Question about chronic mental disorders

[Fether]

I’ve done a little bit of study on this with kit a lot of luck. This is one of those topics where you have to blindly agree with the narrative or you face the wrath of the world. And whether the narrative is true or false, it makes it hard for normal people, like me, to really learn about it.

I don’t doubt that chronic mental disorders like anxiety and depression is a real thing. My question is “CAN it be self inflicted/induced?”. Does society’s obsession with depression, and other emotional/mental disorders, and the constant messaging that it is real and rampant socially encourage people to self diagnose as depressed? And by extension have doctors diagnose people too? After all, if you have depression or anxiety, you now have a legitimate reason for people to go easy on you.

so, here ar met questions:

- Can chronic mental disorders be self inflicted?

- if yes, is it a sub-conscience coping mechanism used to get out of uncomfortable situations?

- is there a concern that even a large minority of diagnosed chronic disorders are self inflicted inflicted and not a legitimate issue?

and again, to avoid straw men and people who are implanting their own meanings in my words so they have something to rage against, here is A list of things I am not saying:

1. chronic depression/anxiety is fake

2. We should freely judge and question people who claim to be depressed because it may be self induced

3. Chronic depression and anxiety is 100% self inflicted/induced

 

Edited May 2, 2022 by Fether

[CA Steve]

Why is a self inflicted (or induced) issue any less an issue that one that is not?

And I always go west on people with depression. 😋

Edited May 2, 2022 by CA Steve

[OGHoosier]

47 minutes ago, Fether said:

I’ve done a little bit of study on this with kit a lot of luck. This is one of those topics where you have to blindly agree with the narrative or you face the wrath of the world. And whether the narrative is true or false, it makes it hard for normal people, like me, to really learn about it.

I don’t doubt that chronic mental disorders like anxiety and depression is a real thing. My question is “CAN it be self inflicted/induced?”. Does society’s obsession with depression, and other emotional/mental disorders, and the constant messaging that it is real and rampant socially encourage people to self diagnose as depressed? And by extension have doctors diagnose people too? After all, if you have depression or anxiety, you now have a legitimate reason for people to go east on you.

so, here ar met questions:

- Can chronic mental disorders be self inflicted?

- if yes, is it a sub-conscience coping mechanism used to get out of uncomfortable situations?

- is there a concern that even a large minority of diagnosed chronic disorders are self inflicted inflicted and not a legitimate issue?

and again, to avoid straw men and people who are implanting their own meanings in my words so they have something to rage against, here is A list of things I am not saying:

1. chronic depression/anxiety is fake

2. We should freely judge and question people who claim to be depressed because it may be self induced

3. Chronic depression and anxiety is 100% self inflicted/induced

 

Thanks for asking this question. Honestly, it would be foolish to rage against people for asking if afflictions like these could be self-inflicted. That sort of reaction, it seems to me, must stem from a perception that those who have a hand in their own suffering are less worthy of support or care. I can see how that would be intuitive when the consequences of their actions were clear and the support they request is excessively burdensome, but when people didn't know what they were doing this sort of reaction is stupid. It is good to identify if people are hurting themselves and help them to stop.

In short, thank you for asking, keep asking these sorts of questions, the rage is both unfounded and counterproductive. 

In response to the actual topic of discussion, I admit I'm not very versed in the literature off the top of my head. I would, however, be extremely surprised if the nocebo effect didn't interact with chronic depression or anxiety in varying degrees. There is research to suggest that the narrative of the permanence of chronic mental health problems actually exacerbates them. Jacob Hess has been a big voice in this and a compendium of his peer-reviewed research and popular-level writing on the subject can be found here: https://unthinkable.cc/mental-health/. Basically, people don't just snap their fingers and say "I have depression," at least not in the majority of cases (I don't doubt that there are some Munchausen-esque cases out there, but I have no power to identify them). However, the way we talk about mental health as a society, and an individual's participation in these narratives, might well exacerbate and perhaps create chronic mental health problems.

