I work with teenagers everyday and my heart sinks for them. Western society says “you are not a child” and “you are not an adult” but these lost humans want deeply to be attached to something. “I can’t help it”, “excuse me. It’s my….”. If their not already drugged, there parents are desperate for it. It’s very sad, we might all need to SLOW down, breathe and listen to their pain and the pain of our Mother Earth. It’s all connected. Bless them and all our pain
Being a teen has always been terrifyingly and frustratingly liminal - inbetween two things and not a thing itself. Historically we've protected these developing minds by providing rights of passage and initiation ceremonies that acknowledged their status. As you say, now we medicate, silence, numb them, divert their attention, keep them tied up in activity rather than allow them, support them.
Being a teen is also a relatively new phenomenon. This period of “freedom” between the worlds of the child and the adult only came about around the 1950s. Before that you were finished school by 12- 15 and then out and working.
The human mind does not do well with too much freedom , nor too much information. Our poor kids now get a bucket full of both.
“The highest rates of diagnosed depression occur among England’s poorest people, but the government probably prefers prescribing antidepressants to trying to solve poverty.”- This makes me think of a quote from an NHS psychologist writing in the Guardian- ‘If a plant were wilting we wouldn’t diagnose it with “wilting-plant-syndrome” – we would change its conditions. Yet when humans are suffering under unliveable conditions, we’re told something is wrong with us, and expected to keep pushing through. To keep working and producing, without acknowledging our hurt.’ https://amp.theguardian.com/commentisfree/2022/sep/06/psychologist-devastating-lies-mental-health-problems-politics
This is absolutely right. I’m a therapist and for the majority of people with mental health problems it is a temporary state which can be addressed with talking therapy and yes changing environmental circumstances! It’s awful people spend years with anxiety and depression without realising it can be addressed and cured without medication.
I can fully identify with your article. I suffered a breakdown at the end of my professional life. I was diagnosed with depression and spent some time in a clinic after therapy showed that I had already gone through two episodes before and tried to ignore it, resulting in somatic symptoms that I still retain today, although I can cope. Today, I see my situation as described by Erich Fromm some time back:
“A person who has not been completely alienated, who has remained sensitive and able to feel, who has not lost the sense of dignity, who is not yet "for sale", who can still suffer over the suffering of others, who has not acquired fully the having mode of existence - briefly, a person who has remained a person and not become a thing - cannot help feeling lonely, powerless, isolated in present-day society. He cannot help doubting himself and his own convictions, if not his sanity. He cannot help suffering, even though he can experience moments of joy and clarity that are absent in the lives of his "normal" contemporaries. Not rarely will he suffer from neurosis that results from the situation of a sane man living in an insane society, rather than that of the more conventional neurosis of a sick man trying to adapt himself to a sick society. In the process of going further in his analysis, i.e. of growing to greater independence and productivity, his neurotic symptoms will cure themselves.”
I survived but met several people in the clinic, and I was not so sure they would. I think many things are happening here, and one of them is that our society does not acknowledge that people are very different. Alone, the fact that introverts and extroverts are bundled together, let alone people on the autism spectrum, shows that we have a brutally pragmatic approach to how we expect people to behave and generally expect the same from everybody.
One person even asked me, whether I expected society to bow down to everybody’s needs, as though that was impossible. Having worked in nursing homes, it was our job to treat each person individually, so I answered yes. The reply I received seemed to betray the fact that the questioner wanted themselves desperately to be treated as they needed but had given up hope.
Dear Rob, I love that you quote Fromm, and particularly that quote... I say "a person who has remained a person and not become a thing" a lot. Along with Krishnamurti - It's no measure of health to be well adjusted to a sick society.
I like, too, that you gave the radical answer to that person. I'm sure it got them thinking differently about what they could be asking for, demanding. Of course society should bend to us, but we should set up a society that serves us
Such a meaningful conversation to be having, and as always, so eloquently put, Sarah. Thank you! It is always curious to me that while a diagnosis can provide (to some degree) initial relief, understanding, identity, belonging and some hopeful direction, it can simultaneously provide shackles, stereotypes, alienation and bewilderment. Diagnoses mean so many different things to different people. I tend to view my diagnosis as a little piece of information from someone who has been invited into my world for a short period to view from a distance how I experience it. Remembering this has helped me to continue to question, absorb, experience, seek and wonder as myself, not my diagnosis.
I look forward to reading the discussion as it unfolds!
I remember when I first got diagnosed having that feeling - that my parents could finally see I was in legitimate pain, not being "trouble". In heinsight, the best outcome would have been to have been seen as a sensitive human with a mind that went wide and who needed to be held in this. x
Interestingly, I never shared my diagnosis with my parents- received at 18 when I had access to a psychologist at university. I think I was frightened I’d be seen as the child you describe- a sensitive child who wanted to held in that!!
Strong, intelligent, independent women were the order of the day and my debilitating traits help me become that when outwardly observed. Oh how I would have loved to have been nurtured in my sensitivity when I was younger- it’s a gift I keep trying to give myself now.
Thanks Sarah. I recently went to a Mental Health First Aid course run professors at my local university (Mental Health nurses) who likened Mental Health on a spectrum comparable mainstream illness ie: a cold (mild sadness) through to serious cancer (schizophrenia). The idea is to view mental health on a spectrum of other common illness where we may have episodes of sickness during our lives, seek treatment, rest, recover and keep going. Viewing it this way allows us to normalise it and reduces a tendency for society to demonise or weaponize the diagnosis and, importantly, for us not to cling it. Personally, I like to view it this way. Don't collapse into your diagnosis is a great mantra.
