What’s Trending in Our Culture (and how it affects mental health)

As a psychologist in private practice, I constantly see how culture affects mental health. The cultural trends, both local and global, are often reflected in clinical work. People mold the culture, and culture molds the people. It’s a reciprocal dynamic, and in it, mental health is frequently found in the spotlight. I’m going to address four trends that have popped up since the pandemic ended.

1. Collective Trauma from Pandemic
2. Mental Health Diagnoses as Identity Labels
3. Overidentification with Neurodivergence
4. Self-Diagnosing

Then I’ll talk about what can be done about them, and you can find more information about it in this podcast!

Collective Trauma from Pandemic

While everyone has different experiences and reactions related to the pandemic, now that we are post-pandemic, there are some overarching cultural themes emerging. Because of the unpredictability and utter chaos of the pandemic, overall anxiety has increased. It’s likely a trauma reaction, as we are all “on edge” for the world to erupt into crisis again - not because it necessarily will - but because that’s how trauma works. We’re hypervigilant and more easily in our fight or flight (or freeze or fawn) trauma responses.

The instability of our world during the pandemic has also led to a distrust of authority/power. How can we trust the people in authority and power when it seemed that no one could help stabilize us, and when there was conflicting information everywhere? I personally think that because there was so much conflicting information - even medical information, there’s just an overall distrust of doctors and medical authorities, which include psychologists. It seems that patients are now the “experts” with all the research at their fingertips - which makes sense as a protective coping mechanism against medical authorities who may or may not be trustworthy. However, it’s extremely unhelpful when diagnosing and treating mental health.

Additionally, hostility seems to have increased significantly, which I think is also a nod toward increased stress as well. Anecdotally, I see this everywhere from driving to social media to visits to the grocery store. Research-wise, one study found that during the pandemic about one third of public health workers experienced some form of harassment, threat, stigma, and even violence in the workplace. Because of the scarcity of adequate care (especially during the pandemic), our need for immediate gratification has increased. We want our appointments and treatment NOW, and we want our providers to fix us NOW. This has resulted in the increased burnout and mental health symptoms (i.e., depression, anxiety, PTSD, suicidal ideation) in workers in the healthcare field. The pandemic has drastically changed the healthcare field, inside and out, and all around.

Mental Health Diagnoses as Identity Labels

Not too long ago (though I may be showing my age), the psychological field went through a movement of separating labels from one’s person. For example, I was taught to say, “the person with schizophrenia” instead of “the schizophrenic,” or “my client on the spectrum” instead of “my autistic client,” or even “you’re feeling angry” instead of “you’re angry.” This movement may still exist in writing words, but not with identity. Psychological diagnoses seem to be worn as badges of specialness wrapped up in identity. People are more apt to say, “I’m ADHD” instead of “my ADHD symptoms…” Why? I think we’re finding specialness in our pain. Voices are often lost in the masses, but if heard and seen, even through a diagnostic label, then maybe it won’t hurt so much. The problems with this is that the mental health struggles faced are now part of the person (ego-syntonic) instead of outside the person (ego-dystonic). Growth is thus hindered as a result. Think about it: If I identify as depressed, how can I expect to grow and change and cope with it? It’s who I am. BUT if I am experiencing a depressive episode, I can more easily internalize that it’s a season of life that I can handle with skills and help. I don’t need to be stuck on the awareness of depression or the label of depression. I can move past the label and start working on my journey toward health.

Overidentification with Neurodivergence

In the 1990s, neurodivergent became a term to describe neurological traits that differ from “normal.” Because of the brain and neurological components, disorders such as autism spectrum disorder, ADHD, and learning disorders fall into this category. A little statistics: When doing research, it is common to consider that 95% of cases are within “normal” boundaries, with 5% of cases outside of the norm (or within 2 standard deviations of the average). Now this is cut in half, because 2.5% of cases are going to be way lower than the norm and 2.5% of cases are going to be way higher than the norm. Neurodivergent means outside of the norm. Theoretically, this means that no more than 2.5% of individuals are diagnosed with autism spectrum and no more than 2.5% of individuals are diagnosed with ADHD. The DSM-5-TR notes that 1-2% of people are on the autism spectrum and 2.5% of adults are diagnosed with ADHD (though children/teens range from .1 - 10.2% depending on the country). The overidentification with neurodivergence, paired with having a diagnostic label as an identity, is extremely problematic. Just go on social media - there are way more than 2.5% of people self-diagnosing as neurodivergent.

Also of important note: the DSM-5-TR criteria for Autism Spectrum Disorder has changed to be more clear: https://www.wpspublish.com/blog/dsm-5tr-updates-autism-diagnostic-criteria. Additionally, previous editions did not provide the following clarity about early development, instead prescribing that symptoms are present before age 3. According to the DSM-5-TR, “Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies later in life” pg. 57). Notably, the culture seems obsessed with this concept of “masking,” but is missing the point that autism is a disorder of early childhood development. Masking in this context is not mutually exclusive to this being a disorder that shows up early in life.

Self-Diagnosing

This has all led to, in my own opinion, the most problematic post-pandemic trend: self-diagnosing. It’s likely people are diagnosing themselves because of a combination of collective pandemic-related trauma, need-it-now mentality, overtaxed healthcare system, distrust of authorities, and search for identity/validation of pain found in mental diagnostic labels. The pandemic resulted in isolation and disruption to communities, so it makes sense that people can now find communities (i.e., neurodivergent) online and in social media. People like to surround themselves with social media “examples” supporting their self-diagnosis. Being in community is great! But social media is misleading…

This article highlights the misleading and “potentially damaging” influence of social media, which they referenced from this study regarding TikTok videos on mental health. Here are the main points:

• Mental Health Advice
  • 54% had accurate information
  • 31% had inaccurate information
  • 83.7% had misleading advice
  • 14.2% include “potentially damaging” content 🚩🚩
• Misleading Mental Health Information
  • 100% of ADHD content 🚩🚩🚩
  • 94.1% of bipolar disorder content
  • 90.3% of depression content
• Relevant Medical Qualifications of TikTokers
  • 9% were qualified 🚩
  • 91% were NOT qualified

⚠️Sooooo, basically it’s not good to self-diagnose or rely on TikTok for mental health information.⚠️

So What Can We Do?

We can aim to grow toward more healthy behaviors, thoughts, emotions, and patterns. Be aware that the pandemic likely affected you in a unique way, and it’s okay to seek help. Work on increasing self-awareness and self-reflection. Talk to someone, and if there’s a waitlist, get on it despite the frustrations with timing. Practice patience. Understand that critical thinking is absolutely necessary AND that most therapists are trustworthy as well. It’s a great idea to increase those critical thinking skills. Ask yourself, “What does getting this diagnosis mean?” Ask yourself - “Does it pass the smell test?” Cross-reference your data and seek accurate information. Find guidance from QUALIFIED mental health professionals (Like the Personality Couch). Try to find community and identity that is not related to mental health. Because You. Are. NOT. Your. Diagnosis. You’re you, and that is a wonderful thing.