage of people at each level who report a current diagnosis.
A chart
Proportion of participants with broad (dark blue) or narrow (light blue) concepts of mental illness who self-diagnosed at different distress levels. (Provided by the authors)
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 quartile 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 more mental health education and less stigmatizing attitudes were also more likely to report a diagnosis.
Two additional findings emerged from our study. People who self-diagnosed but did not receive a professional diagnosis tended to have broader illness concepts than those who did.
Additionally, younger and politically progressive individuals 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 partly explained their higher diagnosis rates.
Why does it matter?
Our findings support the idea that expanded concepts of mental illness promote self-diagnosis and may increase the apparent prevalence of mental ill health. People with 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 that those with narrow concepts under-diagnose. Nor do they prove that having broad concepts 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. Besides increasing mental health literacy, it may increase the likelihood of people misidentifying their problems as pathology.
Inappropriate self-diagnosis can have negative effects. Diagnostic labels can become identity-defining and self-limiting, as people believe their problems are stable and hard to control.
The woman cries
Some people may misidentify their problems as a mental illness. (Karolina Grabowska/Pexels)
Second, unwarranted self-diagnosis may lead people experiencing relatively mild distress to seek help that is unnecessary, inappropriate, and ineffective. Recent Australian research found that people with relatively mild anxiety who received psychotherapy worsened more often than they improved.
Third, these effects may be particularly problematic for young people. They are more likely to hold broad concepts of mental illness, partly due to social media consumption, and they experience mental illness at relatively high and increasing rates.
Whether widespread illness concepts contribute to 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 reduce stigma. However, by pathologizing certain forms of everyday distress, they may have unintended downsides.
As we address the mental health crisis, it is crucial to find ways to raise awareness of mental health issues without inadvertently inflating them.
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.