Are you mentally ill? Why some people answer “yes” even when they have not been diagnosed

Mental disorders such as depression and anxiety are on the rise, especially among young people. Demand for treatment is increasing and prescriptions for some psychiatric drugs are increasing.

This upward trend in prevalence parallels the growing public focus on mental illness. Mental health messages permeate both traditional and social media. Organizations and governments are urgently developing awareness, prevention and treatment initiatives.

Cultural attention to mental health has clear benefits. It increases awareness, reduces stigma and encourages help-seeking.

However, it can also come at a cost. Critics worry that social networking sites are promoting psychiatry, over-diagnosing concepts, and “talk therapy” exacerbating common unhappiness.

Lucy Fowlkes, a British psychologist, believes that people’s tendency to focus and diffuse is related. His “prevalence inflation hypothesis” suggests that increased awareness of mental illness may lead to some people misdiagnosing themselves if they have relatively mild or transient problems.

Foulkes’ assumption is that some people have too broad an understanding of mental illness. Our research supports this view. New research shows that the concept of mental illness has expanded in recent years, a phenomenon we call “conceptual creep,” and that people vary widely in their understanding of mental illness.

Why do people self-diagnose mental illness?

In a new study, we investigated whether people with a broad understanding of mental illness are more likely to self-diagnose.

We defined self-diagnosis as a person’s belief that they have a disease, whether or not they received a diagnosis from a professional. We assessed that people have a “broad understanding of mental illness” when they judge a variety of experiences and behaviors as relatively mild disorders.

We asked 474 nationally representative American adults whether they believed they had a mental illness and whether they had received a diagnosis from a health professional. We also asked about other influencing factors and demographics.

Psychiatric disorders were common in our sample: 42% reported having a current self-diagnosed disorder, most of whom received it from a professional.

Not surprisingly, the strongest predictor of reporting a diagnosis was relatively severe distress.

A second important factor after the breakdown was the widespread understanding of mental illness. When their level of distress was the same, those with a broad understanding were more likely to report a current diagnosis.

The graph below illustrates this effect. It divides the sample by level of distress and shows the proportion of people reporting a current diagnosis. Those with a broad understanding of mental illness (highest quartile of the sample) are represented by the dark blue line. Individuals with a narrow understanding of mental illness (the lowest quarter of the sample) are represented by the light blue line. People with broad perceptions were more likely to have mental illness, especially when their distress was relatively high.

Those with less mental health literacy and less stigma were more likely to report a diagnosis.

Two interesting findings emerged from our study. People who self-diagnose but have not received a professional diagnosis have a broader understanding of the disease than those who do.

In addition, younger and politically progressive individuals were more likely to report a diagnosis, consistent with previous research, and had a broader understanding of mental illness. The tendency to master these broader concepts partially explained their high diagnostic rates.

Why is this important?

Our findings support the idea that broad perceptions of mental illness may encourage self-diagnosis, thereby increasing the apparent prevalence of mental illness. Individuals with lower thresholds for identifying depression as a disorder are more likely to self-identify as mentally ill.

Our findings do not directly indicate that broad perceivers are overdiagnosed and narrow perceivers are underdiagnosed. And they didn’t prove to have a broad understanding causes self-diagnosis or results real mental illness increases. However, the findings raise important concerns.

First, they argue that raising awareness about mental health may be costly. In addition to improving mental health education, it also increases the likelihood that people will misdiagnose their problems as disorders.

Improper self-diagnosis can have negative consequences. Diagnostic labels can become identity-defining and self-limiting because people believe that their problems are hard to control and enduring.

Second, unreasonable self-diagnosis can lead people with relatively mild pain to seek unnecessary, inappropriate, and ineffective care. A recent Australian study found that people with relatively mild pain who received psychotherapy tended to get worse rather than better.

Third, these effects can be particularly problematic for young people. They are at greatest risk for having a broad understanding of mental illness, in part due to social media use, and experiencing relatively high and rising rates of mental ill health. Whether broader concepts of illness play a role in youth mental health crises remains to be seen.

Constant cultural changes are broadening the definition of mental illness. These transitions are likely to bring mixed blessings. By normalizing mental illness, they help break the stigma. However, by pathologising some form of everyday suffering, they may have an undesirable disadvantage.

As we grapple with the mental health crisis, finding ways to raise awareness of mental illness without inadvertently raising it is critical.

This article is republished from The Conversation under a Creative Commons license. Read the original article.