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Key points
- Society has placed a higher value on mental health over the last decade, in part as a result of the internet.
- Online dissemination of information about mental health brings about opportunity and also potential harm.
- Clarification of mental health terms for symptoms, signs, diagnoses, and treatments should be a high priority for mental health experts.
Since the dawn of the internet, followed by the start of blog posting, and the development of social media platforms thereafter, society has had to adjust to a virtual world of rapid and wide-reaching dissemination of information that becomes immediately consumed by the masses. The rate of online engagement has only increased during the COVID-19 pandemic. As an online society, akin to a teenager reaching stages of pubertal development, we’re taking risks, we’re often boastful and self-centered, we’re highly aware and sensitive to others who pose as competition, we’re “experts” at nearly everything, we’re often reckless and irresponsible with what we say and share, we find difficulty in learning from experience, and sadly, it’s all impacting our mental health.
Mental health experts have an opportunity to patch the holes, filling the gaps of knowledge with clarification and understanding. As a psychiatrist, clinical researcher, and social entrepreneur, and alongside colleagues in the mental health field who are also concerned about the direction of our society, we have dedicated ourselves to educating the masses about mental health. I have spent the better part of the pandemic learning and understanding how the masses create and consume information content about matters of mental health. Although I am greatly impressed with the enthusiasm and engagement that people have about mental health, I wish to share a few themes that I think may be helpful in our information consumption.
Misunderstandings and misuses of complex mental health terms
Words matter. This couldn’t be truer of medicine, and particularly of mental health and mental illness. The accuracy of mental health terminology is more important because we do not yet have labs, imaging, or other tools to make our diagnoses. As mental health symptoms and diagnoses have become more widely used in the general population, it has resulted in the inadvertent misunderstanding or misuse of the terms that describe them. Some of these terms have become a part of idiomatic phrases, which I will list below with a brief explanation of why these are potentially harmful.
“Mood swings” = Bipolar disorder
Bipolar disorder is a complex mental illness that impacts about 3% of the population. That means that it is relatively uncommon. The hallmark syndrome of bipolar disorder is that the person has experienced a bout of mania, which is not just a “mood swing” but rather an elevated mood that persists for longer than one week and is associated with decreased need for sleep, disorganized thoughts, abnormal speech patterns, and impulsive/reckless behaviors. A manic episode is so destructive, the person may need to be hospitalized to receive medications to bring them back into a period of normality (called euthymia). While it is true that stress can lead to a manic episode for people with bipolar disorder, many people who experience stress may find that their “mood swings” are varying degrees of irritability. Furthermore, a shift in mood that lasts for longer than a few days may be a sign of other conditions, such as depression. However, this requires a mental health evaluation by an expert.
“I am bipolar”
We are not our medical diagnoses … at least I hope not. If the illness is acute (short-term and time-limited), the person can typically recover without many long-term psychological issues. However, for people with chronic and lifelong illnesses, such as bipolar disorder, hopelessness and shame can impede the person from seeking, establishing, and maintaining treatment. Not to mention the feeling that their brain is “irreversibly broken.” For some people, over the course of their treatment of illness, they can overly emotionally connect and identify themselves with being ill, which could impede the hard work that it takes to treat and manage the illness in order to get better and stay better. For these reasons, I try to teach my patients with bipolar disorder that their condition is treatable, manageable, and that they can choose the myriad of ways to identify themselves other than with their condition.
“My depression…”
Ironically, I have seen a few patients in my practice who tell me about their depression but who do not have the diagnosis of depression. Because it is not clear what they are considering as depression, I work with them to figure out whether “their depression” is a symptom of sadness, discontent, disappointment, indifference, shame, anxiety, or a multitude of other strong negative emotions. While it is true that some patients may have sub-clinical depression that comes in and out and is experienced as intense periods of mood shifts, clinical depression (major depressive disorder) is an acute illness that causes a deviation from the baseline mental functioning that lasts for at least two weeks almost continuously. In my clinical experience, many of the patients I see who say “my depression” are typically feeling symptoms of overwhelm or anxiety related to stress.
“My OCD…”
Obsessions are worried thoughts that recur, whereas compulsions are behaviors that are based on an urge, oftentimes to relieve themselves of the worry. Obsessions and compulsions can be a part of normal life. For example, repeated worries about an upcoming test can motivate a person to feel compelled to study more, which would be an adaptive and productive strategy. On the other hand, people with obsessive compulsive disorder (OCD) can worry about things that can be related or even unrelated to a stressor and can develop unproductive behaviors that solve the worry but not the stressor. For example, a person with OCD can fear an upcoming test and compulsively vacuum and clean the entire household resulting in a clean house, but not adequate time or effort to prepare for the test. In OCD, the obsessions can be realistic or unrealistic worries, but they occupy so much of the person’s time and mental space, they can’t focus on the task at hand. OCD is manageable and treatable, but a proper evaluation is required by a mental health expert.
“My PTSD…”
Acute trauma is an intense emotional response due to a crisis, disaster, or emergency. There are different kinds of trauma each with different potential consequences and potential treatments. Not all trauma leads to a clinical condition, such as post-traumatic stress disorder (PTSD), which affects 3.5% of the population. PTSD is associated with intense and high states of anxiety, avoidance of situations that may trigger the anxiety, and mental re-experiencing of the traumatic incident(s) that can also lead to a trance state, called dissociation. Trauma can certainly lead to psychological issues (broadly) that can be worked on in psychotherapy, but it may not lead to PTSD, thankfully. To make things a bit more confusing, in various clinical settings, the term, “trauma”, can be used to describe a natural course of a person’s life. For example, a therapist may speak to their clients/patients about the “traumas” of growing up- that is- the emotionally intense experiences of normal stages of development. Either way, it may be helpful to speak with a mental health clinician about what is meant by trauma and how that may impact your life.
“I just need to process and/or work through all of this…”
It’s a healthy thing to process our emotions about a situation, and sometimes we need time to evaluate things clearer when emotions are not so intense. The emotional process requires multiple steps that starts with sensing and registering the emotion, then identifying which emotions are being experienced, the context of the situation that is triggering the emotions, determining the end outcome we wish to happen, and eventually developing a plan of how we wish to solve the situation. However, the expression above can be sometimes used to avoid discussing the situation. One way to find out if you’re needing to process or just avoiding the situation altogether is to have a plan to follow up with the person about the situation, and then follow through.
“I’m being triggered…”
We all get triggered emotionally about things throughout our days and weeks. This shouldn’t mean we can’t confront our emotions and figure out ways to solve the issues at hand. If the trigger is one that requires a therapist’s guidance, it would be great to work with the therapist on ways to manage the emotions when they occur, rather than avoid anything that could trigger your emotions. This builds emotional resilience.
“I did my research…”
Finding information about mental health or mental illness online is drastically different from using the scientific process to evaluate medical information. Oftentimes online health information is being written by a non-expert, or a person who calls themselves an expert but has no credentials, training, or experience to speak on the matter. At its worst, online information is being conveyed by those who have a financial interest in the information being one way or the other. A medical doctor or mental health clinician can help with the process of evaluating the scientific evidence for or against diagnoses and treatments. We are well-versed in mental health conditions because our certifications and licenses require a multitude of tests and hours of training, and we invested our own time, money, and effort to help others. Let us help you with your research.
In Summary
Mental health is becoming incredibly important to the masses of people in our society, especially during recent years. Therefore, education is important so that people don’t inadvertently cause more issues to their mental health. We are here to help—use us for what we’ve dedicated our lives to do.