Thanks Sarah - just a great conversation to be having. I feel for my friends who are receiving the diagnosis of ADHD, for example, taking the pills and waiting for a miracle. Yes, medication can help and yes there is also something going on that can be excavated, observed and even changed so the mental health improves. No one size fits all either.
In Ayurveda (I know I mention this a lot) there are the three gunas, or the qualities of the mind - sattva, rajas and tamas. It's a bit to go into here, however a combo of the three states woven together makes up the reality for individuals. So in my best summary, sattva is the most calm of the gunas - clear, balanced and creative. Rajas is the guna of change, transformation and action (if someone is 'rajasic' then this is the guna that is out of balance - the busyness of the mind, the doing the racing, the scrolling, the appointments etc) and the third guna is tamas and it is the heaviest state and often related to potential not being used.
Anyway, the upshot is that we are all a combo of three states and when in balance, things can feel like we are showing up from our soul (rather than our mind!)
This knowledge greatly supports me in being so much more than a diagnosis because my mind state can change for fluidly - I am not stuck with a label of 'generalised anxiety disorder' that I was given some time ago. This new knowledge (ancient wisdom) gives me freedom to explore each of my daily rhythms and how I can easily be swayed from one state of being to another.
The other thing about a diagnosis is that for some it feels like a quick fix - let's get this sorted and move on. That's not always the case and also, for many people, it took a long time to reach this state of imbalance so it might take a while to move through it.
I do love how Ayurveda allows for shifts and tilts and for shadow and brights sides.
That's true re a diagnosis being a perceived quick fix (as well as being no fix at all) that can lead to a cognitive exhaustion when you don't get the result.
I find a dx is typically the beginning of a whole new clusterfuck - stages of grief, the realisation it changes everything and nothing, the work. The worrrrrrk.
I write in First We Make the Beast Beautiful that a diagnosis and meds can help young ppl...it allowed me to put it on a shelf for a while, while I got on with life again. But eventually I had to come back and take it off the shelf and...do the work
Having spent the past 4 years working through my daughters experience with this , I have seen every aspect of the system at play . She was educated in Waldorf system until secondary school .
Creative play , nature play and artistic expression was largely the focus in her schooling until she turned 13 ( also the year she got an iPhone ) and entered a large public mainstream school .
We had the learning issues diagnosed in year 6 ( adhd and dyscalculia ) but once she entered mainstream schooling and her hormones kicked in , the ground fell out from underneath her .
Panic attacks ensued , isolation and anxiety.
She was a joyous , energetic , happy child that fell into a very dark place.
Fast forward to now , we have a young adult who is capable of boarding a long haul flight without experiencing a explosive panic attack and being disembarked . We have explored it all , meditation , therapy , kinesiology, naturopathy , meditation, the list goes on .
What I believe has been the greatest salve has been having an open conversation at all times and not making the condition her personality. She started anxiety and adhd meditation in year 10 and after 6 months decided she wanted to work on managing it without the medication and started doing the work on managing her anxiety from the inside out .
Of course …all of this costs us a huge amount of energy, time and money .
So many of us are short on all 3 .
I also believe the children are our future and useless and pathetic as the boomers and Andrew bolt would like to have us believe .
They’ve had to navigate a life on a metaphorical bullet train with a rave on board 24/7 . It’s a lot . They need a big hug . We all need a big hug x
100%. Realising that no one can do that work except for you, when you’re already so very, very tired is a cruelty, but can definitely be a long game worth playing. Much easier to look back and see that than look ahead and believe it of course.
As a parent/aunt/cousin/friend, I’ve watched as young people in my life have been frozen by their mental health diagnoses. It’s excruciating to watch. I step up as a shoulder to lean on when they need propping up. But it occurs to me that these diagnoses are a way to suppress creatives, people who don’t act or think as society/western medicine expects. Maybe/ likely all those children treated with ADD drugs are our next Einstein or Matisse or Steve Jobs. Maybe their creativity threatens teachers, parents, partners, society because they disrupt the “norm”, they are “ difficult “, “unmanageable. What a beautiful world we may have if we simply accept mental diversity rather than label it, treat it, and suppress individuality.
Vata (very dominant dosha) with a dose of pitta here too Anna! Keeps me interesting and on my toes! Ha! This awareness is really the way I have left behind the mental health diagnosis and moved into a more loving and comfy relationship with myself. I'm 49 next month so it's taken a bit!!
My brain is buzzing with how you can know all of this detailed information and give us so much content constantly.
If that’s a consequence of said mental illness then it’s bloody brilliant.
If we look back through history to the creatives, leaders, artists, people - I’m sure they would all have a named disorder today.
Scott Morrison definitely has one.
There’s a common phrase that I’m starting to detest - ‘First World Problems’ as well as not so commonly - ‘Affluenza’
I’m so reminded of my travels in the nineties and 2000s and wanted to share this 24 years later.
I went to visit Lebanon in May 2000, all based on loving two Lebanese restaurants in London - Fairuz and Le Mignon.
I loved the cuisine and I also loved the comfort of being in those places of friendship and family.
The photos on the wall in Le Mignon convinced me that I had to go and see it for myself.
Beirut was this shell of a city then, buildings like cheese graters riddled with bullet holes.
It was humbling and devastating to be there and see it.
But, the most humbling and amazing thing was the kindness of the people.
Everywhere we went people wanted to talk to us, invite us to their home for dinner, give us gifts.
What??
We heard a story from a school teacher who used to have to dodge the snipers going across the green line every day, trying to get to the place to educate her students.
Not once did anyone say, poor me. Everyone had been through hell and yet they were still there, talking, living, loving.