Also, I can't help but think that the dialogue among the young (and I am young, being only an undergraduate) about mental health isn't great right now. The push to destigmatize depression and anxiety has borne some strange fruit. I think it has lessened the stigma to a certain extent, but it hasn't done away with it entirely, and it has spawned communities (particularly on TikTok but also in many high schools) who go the opposite direction and seem to have adopted the mental health problem as part of their personal identity. I cannot regard that as healthy or frankly as anything other than depressogenic. Is there a social incentive to doing so? I think it can offer a community for lonely kids who don't have one, and a way to distinguish themselves in the world. I don't think it measurably raises social status from what I've seen, though. 

Edited May 2, 2022 by OGHoosier

[bluebell]

1 hour ago, Fether said:

I’ve done a little bit of study on this with kit a lot of luck. This is one of those topics where you have to blindly agree with the narrative or you face the wrath of the world. And whether the narrative is true or false, it makes it hard for normal people, like me, to really learn about it.

I don’t doubt that chronic mental disorders like anxiety and depression is a real thing. My question is “CAN it be self inflicted/induced?”. Does society’s obsession with depression, and other emotional/mental disorders, and the constant messaging that it is real and rampant socially encourage people to self diagnose as depressed? And by extension have doctors diagnose people too? After all, if you have depression or anxiety, you now have a legitimate reason for people to go east on you.

so, here ar met questions:

- Can chronic mental disorders be self inflicted?

- if yes, is it a sub-conscience coping mechanism used to get out of uncomfortable situations?

- is there a concern that even a large minority of diagnosed chronic disorders are self inflicted inflicted and not a legitimate issue?

and again, to avoid straw men and people who are implanting their own meanings in my words so they have something to rage against, here is A list of things I am not saying:

1. chronic depression/anxiety is fake

2. We should freely judge and question people who claim to be depressed because it may be self induced

3. Chronic depression and anxiety is 100% self inflicted/induced

 

There is a difference between situational depression and clinical depression.  

Situational depression is usually short-term and develops because of a traumatic event in the person's life, or some other kind of change (like divorce, loss of a job, etc).  Situational depression should still be treated, because if it goes on too long it can turn into something much more severe.

Clinical depression is more severe and can be caused by chemical issues in the brain as well as genetics.  Drug and alcohol addiction can also cause it.

Likewise with anxiety, there is the anxiety of the unknown (which can be a bit self inflicted if the person never forces themselves to do things that cause them anxiety).  This is the anxiety that people feel when they have to call the doctor's and make an appointment but have never done it before so don't know what to expect and are worried they are going to end up looking dumb.  Refusing to do anything that causes anxiety means that your body never learns that the anxiety wasn't actually a danger to it.  So it just keeps on believing these situations are dangerous, and might start applying that danger to other 'non-dangerous' situations as well, just making everything worse.

And then there is the anxiety that can stem from post traumatic stress.    This is the kind where someone starts having panic attacks when they drive at night for example, after being in a bad car accident one night.  Or the panic attacks that might start to happen after a sexual assault, for another.

[pogi]

1 hour ago, Fether said:

This is one of those topics where you have to blindly agree with the narrative or you face the wrath of the world. And whether the narrative is true or false, it makes it hard for normal people, like me, to really learn about it.

What "narrative" are you referring to?  This will help us understand where you are coming from.  What are your questions/concerns with such narrative.  

1 hour ago, Fether said:

After all, if you have depression or anxiety, you now have a legitimate reason for people to go east on you.

I am guessing this was a typo and you meant to say "easy on you".   Can you explain what you mean.  In what way do people with anxiety and/or depression get the easy way out?  I am not quite sure what you are getting at with this statement to be honest. 

1 hour ago, Fether said:

- Can chronic mental disorders be self inflicted?

