Rethinking Mental Health: Challenging the Dangers of Labels

In the contemporary world, mental health issues have garnered increasing concern. Prominent figures in politics and the entertainment industry are opening up about their struggles with depression and anxiety, and statistics indicate a rise in self-reported cases of these conditions among adults.

However, amid this surge, it becomes essential to question whether we are genuinely facing a mental health epidemic or if a more nuanced perspective deserves attention. At the core of this matter lies society's approach to mental health. Life is fraught with challenges, and experiencing feelings of unhappiness, stress, or insecurity when confronted with adversity is entirely normal. The past couple of years, characterized by enforced isolation, economic uncertainty, and job losses, have affected us all. But do these natural emotional responses automatically warrant the label of a mental "disorder," such as depression? Understanding mental health is a complex endeavour, dealing with subjective experiences and behaviours, unlike tangible physical abnormalities seen in other branches of medicine.

Science or Rhetoric

Psychiatry has presented itself as a scientific discipline, relying on evidence-based research to comprehend mental health issues and propose treatments. However, concerns are emerging about the growing dominance of "scientism" within mainstream psychiatric literature. Scientism refers to the promotion of beliefs that seem scientifically credible but may lean more towards rhetoric than genuine scientific accuracy. While evidence-based medicine aims to improve decision-making, the encroachment of scientism has resulted in biased research and the perpetuation of certain concepts and treatments without solid scientific support. Some critics argue that pharmaceutical companies and market forces may have played a role in this process, potentially compromising the credibility of evidence-based practices.

Organic and Subjective

A significant challenge in psychiatric research lies in its basic assumptions. Unlike physical medicine, which identifies the organic cause of a problem for specific treatments, mental health often relies on descriptive terms like "anxiety" and "depression" without pinpointing a clear underlying cause or aetiology. Consequently, psychiatric diagnoses may describe symptoms without offering a comprehensive explanation of their root causes. The notion of psychiatric scientism perpetuates the belief in psychiatric diagnoses as true as or equal to medical diagnoses, despite lacking the clear causal connections seen in other medical fields. In simpler terms, descriptive classifications like depression or ADHD can describe certain behaviours, but they don't provide clear explanations for why these behaviours occur. This can lead to circular reasoning and arguments that cannot be verified. As mentioned in a previous post on Ian Hacking's looping theory, humans tend to fit loose descriptions to match their experiences, which can sometimes lead to self-diagnosis. In other words, these labels may be applied to behaviours, but they don't necessarily provide a deep understanding of the underlying causes behind those behaviours.

The Impact of Labeling

Labelling individuals with mental disorders can be harmful, as described in the theory of performative language. This can include stereotypes and stigmatizing terms, which can lead to biased psychological labelling. Negative or limiting language perpetuates stereotypes and creates harmful labels that influence how individuals are perceived and treated by others. Labelling theory in sociology suggests that individuals may internalize and conform to the labels assigned to them, potentially reinforcing certain traits due to performative aspects of communication. Labelling can overshadow understanding and lead individuals to adopt the identity of a mentally ill patient, even when their experiences are entirely normal given their life situations. When clinicians follow these rigid performative linguistic categories about mental health, it can create traps, and people may start behaving according to the labels given to them. This can lead to a cycle where the labels become true because of how people treat them, generating a self-fulfilling prophecy.

Prophecy Foretold

The way we talk about mental health can shape how we see it, experience it, and examine it. When we use certain labels to describe someone's mental state, it can have real consequences. For example, if we call someone "depressed," they may start to believe and act like it, influenced by how others treat them based on that label. This cycle can make the label stick, even if it may not accurately reflect their experiences.

Given these challenges, it's important to approach mental health differently. The prevailing ideologies surrounding mental health pose serious challenges for mainstream services, beyond issues of funding or access. These ideologies perpetuate the notion that mental disorders are widespread and require a diagnosis for effective treatment, fueling an industry centred around psychiatric labels. Consequently, these ideologies have seeped into our daily lives, making us feel like we are potential patients, alienating us from normal emotions, and making us believe that our experiences indicate deep-rooted problems in our minds. Many people can end up seeing themselves as broken and in need of fixing instead of understanding that their emotions are part of normal, natural human experiences that call for empathy, connection, and compassion.

The Goal of a New Approach

The current model of diagnosing mental disorders and providing specific treatments may be outdated and flawed, potentially overlooking the natural resilience people exhibit in the face of adversity. It is crucial to move away from the idea that mental disorders are solely based on genetics or biological factors, as there is insufficient evidence to support this view. The ultimate goal should be to prioritize the observation of relationships humans have or develop with their own unique reality and social context. Focusing on human connections and addressing fundamental needs such as safety, housing, and meaningful employment will impact greatly our understanding of the so-called "mental health epidemic." While challenging scientism is necessary, abrupt and hasty shifts could lead to unintended consequences. Collaboration, open dialogue, and an unwavering focus on genuine scientific evidence, gleaned from real-life clinical settings, pave the way for mental health professionals to evolve into a more compassionate and effective field, truly helping those in need.

Operative Diagnosis

Instead of starting with a fixed idea of what the problem is, a scientific operative diagnosis encourages a flexible approach. Clinicians should closely observe and evaluate how different methods and treatments affect the problem and the person's behaviours. The central idea is to "know through changing." Instead of solely relying on theories or preconceived notions, clinicians actively engage with the problem and see how it responds to different treatments as we do in science. One of the main benefits of operative diagnosis is its focus on effective problem-solving. Instead of getting stuck on a rigid diagnosis, the main goal is to achieve positive results and meet the patient's needs. This approach prioritizes the individual's unique requirements and situation. By actively interacting with the person and continuously assessing their response to treatments, clinicians can think more creatively and avoid being limited by strict labels.

Operative diagnosis recognizes that each problem is different and needs personalized attention, as it's expressed within the context of that particular individual. It's all about being patient-centred and ensuring successful outcomes and the overall well-being of the person. This approach provides a flexible framework for dealing with psychological and behavioural issues. Clinicians are encouraged to think outside the box and remain open to new and innovative solutions.