On the morning we were to fly out the power went off. The power station in Beirut had been bombed.
A few days later we saw the road to Baalbek had been bombed and saw the huge crater on the news.
We had been on that road days before.
We were just tourists, with the safety of returning to our homelands with no snipers or bombs.
I cried as the plane took off, I didn’t want to leave.
Lebanon - huge bright shining light in my heart always. ❤️
My experience - people often with the least are the most generous and the most happy.
I know this is a divergence from the mental health labelling but I feel it’s an important memory to share here X
ah...so much here. I think another part to this conversation is the work of Richard Tedeschi - on post traumatic growth. 70% of trauma leads to growth NOT a disorder.
We don’t have to BE our trauma. It becomes part of our story and will likely define who we are. Isn’t that what makes our uniqueness so very necessary? Maybe we are all just amazing beings with love at our core, not needing to be diagnosed or treated, but rather accepted as we are. Some of us will need medical intervention for our mental health issues, but as so many readers have already stated here, it doesn’t have to mean a lifetime of drug therapy
I think it makes sense that we are sick as a species. Perhaps the reported rise of mental illness is a symptom of an unwell culture, our ways of connecting to each other and nature are so far from how we evolved. It makes sense that we are all unwell. As a species we treat the earth, other species and nature like it is separate from us, raping and pillaging the planet for profit. I think it makes sense that we are sick. Our current systems are unsustainable and damaging not only to the planet but to ourselves and our psyche. Many different ways of looking at the issue but I do see it through this lens.
Another way of saying it is who isn’t sick or suffering in some way at some time in the current climate? We need change not just for the planet but for ourselves.
Omg it’s like you’re me. I’d actually like to have those earlier dx removed from my medical record now the long overdue ‘well duh’ ASD dx is there. I’m also feeling an urge to distance myself from the tedium of my conditions and the way they have come to define me, internally and externally. I’d just like to ‘be’ and ‘DO’. Thanks for this, so on the nail.
The desire to distance from the tedium of the actual conditions - I get it. I get TIRED of the story. I think it comes w getting older, an impatience, which Alain de Botton refers to in our recent chat.
We should be able to wipe that medical slate clean, like having an arrest record expunged. No one but YOU should be able to define you, and in the present moment, rather than via a decade old dx.
Yes, this really resonates for me too! I'm 45 and have been a mental health detective since my teens trying to unravel the secrets of my brain (anxiety, depression, eating disorders, ADHD) and it turns out it's all explained by ASD. I've been 'masking' my whole life apparently. Like you Holli, it's an opportunity to relax and be able to drop all those other labels we've been given over the years. Just useful information which will know help me to get on with life and ultimately be kinder to myself. And yes, age and lived experience definitely helps.
I agree with your points Sarah, and am concerned with the ADHD clinics popping up like the pain clinics in the US. Handing out meth rather than opioids.
I had the conversation with my therapist the other day, I challenged him for facilitating poor and immature behaviour And asked him to start challenging me and holding me more
accountable. Navel gazing is as much a disorder as the disorder which made it necessary in the first place. Pain is as good a distraction as pleasure, and it is the distraction from “real life” which is at the core of the issues you have raised.
Nothing makes me more happy than to gather enough energy through good behaviour, to engage a new behaviour. And this can only be done in real life, in real time.
That is the challenge and joy of being a good therapist. Keeping your shit tight while just being there for another. It is a mutual journey in the therapeutic journey. And a challenge for either sex when working with the other gender.
There is something in this challenge also, especially the hang on, this does not sit right, or to have that awkward conversation. My “issues” all stem from not having those conversations. That pressure manifests as so many disorders. Like you or others have said, first thing to do when someone says they are depressed is to look left and right and see if they are surrounded by arseholes. Or to ask the tough question , are you, am I the arsehole. Have I become that scared that I behave in such a manner 🤔.
Good work for getting fired, I hope that you got some “I am not crazy” certificates also.
Oh and another point to make out to the crew here. It is okay, and essential that you outgrow your therapist. If you are doing the work, that person who has come into your life to mirror you will eventually leave. It’s okay to break up with a therapist also, just don’t ghost them. Break up as you would break up with yourself. With grace, slowly and on purpose.
From my own study in psychotherapy and experiences with therapists. I believe that there is a shift towards healing, and management. 🙏🏼 Rather than dampening, dismissing or drugging. Especially as these are not a solution and only acerbate the problem until it finds its way to attention again.
There is the element amongst Psychs, Psychiatrists, and Spiritual guides that loves a codependent and never ending revenue stream. Suits their lifestyle and their ego. Fire them or get fired until you find someone who is in it for the right reasons. And I know it’s a minefield out there. 70-80 % of mental health professionals are there because they have a severe illness themselves. But that’s all part of the journey. The wounded healer is the best one. Their faults will allow you to find yours and stand on your own two feet. Good luck out there everyone, stay cool, stay safe ✌🏼
and watch out for their faults being a reason to keep running from yourself or others
there is a concept or rather a phenomenon in group therapy called group storming , where the group will rebel against the therapist , test them , and try to run.
definitely something I do : ) and something good to explore with a safe therapist , why am I seducing you ? running ? Why does it feel like you are seducing me , running ?
tricky territory for a therapist , but definitely the next level in ones journey with a healer , or a friend , family or a lover
My treatment of choice is Internal Family Systems. I find talk therapy useful to some extent but also limiting. Healing happens through a deeper internal process.
“I asked Leif Kennair, a world-renowned expert in the treatment of anxiety, and Michael Linden, a professor of psychiatry at the Charité University Hospital in Berlin, what they thought of practice. Both said this unceasing attention to feelings was likely to make kids more dysregulated.