Do you mean intentionally?  Of course the choices we make in life can lead to depression/anxiety, but that doesn't make them any less concerning.  Mentally healthy individuals can experience acute depression/anxiety from poor life choices (if that is what you mean by "self inflicted"), but chronic issues usually stem from long, sometimes life-long learned unhealthy mental patterns, or unhealthy coping mechanisms, lack of social support, past trauma, etc.  Anyone who habitually makes poor life choices usually has some history that led them to that.  This is not to say that they have no accountability for their choices, but it is not as simplistic as suggesting that they did it to themselves.    I don't think it helps to place blame when it comes to mental illness.  Trauma is trauma, physical or mental.  There seems to be a stigma around mental illness that it is somehow less legitimate or worthy of compassion and concern if our own life choices have in some way led to it.  Addressing mental health should be no different than treating physical trauma.  It doesn't matter if it was "self-inflicted" or not.  It needs to be taken seriously and addressed with compassion. 

1 hour ago, Fether said:

- if yes, is it a sub-conscience coping mechanism used to get out of uncomfortable situations?

Depression/anxiety is a mental state you experience.  People may try to leverage their diagnosis of depression/anxiety to get out of uncomfortable situations, which may be an unhealthy coping mechanism, but depression/anxiety itself is not a coping mechanism.  Unhealthy coping mechanisms are often part of the problem, while anxiety/depression are the symptoms of the problem. 

What if some people are using their diagnosis as leverage in unhealthy ways to cope, would that change things for you?  Why or why not?  Should we expect them to behave like mentally healthy individuals simply because we can see the problem in their behavior?  These things take time and work.  We shouldn't always have the same expectations as we have with otherwise mentally healthy people.  We need to work with them from where they are at and work on incremental progress towards more healthy behaviors and coping mechanisms. 

1 hour ago, Fether said:

- is there a concern that even a large minority of diagnosed chronic disorders are self inflicted inflicted and not a legitimate issue?

What do you mean by "self inflicted", and what do you mean by "not a legitimate issue"?

If someone came into an ER with severe head trauma because of their poor life choices to not wear a helmet on their motorcycle while causing an accident by reckless driving, would you consider that "not a legitimate issue"?  Why should mental health be seen any different from physical health in this regard?  

 

Edited May 2, 2022 by pogi

[pogi]

Duplicate

Edited May 2, 2022 by pogi

[Navidad]

I am not a big fan of the concept of self-induced chronic mental illness. I think in the case of genuine mental illness, a better distinction is between functional and organic mental illness. Both are real mental illnesses. Both have causes and need treatment. My experience (as director of counseling services) at two institutions of higher education is that it can be challenging to differentiate between the two. The treatment modalities may be different but the presenting symptoms may be quite the same. Determining causation is the challenge. That often requires the skills of physicians.

Family dysfunctions are most often functional and are very terribly real. They may be caused by one or more family members with organic illness, but they manifest throughout the family, often in some form of dissociative reactions. Schizophrenia has been sometimes characterized as the "go away closer" disease, especially when there is evidence of family dysfunction. Of course, schizophrenia has no one common antecedent; it may be either functional or organic or both.

I spent eight long years in regular debates with mostly Fundamentalist and often Reformed Biblical counselors who believed that all non-organic mental illness was the result of sin and could be treated with doses of Bible verses and repentance. That is another story. Take care and best wishes.

[OGHoosier]

38 minutes ago, Navidad said:

I think in the case of genuine mental illness, a better distinction is between functional and organic mental illness

Could you expand on the difference between functional and organic mental illness? I presume they both contain an element of biology.

[bluebell]

The OP made me think of something that I read last night in the book "Where the Soul Hungers" By Samuel Brown.  You can get it in Deseret Book and the author was an atheist who is now an active member of the church of Jesus Christ of Latter-day Saints.  It's not really about his faith journey but more a hodge podge of stuff that he's learned throughout the years, especially when his wife had cancer.

Anyway, I was reading a chapter last night about Solomon's wisdom and the two women who came to him to settle the issue of the lone living baby.  Brown has an interesting take on the story, contemplating that maybe the woman who was ok with the baby being cut in two was actually illustrating how her immense grief for her dead son caused her to go a little crazy.  Changing her from a woman who gave life to one who would happily take it away.

Brown then applies this to us, and how we might respond to those around us who give us a glimpse of the grief that's inside of them.  He says that "such a stark view into the heart of another person is an obligation.  It's a covenant...." 

