You would hope that all this confusion in the news over what’s true would stay far away from topics like health and wellness, but unfortunately these are just as prone to miscommunication and misinformation. In an effort to prevent people with mental health issues from struggling more than they already do, let’s debunk some common myths about mental health. We’ll also look at something closer to the truth for each one, so you can go around helping your family, your friends, and even your very worst enemies see things differently. Here goes!
1) Myth: People struggling with their mental health are more likely to be violent
Not only are people with mental illness no more likely to be violent than anyone in the general population, they’re ten times more likely to be victims of violent crime. If you’re walking around your school or office, or taking public transportation at night, or whatever else you do, consider keeping an eye out for people who are visibly struggling with their mental health instead of just avoiding them.
2) Myth: Depression is caused by low serotonin levels
Although the serotonin hypothesis became the dominant explanation for depression in the 1960s, the scientific community has shifted and no longer believes that depression is caused by anything as simple as a lack of serotonin. SSRIs and SNRIs are still the most widely used psychiatric treatment for depression, and the medical community still seems to believe that some kind of change in the way serotonin interacts with neurons can help people feel better. But the nature of this change– and the reason people get depressed in the first place– remains unknown.
3) Myth: Mental health problems are rare
About 20% of people in the United States have a mental health condition. For comparison, 16.6% of Americans have blue eyes. Although eye color varies significantly depending on the part of the world you’re in, mental illness incidence probably doesn’t. (Although it’s important to acknowledge that mental illnesses are diagnosed and treated in very different ways around the world.) The exact percentage doesn’t matter; this one is probably an underestimate anyways, because most people try to hide what they’re going through. The Rare Diseases Act of 2002 defined a rare disease as one that affects fewer than 200,000 people in the United States. Even if you take each form of mental illness individually, they don’t fit into this category.
4) Myth: People will be happy if they just choose to see the world more positively
This is a particularly painful one. We love to tell people who are struggling things like Just think more positively and the world will respond positively. But this isn’t true; your brain is not, in fact, in control of the world. It’s not even really in control of itself. Although there’s always a degree of intentionality that needs to go into the treatment of mental illness– you do need to choose to do things differently at some point– positive thinking is not a treatment. A number of studies have found differences in thinking and emotion in depressed patients, leading many to speculate that attempts by unhappy people to force themselves to think positively actually make things worse.
5) Myth: Kids have mental health problems because of bad parenting
We don’t know what causes psychiatric disorders– it’s that simple. While it’s believed that stressful home environments and difficult relationships with parents contribute to mental illness in children, saying that they cause mental illness is dishonest. To do so is to ignore the complexities of the brain and its illnesses, which are thought to come from some nuanced combination of genetics and environment. Of course, you should still treat children as well as possible. The point is more about the way we assess parents: don’t assume that they’ve somehow “ruined” their child if the kid is struggling.
6) Myth: Kids are overmedicated and shouldn’t be put on medication
Taking a broad societal issue (all those headlines about the overmedication of children) and applying it to specific cases is rarely a good idea. Yes, it’s bad to dispense a few of your extra Prozac to your kid like Tylenol in the hope they’ll feel better. But if you’re taking them to a psychiatrist, the psychiatrist should be doing a thorough examination and making a careful evaluation of all the options. Every treatment decision is a balance of potential pros and cons, and we don’t really know what most medications do to children or long-time users. But the same is true of adults: seeing as most of these medications have been around for just a few decades at most, we don’t really know what’s going to happen to people who take them throughout their lives.
We can address the broader societal implications later on, but for now it’s worth saying: if your child is working closely with an experienced professional who believes that medication would be a good treatment option for them, you should probably trust them and not the person on your Facebook feed posting repeatedly about how psychiatric drugs are turning children into zombies.
7) Myth: All therapists are basically the same
A lot of friends and family members have told me they don’t really like therapy, or therapy just isn’t for them, or something else like that. While there are real problems with therapy today (like financial and geographical inaccessibility), saying you don’t like therapy is a lot like saying you don’t like traveling because you had a bad experience in one place. More likely you saw one therapist, or a couple therapists, and decided that the whole thing was silly because you didn’t like how it went. There are tons of different approaches to therapy and different types of clinicians. And then there are the countless individual differences between therapists that can determine– much more than the type of therapy or the amount of education they’ve completed– whether or not you enjoy meeting with them on a regular basis.
Back when I was looking for a clinician, it was important that they had a good sense of humor, were always staying updated on the latest research, and were willing to draw from multiple different types of therapy as needed, instead of insisting on seeing everything through one methodological lens the whole time. If you don’t like your therapist, don’t stick with them; unlike most relationships in life, walking away from your therapist should be relatively uncomplicated (though not free of guilt or sadness). But try not to write off therapy as a whole, because you’ll risk missing out on really helpful stuff.