If we want to help kids with emotional regulation, what should we communicate instead?
“I’d say: worry less. Ruminate less,” Kennair told me. “Try to verbalize everything you feel less. Try to self-monitor and be mindful of everything you do—less.”
There’s another problem posed by emotions check-ins: they tend to induce a state orientation at school, potentially sabotaging kids’ abilities to complete the tasks in front of them.
Many psychological studies back this up. An individual is more likely to meet a challenge if she focuses on the task ahead, rather than her own emotional state. If she’s thinking about herself, she’s less likely to meet any challenge.
“If you want to, let’s say, climb a mountain, if you start asking yourself after two steps, ‘How do I feel?’ you’ll stay at the bottom,” Dr. Linden said.”
Oh goodness, I'm glad someone has said/written this. I hear my friends labour with their kids about what their feeling etc and I can see the kids looking a bit bewildered and kind of pressured to not just be in the emotion and to process it as they need to (potentially through running, playing, climbing something)
Yes to not identifying with mental health issues. I’m a psychologist and I see too much of ‘I am my mental health’. And that blocks the very real invitation here to, which is to heal. We’re not meant to stay stuck in a diagnosis. We’re meant to grow through it. Thank you for calling this out, Sarah!
Diagnosis in the mental health field has always been controversial. In part because the labels lack inherent validity and were arrived at fairly arbitrarily many decades back. Homosexuality was a psychiatric diagnosis at one point in history! They have become enshrined as if they 'exist' but really they are just shorthand for clusters of internal experiences and externally observed behaviours. They cannot be measured or 'seen' on a test in the way that physical health issues can, therefore even among trained professionals there is often huge disagreement about diagnosis. We have adopted a model from physical health and clumsily applied it to mental health. In my experience, diagnostic labels help some people, to give validity to their experience and a language that they can communicate with others, or access to supports and resources. They also harm some people when they feel diminished, stigmatised, or, as you say, overly identified with a fixed label as if it is a static thing, a fault within them. They fail to take account of the context to someone's struggles. The reality is we all struggle to varying degrees with emotion regulation and mental states at different times. I'd like to see us move away from diagnostic labels and towards more individualised and nuanced descriptions of what an individual is facing at any given time. In the school of psychology I trained in, we focus on formulation -understanding why someone presents with a particular set of struggles at a particular point in time and in a particular context - rather than diagnosis, which tells us none of those things.
I love this insight thank you. It’s much harder to actually work out why someone is feeling unwell and come up with individualised, thoughtful solutions rather than branding them with a generic label and giving them a pill.
Especially in this post Covid world where everyone has an online therapist. How can they possibly individualize tx plans when as an on line therapist they are facing long days with back to back zoom therapy sessions. I have two friends that are therapists that describe their hellish schedules to me and I wonder how can they possibly be helping people??
I agree with your point I don’t think the responsibility should fall on therapists. The ‘fix’ or fixes needs to be much deeper and requires structural change in society. I think the question is how to alter our systems, goals and approaches to be kinder place.
Hi Sarah. I recently starting writing about this too. I've overly identified with my different diagnoses for years (GAD, depression, PTSD and then OCD), and it got me nowhere. I suspect I would qualify for the ASD label as well, but honestly, I am just so tired of medical system and trying to find answers that never actually lead me to feeling any better.
I decided to side-step the mainstream health system for now and am trying out private coaching. Their approach is very much what you are learning to do- manage the anxiety and grow through it, doing your best to live the life you wish to live despite it all. It's the most hopeful I've felt in years. Before this I felt I had to micromanage every facet of my life to cope, and just wanted to give up. I really do feel for Gen-Z.
You might be interested in reading the work of Freya India and Jessie Meadows if you haven't already. Both have some interesting things to say in the area.
This issue not mentioned in this article is we are also now talking about a large industry where people are making lots of money at the expensive of such issues.
In Australian schools, they receive more funding when a child has been labelled with ADHD, Autism etc. If we think this is not pushing up numbers, then we have our head in the sand.
Sorry to say it’s true. If the kid is diagnosed with autism or adhd etc, the school receives more funding for teachers or teacher aides etc. The funding amount varies on the level of severity. . it’s completely being abused with kids as young as 4.5 yrs old being pushed to be diagnosed with ADHD. A friend teachers year 6, 50 percent of her class are on meds. It’s completely out of control.
Yes, I had also heard this Matt. We're becoming more aligned with the US model of incentivising diagnosis of this disorders and over medicating. If you haven't read Johann Hari's book 'Stolen Focus', I highly recommend (Sarah has also interviewed him on Wild) he talks about this in some detail. It's really concerning. There are many other ways to improve attention and focus as he explores.
I work with teenagers everyday and my heart sinks for them. Western society says “you are not a child” and “you are not an adult” but these lost humans want deeply to be attached to something. “I can’t help it”, “excuse me. It’s my….”. If their not already drugged, there parents are desperate for it. It’s very sad, we might all need to SLOW down, breathe and listen to their pain and the pain of our Mother Earth. It’s all connected. Bless them and all our pain
Being a teen has always been terrifyingly and frustratingly liminal - inbetween two things and not a thing itself. Historically we've protected these developing minds by providing rights of passage and initiation ceremonies that acknowledged their status. As you say, now we medicate, silence, numb them, divert their attention, keep them tied up in activity rather than allow them, support them.
Being a teen is also a relatively new phenomenon. This period of “freedom” between the worlds of the child and the adult only came about around the 1950s. Before that you were finished school by 12- 15 and then out and working.