And then he goes on to say, "here I stand, heartbroken and renewed not so much by the wisdom of Solomon as by the covenantal obligation that another's grief imposes on me.  The tears of the grief-mad woman flow from the waters in which I was baptized.  I cannot refuse to see them."

In the end, whether someone's mental illness is brought on (or exacerbated) by their own choices or not, Brown's view on the mourning of others has touched me and when it's all said and done, I agree with him. 

I do believe we have a covenantal obligation to see that grief, and respond with love.

[Fether]

2 hours ago, CA Steve said:

Why is a self inflicted (or induced) issue any less an issue that one that is not?

Because then we can combat it.

[Fether]

1 hour ago, bluebell said:

Clinical depression is more severe and can be caused by chemical issues in the brain as well as genetics.  Drug and alcohol addiction can also cause it.

Can these chemical issues in the brain be caused by ourselves if we develop habits if shameful thinking?

[Fether]

1 hour ago, pogi said:

What "narrative" are you referring to? 

Narrative in general. In the mental health space, it isn’t really looked positively on to question someone’s depression as to whether it is fixable through positive thinking. Medicine and therapy are the only acceptable routes

[Fether]

1 hour ago, pogi said:

am guessing this was a typo and you meant to say "easy on you".   Can you explain what you mean.  In what way do people with anxiety and/or depression get the easy way out?  I am not quite sure what you are getting at with this statement to be honest. 

Easy*
 

I fixed it

[Fether]

5 hours ago, pogi said:

What do you mean by "self inflicted", and what do you mean by "not a legitimate issue"?

If someone came into an ER with severe head trauma because of their poor life choices to not wear a helmet on their motorcycle while causing an accident by reckless driving, would you consider that "not a legitimate issue"?  Why should mental health be seen any different from physical health in this regard?  

The vast majority of depression can be fixed by making changes in your life, choosing the think positively, and staying away from negative situations. Happiness is very much a choice… but don’t tell people that if they experience depression because that won’t go over well. But what if that is the solution? It was for me

EDIT: I see a lot of people were offended by this. I changed it a little to clarify what I intended to say

Edited May 2, 2022 by Fether

[bluebell]

9 minutes ago, Fether said:

Can these chemical issues in the brain be caused by ourselves if we develop habits if shameful thinking?

I'm no expert (so hopefully someone who knows more will jump in) but that's not how it's been described to me.   

Think about it this way, can someone cause type 1 diabetes because of their eating habits?  No.  Our eating habits affect many aspects of our health, and they can certainly affect a kind of diabetes, but not type 1.  If someone tried to 'eat better and exercise' their way out of type 1 diabetes, they would most likely end up dead. 

The physiology of that disease is outside of our internal control.

For depression caused by the dysfunction or lack of specific chemicals, it can be the same idea (again, from how it's been explained to me).  This is why some forms of depression are genetic.  The dysfunction of the brain can be something that we are born with.

That doesn't mean that our actions and practices cannot make this kind of depression better or worse though. 

Edited May 2, 2022 by bluebell

[Chum]

2 hours ago, Fether said:

Can chronic mental disorders be self inflicted?

Off the top of my head.

Directly: In theory one could, if that person expended a great deal of persistent, carefully crafted efforts to that end. I suspect very few people would have the inclination and ability to pull it off.

Indirectly: Signing on as a first responder or combat soldier is a solid path toward PTSD and all the psychological maladies that go along with it.  To get PTSD w/o a paycheck, a person could embed themselves in a long-term, abusive relationship.

[bluebell]

2 minutes ago, Fether said:

Depression can be fixed by making changes in your life, choosing the think positively, and staying away from negative situations. Happiness is very much a choice… but don’t tell people that if they experience depression because that won’t go over well. But what if that is the solution? It was for me

In my experience, people who have struggled with situational depression and then were able to move past it, really struggle with being able to be empathetic to people who struggle with the kinds of depression that you can't think or behave your way out of.

