Modern Mental Health Culture: An Apocalyptic Start
Abigail Shrier argues the current state of modern mental health is categorised as "apocalyptic," as it is being made worse by excessive treatment, diagnosis, and psychiatric medications. Many individuals who are otherwise well are being convinced they are unwell or have mental health problems. This issue is particularly detrimental for children, who lack the ability of adults to push back against unneeded interventions.
The Pathologisation of Normal Emotions and Experiences
A significant problem is the over-medicalisation and pathologisation of human emotions. Normal sadness is rebranded as depression, and normal worry becomes anxiety, leading young people to perceive these feelings as illnesses that require treatment. Unhappiness, which could be a natural signal to address issues in one's life, is instead seen as a mental health problem to be eliminated. Grief, for instance, is a natural and healthy response to loss, not an illness. This culture promotes pathologising normal life and interpreting oneself and others through the lens of psychopathology, often using the language of psychotherapy. The overuse of the term "trauma" is also seen as highly detrimental, as building a narrative around an event as traumatic, even if objectively not severe, can lead to adult psychopathology. Identifying with a diagnosis, such as "I have depression," can also strip individuals of agency and the belief in their capacity to overcome challenges. There is a paradox where increasing access to and prevalence of depression treatment has coincided with a stark and rapid rise in depression rates across the West. This suggests that treatments are not effectively reducing depression, and may even be contributing to its rise by encouraging behaviour symptomatic of depression, such as dwelling on pain and pathologising normal life.
The Harmful Impact of "Bad Therapy" on Young People
"Bad therapy" is defined as any therapeutic intervention that exacerbates existing symptoms or introduces new ones. Key issues include:
- Constant Feelings Focus: There is a continuous emphasis on monitoring and discussing feelings, particularly negative ones, which can worsen already unhealthy lives for children. This hyperfocus on emotions can lead to increased disregulation.
- Increased Diagnosis and Demoralisation: Children are being diagnosed at alarming rates, with one in six American children aged two to eight having a mental or behavioural diagnosis as of 2016. This includes diagnoses like ADHD, Oppositional Defiance Disorder, and anxiety. A common side effect of diagnosis is demoralisation, where individuals feel permanently limited by their label and believe they cannot overcome issues like shyness, needing medication or a therapist instead.
- Treatment Dependency and Lack of Agency: Many young people develop a dependency on treatment, believing they cannot manage without consulting an adult. This constant need to "check in with an adult" can make them feel frantic and incapable of handling normal life independently, undermining their agency and willingness to take risks.
- Ineffectiveness and Worsening Outcomes: Studies have shown that therapy can make people sadder and feel less capable. Research on burn victims, first responders, breast cancer survivors, and those experiencing natural bereavement indicated that groups receiving therapy felt worse than control groups who did not. This is because humans are naturally built to recover from grief and distress, often through social connections, activities, and exercise.
- School-Based Interventions: Social Emotional Learning (SEL) programs in schools, intended to teach emotional regulation, often lead to rumination by encouraging children to focus incessantly on their negative feelings and past pain. This can also cause children to become more anxious, depressed, and alienated from their parents. School counselors can inadvertently act as tools of avoidance, helping children evade difficult challenges like tests, which ultimately worsens anxiety.
- Degradation of Parent-Child Trust: Therapy can lead children to mistrust their parents, especially when discussions of past pain lead to the conclusion that parents failed them. While adults can process childhood issues with distance, children still rely on their parents for safety and protection; therefore, degrading this trust can increase their fear and lead to a belief that they cannot trust any adults. Therapists have also been observed contributing to young adults cutting off parents for non-severe reasons, such as feeling emotionally unsupported.
- Lack of Accountability: Unlike the medical profession, therapy often lacks rigorous tracking of side effects or objective measurement of improvement. This is partly because patients may feel a temporary "purge" or relief after a session, even if their condition is worsening long-term.
Contrast: Beneficial Therapy for Adults vs. Harm for Children
Adults are generally capable of managing their own lives and can discerningly choose whether therapy is helping them. They can benefit from therapy for various reasons, from severe problems to trivial ones, because they possess the life experience and agency to evaluate its impact and push back if needed. However, children, lacking this life experience and capacity for evaluation, are more susceptible to the negative influences of "bad therapy," making it a much greater problem for them.
Root Causes of Youth Unhappiness and Alternative Solutions
Many young people are suffering from "bad lives" marked by loneliness, isolation, excessive online activity, and a lack of real-world connections. Instead of viewing unhappiness as an illness, it should be recognised as a healthy signal from the body indicating that something in life needs to be addressed. Effective solutions proposed include:
- Subtraction of Negative Influences: Less obsession with mental health, less focus on "wellness" and feelings, and less time spent on technology and social media.
- Addition of Positive Practices: More exercise, more engagement with the real world, increased human connection, stronger ties with extended family, and involvement in projects larger than themselves or contributing to the community. Exercise, including dancing, is highlighted as remarkably beneficial for mental health.
- Parental Role: Parents are seen as primarily responsible for making these changes. They should assert their authority, limit technology, and instill faith in their children's ability to overcome adversity, focusing on building strength rather than merely pursuing happiness.
- Learning from Failure: The current generation has been shielded from failure, hindering their ability to develop emotional regulation. Experiencing and overcoming setbacks is crucial for learning resilience.
Permissive/Surveillance Parenting and "Neuro-trash"
Modern parenting styles are a significant contributor to the problem.
- Lack of Independence: While traditional permissive parenting (anything goes) had its flaws, it at least offered children genuine independence. Modern "surveillance parenting" combines emotional affirmation with a lack of rules, punishment, or genuine independence, leading to worse outcomes. Children are given trivial choices but denied the opportunities to develop abilities through facing hard things independently. Parents need to remain in charge, even while being gentle, rather than letting children dictate family dynamics.
- "Neuro-trash": Parents are often misled by claims from the mental health establishment that assert a need to understand complex neurological concepts like the amygdala to raise children effectively. These claims are often based on crude understandings of the brain and misapplication of research, such as extrapolating findings from combat veterans with PTSD to children experiencing ordinary distress like teasing.
Over-medication of Young People
Children and young people are extensively over-medicated, a trend different from adults choosing medication. The approval of strong antidepressants like Lexapro for seven-year-olds is cited as an example. Many young people are on multiple psychotropic drugs, often prescribed by pediatricians.
- Dangers to Development: Medication can interfere with a young person's ability to develop emotional resilience and musculature, preventing them from experiencing and learning to navigate difficult feelings.
- Impact on Intimacy and Agency: Interfering with a young person's sex drive through medication can hinder their ability to form intimate relationships, potentially permanently, as sex drive is linked to the drive for close connections. Furthermore, a teenager who starts medication early may never learn if they can handle life's challenges without pharmacological support, undermining their self-belief and capacity.
Climate Anxiety and Externalised Locus of Control
Climate anxiety in young people is largely not an organic problem but is induced by adults and "climate therapists" who present climate change in an overly terrifying manner. This often involves omitting positive environmental trends or exaggerating negative ones, which is described as "lying". This rhetoric contributes to an externalised locus of control, where young people believe they have little agency over their future and are at the mercy of uncontrollable forces. This belief in being "unwell" or "sick" further limits their perceived capacity to face life's challenges.