The human mind does not do well with too much freedom , nor too much information. Our poor kids now get a bucket full of both.
Listening to nature. What a gift and what a tonic.
“The highest rates of diagnosed depression occur among England’s poorest people, but the government probably prefers prescribing antidepressants to trying to solve poverty.”- This makes me think of a quote from an NHS psychologist writing in the Guardian- ‘If a plant were wilting we wouldn’t diagnose it with “wilting-plant-syndrome” – we would change its conditions. Yet when humans are suffering under unliveable conditions, we’re told something is wrong with us, and expected to keep pushing through. To keep working and producing, without acknowledging our hurt.’ https://amp.theguardian.com/commentisfree/2022/sep/06/psychologist-devastating-lies-mental-health-problems-politics
This is absolutely right. I’m a therapist and for the majority of people with mental health problems it is a temporary state which can be addressed with talking therapy and yes changing environmental circumstances! It’s awful people spend years with anxiety and depression without realising it can be addressed and cured without medication.
Yes! I hear you. And I love that wilting plant analogy (may borrow that!)
So true!
YES
Love this analogy!
Hello Sarah,
I can fully identify with your article. I suffered a breakdown at the end of my professional life. I was diagnosed with depression and spent some time in a clinic after therapy showed that I had already gone through two episodes before and tried to ignore it, resulting in somatic symptoms that I still retain today, although I can cope. Today, I see my situation as described by Erich Fromm some time back:
“A person who has not been completely alienated, who has remained sensitive and able to feel, who has not lost the sense of dignity, who is not yet "for sale", who can still suffer over the suffering of others, who has not acquired fully the having mode of existence - briefly, a person who has remained a person and not become a thing - cannot help feeling lonely, powerless, isolated in present-day society. He cannot help doubting himself and his own convictions, if not his sanity. He cannot help suffering, even though he can experience moments of joy and clarity that are absent in the lives of his "normal" contemporaries. Not rarely will he suffer from neurosis that results from the situation of a sane man living in an insane society, rather than that of the more conventional neurosis of a sick man trying to adapt himself to a sick society. In the process of going further in his analysis, i.e. of growing to greater independence and productivity, his neurotic symptoms will cure themselves.”
I survived but met several people in the clinic, and I was not so sure they would. I think many things are happening here, and one of them is that our society does not acknowledge that people are very different. Alone, the fact that introverts and extroverts are bundled together, let alone people on the autism spectrum, shows that we have a brutally pragmatic approach to how we expect people to behave and generally expect the same from everybody.
One person even asked me, whether I expected society to bow down to everybody’s needs, as though that was impossible. Having worked in nursing homes, it was our job to treat each person individually, so I answered yes. The reply I received seemed to betray the fact that the questioner wanted themselves desperately to be treated as they needed but had given up hope.
Rob
Dear Rob, I love that you quote Fromm, and particularly that quote... I say "a person who has remained a person and not become a thing" a lot. Along with Krishnamurti - It's no measure of health to be well adjusted to a sick society.
I like, too, that you gave the radical answer to that person. I'm sure it got them thinking differently about what they could be asking for, demanding. Of course society should bend to us, but we should set up a society that serves us
Such a meaningful conversation to be having, and as always, so eloquently put, Sarah. Thank you! It is always curious to me that while a diagnosis can provide (to some degree) initial relief, understanding, identity, belonging and some hopeful direction, it can simultaneously provide shackles, stereotypes, alienation and bewilderment. Diagnoses mean so many different things to different people. I tend to view my diagnosis as a little piece of information from someone who has been invited into my world for a short period to view from a distance how I experience it. Remembering this has helped me to continue to question, absorb, experience, seek and wonder as myself, not my diagnosis.
I look forward to reading the discussion as it unfolds!
I remember when I first got diagnosed having that feeling - that my parents could finally see I was in legitimate pain, not being "trouble". In heinsight, the best outcome would have been to have been seen as a sensitive human with a mind that went wide and who needed to be held in this. x
Interestingly, I never shared my diagnosis with my parents- received at 18 when I had access to a psychologist at university. I think I was frightened I’d be seen as the child you describe- a sensitive child who wanted to held in that!!
Strong, intelligent, independent women were the order of the day and my debilitating traits help me become that when outwardly observed. Oh how I would have loved to have been nurtured in my sensitivity when I was younger- it’s a gift I keep trying to give myself now.
That is such a beautiful reflective thought.
I just thought, pressing like on it didn't do it justice☺️
And to how it then made me reflect at 4am long enough that I'm late now for work.🫤
Thankyou, I love when a comment stills you and buries itself in my thoughts for the day,month,years.
Thanks Sarah. I recently went to a Mental Health First Aid course run professors at my local university (Mental Health nurses) who likened Mental Health on a spectrum comparable mainstream illness ie: a cold (mild sadness) through to serious cancer (schizophrenia). The idea is to view mental health on a spectrum of other common illness where we may have episodes of sickness during our lives, seek treatment, rest, recover and keep going. Viewing it this way allows us to normalise it and reduces a tendency for society to demonise or weaponize the diagnosis and, importantly, for us not to cling it. Personally, I like to view it this way. Don't collapse into your diagnosis is a great mantra.
Thanks Sarah - just a great conversation to be having. I feel for my friends who are receiving the diagnosis of ADHD, for example, taking the pills and waiting for a miracle. Yes, medication can help and yes there is also something going on that can be excavated, observed and even changed so the mental health improves. No one size fits all either.