In these situations I think one good option is to remember that when it comes to mental health, just because something was true for you doesn't mean it's true for everyone.  Everyone's brain is a little different, and everyone's dysfunction can be a little different too.  That's why it's such a struggle to find prescription drugs that work well for everyone.

[CA Steve]

32 minutes ago, Fether said:

Because then we can combat it.

Can't we combat depression that is a result of other factors?

Obviously we can so I am not sure what your point is here.

[The Nehor]

Competitive depression is a sport for the young in my opinion. I have retired from it and just compete for fun at the amateur level.

[halconero]

Do you mind if I take two of your questions and respond to both with one answer?

Specifically, if a lot (maybe even a majority?) of mental illness is self-induced and a subconscious coping mechanism.

The answer to this is "sure," but you have to square "self-induced," which implies some level of agency, and "subconscious," which implies some limits on agency.

It is absolutely true that mental health disorders can manifest in behaviours that psychologists, psychotherapists, and social workers describe as maladaptive. Maladaptive behaviours can start after major life events, or they can be habits that are picked up early on in life. These are behaviours that allow us to cope with or deal with a situation in a way that is harmful at worst, or generally unhelpful at best. We can behave in a way that certainly affects our anxiety or depressive moments.

The big thing with a maladaptive behaviour is that the person doing them often has not learned the techniques to address that behaviour directly or address the situation that they address with their behaviour. That, or they have learned the techniques, received the medication, or gotten the help, but they are not yet applying it for various reasons, both good (e.g. they are new to and stumbling through application) and bad (they are unwilling to apply them).

I don't think you'll find any serious mental health professional who believes that agency has no role or that mental health issues can't be coping mechanism (again, it's the whole concept of a maladaptive behaviour). When they seek to diagnose a patient and form a treatment plan they'll often use your medical history to determine the extent to which these behaviours play a role in your mental illness compared to enviromental factors, family history (i.e. genetics), etc. It's multifactorial and individual to the person at the same time.

[Kenngo1969]

2 hours ago, Navidad said:

... I spent eight long years in regular debates with mostly Fundamentalist and often Reformed Biblical counselors who believed that all non-organic mental illness was the result of sin and could be treated with doses of Bible verses and repentance. That is another story. Take care and best wishes.

Whether organic or not, there are those in the Church of Jesus Christ of Latter-day Saints who believe that mental illness is either: (1) punishment from God or (2) the direct influence of Satan (or both) and who believe that, thus, it can be "cured" (my word, but I think it captures the sentiment) by greater obedience to God or yielding less to Satan's lures.  I think these positions are simplistic, not helpful, and perhaps even harmful.

[Calm]

1 hour ago, Fether said:

Because then we can combat it.

You mean we as individuals or we as a community?  And by combat, do you mean prevent or lessen severity?

[Calm]

1 hour ago, Fether said:

Depression can be fixed by making changes in your life, choosing the think positively, and staying away from negative situations.

Do you believe any form of depression can be fixed in this way?

[The Nehor]

34 minutes ago, Fether said:

Narrative in general. In the mental health space, it isn’t really looked positively on to question someone’s depression as to whether it is fixable through positive thinking. Medicine and therapy are the only acceptable routes

What do you think medicine and therapy do? A lot of therapy involves techniques to overcome negative thinking. Medication (ideally) mitigates the worst of the pain and self-destructive thinking so you can dig your way out or at least dig a little ways up.

34 minutes ago, Fether said:

Depression can be fixed by making changes in your life, choosing the think positively, and staying away from negative situations. Happiness is very much a choice… but don’t tell people that if they experience depression because that won’t go over well. But what if that is the solution? It was for me

Sounds like situational depression and I am glad you were able to find a way to mitigate and eliminate the causes.

3 hours ago, Fether said:

I don’t doubt that chronic mental disorders like anxiety and depression is a real thing. My question is “CAN it be self inflicted/induced?”. Does society’s obsession with depression, and other emotional/mental disorders, and the constant messaging that it is real and rampant socially encourage people to self diagnose as depressed? And by extension have doctors diagnose people too? After all, if you have depression or anxiety, you now have a legitimate reason for people to go easy on you.