8) Myth: You need to have a diagnosis to start thinking more about your mental health
The times, they are a-changin’. Very slowly. And maybe not. But we’ve all been stuck for a long time thinking in terms of distinct mental health conditions, as listed in the Diagnostic and Statistical Manual of Mental Disorders (or the ICD, for those of you in Europe). The DSM has had its fair share of controversies since the first edition was published in 1952, like its inclusion of homosexuality as a “sociopathic personality disturbance” until 1974 and the fact that it seems intent on eventually classifying every deviation from contentment as a treatable disorder. But, in large part due to the pressures created by our daunting bureaucracy of insurers, pharmaceutical companies, and clinicians, the DSM has stuck around.
Another concern about diagnostic manuals is the difficulty of defining specific criteria for each disorder. If you spend three weeks feeling really down, are you depressed? How about four weeks? What does it mean to be really down? Then are you depressed, or just dysthymic? Do you have an anxiety disorder, or a psychiatric condition like OCD that has a lot in common with some of the anxiety disorders?
These aren’t the questions that people trying to feel better really need to spend time thinking about. Diagnosis can help people get the best possible treatment for their unique struggles, but it can also become a distraction for patient and clinician alike. Especially with anxiety disorders and OCD, many people end up fixated on their diagnosis, to their own eventual detriment.
Many clinicians and researchers have stopped thinking much of the DSM’s classification system, though they have to keep dealing with it in one way or another. In fact, some of them are proposing an entirely different system called the Hierarchical Taxonomy of Psychopathology. The HiTOP assesses people’s place in a bunch of different categories and takes a close look at the specific ways these categories come into play. Whether or not this new system is substantially different, the point remains: you don’t need to wait for a diagnosis to start improving your mental health, and any diagnosis you receive is going be a “best guess” based on your symptoms. Clinging to a diagnosis might help you find other people and new information that you can relate to and benefit from. But it won’t make you better.
Final thoughts: What can we all do to become better informed?
Health information has always spread in a way that makes it prone to misunderstanding: by word of mouth, based mostly on anecdotal evidence, credible only because someone you trust is telling you about it. If you’re interested in losing weight, and a close friend tells you that eating 30 almonds per day has been shown to make you lose weight, you’ll likely try it.
Further complicating things, the media tends to present all research as if it’s conclusive. People in media are evaluated based on the number of readers or viewers that their content attracts, because ad revenue comes from quantity. This means there’s constant pressure to make articles feel urgent so that more people want to click on them. I’ve done something similar in the title of this blog post, telling you these myths make us feel worse in an attempt to get people reading it. Nobody wants to feel bad; whether or not an article actually provides something that can help people feel better, the promise that it will do so generates a lot of interest. Look below: which of these two articles is going to get more readers?
The point isn’t to suggest that the media is evil; rather, it’s about understanding an author’s motivation and being more cautious when health news is promoted as conclusive information rather than as an impressive new step toward some unknown destination. Some media outlets are more responsible than others about the way they present health news, and even an article that seems like clickbait can deliver on the promise in its title.
But you can also help yourself. Let’s say you see a headline claiming coffee is bad for your mental health. Listening to that healthy skepticism in your gut, you look for the link to the actual study. There you see that the study never says coffee is bad for your mental health. Instead, it points to a more specific finding that might indicate some negative effects of coffee on the mental health of one subset of the population. (For the record, this isn’t a real study. And if it is, I don’t want to see it. I’m drinking coffee right now.)
Always try to read just a bit of the study that an article is based on. Most people don’t have time to read a bunch of scientific studies, but you only have to read a few paragraphs. The abstract and conclusion are usually quick reads, and will help you understand what really happened in the study. Almost every study will conclude with some thoughts about all the additional research that’s needed on its topic. This is the kind of humility that we all should bring to discussions of health, given how little we actually know.
As if health information weren’t already convoluted enough, mental health also has to deal with stigma and with the (related) fact that people have only been even trying to understand mental health for a few decades. People are afraid of what they don’t understand, and mental illness appears unknowable because we as a society have invested so little in trying to understand it better. Even more than the way media overstates new findings, our culture of fear creates mental health miscommunication. So you’ll have to be the first step for many people around you. Tell them all the things you know, but remember that all of our so-called knowledge could be flipped on its head at any moment.
That’s all for now. What other mental health myths do you want to dispel? Tell us on social media!
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