In Ayurveda (I know I mention this a lot) there are the three gunas, or the qualities of the mind - sattva, rajas and tamas. It's a bit to go into here, however a combo of the three states woven together makes up the reality for individuals. So in my best summary, sattva is the most calm of the gunas - clear, balanced and creative. Rajas is the guna of change, transformation and action (if someone is 'rajasic' then this is the guna that is out of balance - the busyness of the mind, the doing the racing, the scrolling, the appointments etc) and the third guna is tamas and it is the heaviest state and often related to potential not being used.
Anyway, the upshot is that we are all a combo of three states and when in balance, things can feel like we are showing up from our soul (rather than our mind!)
This knowledge greatly supports me in being so much more than a diagnosis because my mind state can change for fluidly - I am not stuck with a label of 'generalised anxiety disorder' that I was given some time ago. This new knowledge (ancient wisdom) gives me freedom to explore each of my daily rhythms and how I can easily be swayed from one state of being to another.
The other thing about a diagnosis is that for some it feels like a quick fix - let's get this sorted and move on. That's not always the case and also, for many people, it took a long time to reach this state of imbalance so it might take a while to move through it.
It's a long game, that's for sure.
Love Cherie
I do love how Ayurveda allows for shifts and tilts and for shadow and brights sides.
That's true re a diagnosis being a perceived quick fix (as well as being no fix at all) that can lead to a cognitive exhaustion when you don't get the result.
I find a dx is typically the beginning of a whole new clusterfuck - stages of grief, the realisation it changes everything and nothing, the work. The worrrrrrk.
oh yes...work!
I write in First We Make the Beast Beautiful that a diagnosis and meds can help young ppl...it allowed me to put it on a shelf for a while, while I got on with life again. But eventually I had to come back and take it off the shelf and...do the work
Having spent the past 4 years working through my daughters experience with this , I have seen every aspect of the system at play . She was educated in Waldorf system until secondary school .
Creative play , nature play and artistic expression was largely the focus in her schooling until she turned 13 ( also the year she got an iPhone ) and entered a large public mainstream school .
We had the learning issues diagnosed in year 6 ( adhd and dyscalculia ) but once she entered mainstream schooling and her hormones kicked in , the ground fell out from underneath her .
Panic attacks ensued , isolation and anxiety.
She was a joyous , energetic , happy child that fell into a very dark place.
Fast forward to now , we have a young adult who is capable of boarding a long haul flight without experiencing a explosive panic attack and being disembarked . We have explored it all , meditation , therapy , kinesiology, naturopathy , meditation, the list goes on .
What I believe has been the greatest salve has been having an open conversation at all times and not making the condition her personality. She started anxiety and adhd meditation in year 10 and after 6 months decided she wanted to work on managing it without the medication and started doing the work on managing her anxiety from the inside out .
Of course …all of this costs us a huge amount of energy, time and money .
So many of us are short on all 3 .
I also believe the children are our future and useless and pathetic as the boomers and Andrew bolt would like to have us believe .
They’ve had to navigate a life on a metaphorical bullet train with a rave on board 24/7 . It’s a lot . They need a big hug . We all need a big hug x
You probably need a big hug xx
100%. Realising that no one can do that work except for you, when you’re already so very, very tired is a cruelty, but can definitely be a long game worth playing. Much easier to look back and see that than look ahead and believe it of course.
Yes, it is so cruel!! When you’re already hanging on by one thread and so tired yet it’s you that has to do the work! Cruel
As a parent/aunt/cousin/friend, I’ve watched as young people in my life have been frozen by their mental health diagnoses. It’s excruciating to watch. I step up as a shoulder to lean on when they need propping up. But it occurs to me that these diagnoses are a way to suppress creatives, people who don’t act or think as society/western medicine expects. Maybe/ likely all those children treated with ADD drugs are our next Einstein or Matisse or Steve Jobs. Maybe their creativity threatens teachers, parents, partners, society because they disrupt the “norm”, they are “ difficult “, “unmanageable. What a beautiful world we may have if we simply accept mental diversity rather than label it, treat it, and suppress individuality.
Oh my goodness Paola I think you have nailed it. Much of this is based in fear.
Vata (very dominant dosha) with a dose of pitta here too Anna! Keeps me interesting and on my toes! Ha! This awareness is really the way I have left behind the mental health diagnosis and moved into a more loving and comfy relationship with myself. I'm 49 next month so it's taken a bit!!
Brilliant thoughts Sarah.
My brain is buzzing with how you can know all of this detailed information and give us so much content constantly.
If that’s a consequence of said mental illness then it’s bloody brilliant.
If we look back through history to the creatives, leaders, artists, people - I’m sure they would all have a named disorder today.
Scott Morrison definitely has one.
There’s a common phrase that I’m starting to detest - ‘First World Problems’ as well as not so commonly - ‘Affluenza’
I’m so reminded of my travels in the nineties and 2000s and wanted to share this 24 years later.
I went to visit Lebanon in May 2000, all based on loving two Lebanese restaurants in London - Fairuz and Le Mignon.
I loved the cuisine and I also loved the comfort of being in those places of friendship and family.
The photos on the wall in Le Mignon convinced me that I had to go and see it for myself.
Beirut was this shell of a city then, buildings like cheese graters riddled with bullet holes.
It was humbling and devastating to be there and see it.
But, the most humbling and amazing thing was the kindness of the people.
Everywhere we went people wanted to talk to us, invite us to their home for dinner, give us gifts.
What??
We heard a story from a school teacher who used to have to dodge the snipers going across the green line every day, trying to get to the place to educate her students.
Not once did anyone say, poor me. Everyone had been through hell and yet they were still there, talking, living, loving.
On the morning we were to fly out the power went off. The power station in Beirut had been bombed.