To go easy on you?

LOLOLOLOLOLOLOLOLOLOLOLOLOLOLOLOL!!!!!!!!!!!!

Outside of some internet spaces and some potentially codependent parents where are people and society in general going easy on the depressed? I have ADHD which often leads to depression and in my case has. It amuses me to no end when someone asks if the whole thing is self-inflicted and if I would just buckle up and bear down and think more positively it would melt away. I know that song and dance. It is an echo of what my brain has been telling me every day since childhood:

If I would just work a little harder and fight harder and really focus the whole thing is beatable. The medication is an unhealthy coping mechanism that could potentially cost a few years from my life, I am obviously mired in self-pity and I am a fraud using the diagnosis to justify what is clearly just a moral weakness. Drop the medication and try harder and you will finally achieve the true potential you have been squandering your whole life.

I think instead of asking how many people are faking chronic illness as an excuse to live an exciting life of misery we should instead be asking about the spike in mental illness what are the environmental effects that are exacerbating these conditions and triggering them. We also often ignore that these conditions aren’t new. People didn’t go to the torture chambers of the old sanitariums in Europe because it was an easier life. The mentally ill went there or self-medicated themselves with alcohol or some other vice into oblivion or ended the pain through death or found some way to cope (healthy or otherwise) and endured in long-term misery.

52 minutes ago, Fether said:

Can these chemical issues in the brain be caused by ourselves if we develop habits if shameful thinking?

You have someone who has lived in an echo chamber of how worthless they are for their entire life. Would the habits of shameful thinking still be considered self-inflicted? Does the nature of the cause mean that it is easier or even possible to cure?

 

[pogi]

2 hours ago, Fether said:

Depression can be fixed by making changes in your life, choosing the think positively, and staying away from negative situations. Happiness is very much a choice… but don’t tell people that if they experience depression because that won’t go over well. But what if that is the solution? It was for me

I agree that happiness is a choice, but I think you are being too simplistic about it.  It is a learning process like anything else, and for some, that choice to be happy is assisted (sometimes necessarily so) with psycho-therapy and/or drugs.  

I believe in a more holistic multi-pronged approach to anxiety/depression.  It is not a one-size fits all kind of deal.   Drugs should not be seen as a solution, but for many they are a helpful tool that allows someone a more healthy head-space to process root-causes and address life-style changes, etc.  Even with meds, everybody reacts differently and it can be challenging to find what works.  Unfortunately there are not a lot of good options with anxiety/depression meds that don't have other negative side-effects.

You can't tell someone who has a life-time of unhealthy thought processes and unhealthy coping mechanisms to just think happy thoughts.  It doesn't work like that.  While the brain is plastic and malleable, it is not instantly so.  It can take a lifetime to rewire neuronal pathways into more healthy ways of thinking and perceiving the world.  It requires overcoming deeply held beliefs about ones self and the world around them.  These beliefs are as real as the sun and moon to them.  Telling someone to just choose to be happy can be = like telling someone to just choose to stop believing in the sun, for some.  Unhealthy thought processes usually perpetuate other unhealthy thought processes, so it often requires intervention from a healthy outside source to help one along the path to healthy thinking.  When someone is blind (unhealthy thought process/coping mechanisms) it usually helps to have a guide who can see.  If there is a drug that can help one see more clearly, that is helpful too.   Often times these deeply held beliefs are on the subconscious level and it often requires trained professionals to help individuals identify them and address them in healthy ways.   Medications, life-style changes, positive mental thinking, mindfulness, therapy, physical exercise, learning healthy coping mechanisms, spiritual/emotional healing from past trauma - these are all tools that may be helpful for different individuals, and absolutely necessary for others.   So, yes, it is a choice to be happy, but that is not to say that it doesn't require long and hard personal work and support from others, and sometimes medicine. 

To tell someone that they just need to chose to be happy, and leave it at that, when they are depressed truly is a really bad idea.  There is a reason why it doesn't go over well.  

 

 

Edited May 2, 2022 by pogi