A few days later we saw the road to Baalbek had been bombed and saw the huge crater on the news.
We had been on that road days before.
We were just tourists, with the safety of returning to our homelands with no snipers or bombs.
I cried as the plane took off, I didn’t want to leave.
Lebanon - huge bright shining light in my heart always. ❤️
My experience - people often with the least are the most generous and the most happy.
I know this is a divergence from the mental health labelling but I feel it’s an important memory to share here X
ah...so much here. I think another part to this conversation is the work of Richard Tedeschi - on post traumatic growth. 70% of trauma leads to growth NOT a disorder.
further to this...growth can also take the form of prioritising humans and humanity over and over.
We don’t have to BE our trauma. It becomes part of our story and will likely define who we are. Isn’t that what makes our uniqueness so very necessary? Maybe we are all just amazing beings with love at our core, not needing to be diagnosed or treated, but rather accepted as we are. Some of us will need medical intervention for our mental health issues, but as so many readers have already stated here, it doesn’t have to mean a lifetime of drug therapy
I think it makes sense that we are sick as a species. Perhaps the reported rise of mental illness is a symptom of an unwell culture, our ways of connecting to each other and nature are so far from how we evolved. It makes sense that we are all unwell. As a species we treat the earth, other species and nature like it is separate from us, raping and pillaging the planet for profit. I think it makes sense that we are sick. Our current systems are unsustainable and damaging not only to the planet but to ourselves and our psyche. Many different ways of looking at the issue but I do see it through this lens.
Another way of saying it is who isn’t sick or suffering in some way at some time in the current climate? We need change not just for the planet but for ourselves.
Omg it’s like you’re me. I’d actually like to have those earlier dx removed from my medical record now the long overdue ‘well duh’ ASD dx is there. I’m also feeling an urge to distance myself from the tedium of my conditions and the way they have come to define me, internally and externally. I’d just like to ‘be’ and ‘DO’. Thanks for this, so on the nail.
The desire to distance from the tedium of the actual conditions - I get it. I get TIRED of the story. I think it comes w getting older, an impatience, which Alain de Botton refers to in our recent chat.
I’ll check that conversation out, thanks. Yes, definitely think it comes with age. 40 next year and the micro shifts are coming thick and fast!
We should be able to wipe that medical slate clean, like having an arrest record expunged. No one but YOU should be able to define you, and in the present moment, rather than via a decade old dx.
Yes, this really resonates for me too! I'm 45 and have been a mental health detective since my teens trying to unravel the secrets of my brain (anxiety, depression, eating disorders, ADHD) and it turns out it's all explained by ASD. I've been 'masking' my whole life apparently. Like you Holli, it's an opportunity to relax and be able to drop all those other labels we've been given over the years. Just useful information which will know help me to get on with life and ultimately be kinder to myself. And yes, age and lived experience definitely helps.
I agree with your points Sarah, and am concerned with the ADHD clinics popping up like the pain clinics in the US. Handing out meth rather than opioids.
I had the conversation with my therapist the other day, I challenged him for facilitating poor and immature behaviour And asked him to start challenging me and holding me more
accountable. Navel gazing is as much a disorder as the disorder which made it necessary in the first place. Pain is as good a distraction as pleasure, and it is the distraction from “real life” which is at the core of the issues you have raised.
Nothing makes me more happy than to gather enough energy through good behaviour, to engage a new behaviour. And this can only be done in real life, in real time.
So important to challenge your therapist. I've been "fired" twice by therapists. One told me I was too seductive.
Hehe hehehe , who was projecting on who 😅
That is the challenge and joy of being a good therapist. Keeping your shit tight while just being there for another. It is a mutual journey in the therapeutic journey. And a challenge for either sex when working with the other gender.
There is something in this challenge also, especially the hang on, this does not sit right, or to have that awkward conversation. My “issues” all stem from not having those conversations. That pressure manifests as so many disorders. Like you or others have said, first thing to do when someone says they are depressed is to look left and right and see if they are surrounded by arseholes. Or to ask the tough question , are you, am I the arsehole. Have I become that scared that I behave in such a manner 🤔.
Good work for getting fired, I hope that you got some “I am not crazy” certificates also.
Oh and another point to make out to the crew here. It is okay, and essential that you outgrow your therapist. If you are doing the work, that person who has come into your life to mirror you will eventually leave. It’s okay to break up with a therapist also, just don’t ghost them. Break up as you would break up with yourself. With grace, slowly and on purpose.
From my own study in psychotherapy and experiences with therapists. I believe that there is a shift towards healing, and management. 🙏🏼 Rather than dampening, dismissing or drugging. Especially as these are not a solution and only acerbate the problem until it finds its way to attention again.
Sorry to say I don't agree. Too much money to be made on the other side.
There is the element amongst Psychs, Psychiatrists, and Spiritual guides that loves a codependent and never ending revenue stream. Suits their lifestyle and their ego. Fire them or get fired until you find someone who is in it for the right reasons. And I know it’s a minefield out there. 70-80 % of mental health professionals are there because they have a severe illness themselves. But that’s all part of the journey. The wounded healer is the best one. Their faults will allow you to find yours and stand on your own two feet. Good luck out there everyone, stay cool, stay safe ✌🏼
Plumbers have leaky loos
they do too :P
and watch out for their faults being a reason to keep running from yourself or others
there is a concept or rather a phenomenon in group therapy called group storming , where the group will rebel against the therapist , test them , and try to run.
definitely something I do : ) and something good to explore with a safe therapist , why am I seducing you ? running ? Why does it feel like you are seducing me , running ?
tricky territory for a therapist , but definitely the next level in ones journey with a healer , or a friend , family or a lover
My treatment of choice is Internal Family Systems. I find talk therapy useful to some extent but also limiting. Healing happens through a deeper internal process.
Yes I agree and the various somatic therapies
I found this interesting reading on kids/teens being taught to focus constantly on their feelings: https://open.substack.com/pub/bariweiss/p/how-bad-therapy-hijacked-american-schools?r=1cf7q5&utm_medium=ios&utm_campaign=post
“I asked Leif Kennair, a world-renowned expert in the treatment of anxiety, and Michael Linden, a professor of psychiatry at the Charité University Hospital in Berlin, what they thought of practice. Both said this unceasing attention to feelings was likely to make kids more dysregulated.
If we want to help kids with emotional regulation, what should we communicate instead?
“I’d say: worry less. Ruminate less,” Kennair told me. “Try to verbalize everything you feel less. Try to self-monitor and be mindful of everything you do—less.”
There’s another problem posed by emotions check-ins: they tend to induce a state orientation at school, potentially sabotaging kids’ abilities to complete the tasks in front of them.
Many psychological studies back this up. An individual is more likely to meet a challenge if she focuses on the task ahead, rather than her own emotional state. If she’s thinking about herself, she’s less likely to meet any challenge.
“If you want to, let’s say, climb a mountain, if you start asking yourself after two steps, ‘How do I feel?’ you’ll stay at the bottom,” Dr. Linden said.”
Oh goodness, I'm glad someone has said/written this. I hear my friends labour with their kids about what their feeling etc and I can see the kids looking a bit bewildered and kind of pressured to not just be in the emotion and to process it as they need to (potentially through running, playing, climbing something)
Brianna - major sub stack crossover. :) This was a good article from TFP.
Yes to not identifying with mental health issues. I’m a psychologist and I see too much of ‘I am my mental health’. And that blocks the very real invitation here to, which is to heal. We’re not meant to stay stuck in a diagnosis. We’re meant to grow through it. Thank you for calling this out, Sarah!
Diagnosis in the mental health field has always been controversial. In part because the labels lack inherent validity and were arrived at fairly arbitrarily many decades back. Homosexuality was a psychiatric diagnosis at one point in history! They have become enshrined as if they 'exist' but really they are just shorthand for clusters of internal experiences and externally observed behaviours. They cannot be measured or 'seen' on a test in the way that physical health issues can, therefore even among trained professionals there is often huge disagreement about diagnosis. We have adopted a model from physical health and clumsily applied it to mental health. In my experience, diagnostic labels help some people, to give validity to their experience and a language that they can communicate with others, or access to supports and resources. They also harm some people when they feel diminished, stigmatised, or, as you say, overly identified with a fixed label as if it is a static thing, a fault within them. They fail to take account of the context to someone's struggles. The reality is we all struggle to varying degrees with emotion regulation and mental states at different times. I'd like to see us move away from diagnostic labels and towards more individualised and nuanced descriptions of what an individual is facing at any given time. In the school of psychology I trained in, we focus on formulation -understanding why someone presents with a particular set of struggles at a particular point in time and in a particular context - rather than diagnosis, which tells us none of those things.
I love this insight thank you. It’s much harder to actually work out why someone is feeling unwell and come up with individualised, thoughtful solutions rather than branding them with a generic label and giving them a pill.
Especially in this post Covid world where everyone has an online therapist. How can they possibly individualize tx plans when as an on line therapist they are facing long days with back to back zoom therapy sessions. I have two friends that are therapists that describe their hellish schedules to me and I wonder how can they possibly be helping people??
I agree with your point I don’t think the responsibility should fall on therapists. The ‘fix’ or fixes needs to be much deeper and requires structural change in society. I think the question is how to alter our systems, goals and approaches to be kinder place.
Hi Sarah. I recently starting writing about this too. I've overly identified with my different diagnoses for years (GAD, depression, PTSD and then OCD), and it got me nowhere. I suspect I would qualify for the ASD label as well, but honestly, I am just so tired of medical system and trying to find answers that never actually lead me to feeling any better.
I decided to side-step the mainstream health system for now and am trying out private coaching. Their approach is very much what you are learning to do- manage the anxiety and grow through it, doing your best to live the life you wish to live despite it all. It's the most hopeful I've felt in years. Before this I felt I had to micromanage every facet of my life to cope, and just wanted to give up. I really do feel for Gen-Z.
You might be interested in reading the work of Freya India and Jessie Meadows if you haven't already. Both have some interesting things to say in the area.
The micromanaging is an important element ...at some point we just have to LIVE
This issue not mentioned in this article is we are also now talking about a large industry where people are making lots of money at the expensive of such issues.
In Australian schools, they receive more funding when a child has been labelled with ADHD, Autism etc. If we think this is not pushing up numbers, then we have our head in the sand.
I was not aware of this. I know most of the kids who do have issues are in public schools, which receive less Federal funding than private schools
Sorry to say it’s true. If the kid is diagnosed with autism or adhd etc, the school receives more funding for teachers or teacher aides etc. The funding amount varies on the level of severity. . it’s completely being abused with kids as young as 4.5 yrs old being pushed to be diagnosed with ADHD. A friend teachers year 6, 50 percent of her class are on meds. It’s completely out of control.
Yes, I had also heard this Matt. We're becoming more aligned with the US model of incentivising diagnosis of this disorders and over medicating. If you haven't read Johann Hari's book 'Stolen Focus', I highly recommend (Sarah has also interviewed him on Wild) he talks about this in some detail. It's really concerning. There are many other ways to improve attention and focus as he explores.