How many adults have you come across who (inappropriately) describe pedantry as OCD, or losing focus from time to time as ADHD, or being a bit withdrawn as 'autistic'?
There's no scope for people to simply be imperfect people with imperfect character traits any more. Any minor deviation is considered to be a personal disability.
That's not to say ADHD and OCD and autism don't exist—of course they do. And I also believe that they've been under-diagnosed historically. But not all symptoms are diseases. I don't know how we solve it without ignoring people who really need help, but it's definitely an issue.
I'm very sure that my diagnosis is right (they even talked with my primary school teachers and I respond very well to the meds), but I still get these moments of self doubt / imposter syndrome in which im thinking, that I might just have made this up to trick other people and lift some responsibility from myself.
It's actually HN itself where someone mentioned a paper/medication that turned out to work quite well for me.
Being able to talk about issues like mental health problems is incredibly important and even nowadays in a modern country like Germany, not everyone is happy to do so. Every little bit of normalization helps.
Apart from that, I think it's better to help a few people who "didn't really need it" than to make it harder for those who really need help to get it.
I guess that's just it, it's a spectrum and even "normal" people can be somewhere on it. And decisions about diagnosis or labeling etc should be taken based on degree of impairment to functioning.
Saying that, we really do want to make kids aware of mental health issues (the same as health in general). I really could have benefited from an education about OCD, as it took me more than ten years to understand why I struggled so much.
If we take OCD as an example, there's clearly a huge range from 'I like the TV volume to be set to an even number' through to massive impairments to functioning to the point it's impossible to hold down a job, or that it's damaging your personal relationships.
I am a bit less comfortable with saying that it's "super subjective" where you draw the cutoff though. I agree there's some subjectivity there, but the diagnostic cutoff (per DSM-V) is quite clearly defined, and leaves relatively little room for subjective interpretation: "The obsessions or compulsions are time-consuming (e.g. - take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."
I think it's unhelpful if folks who (for example) like their TV to be set to an even number talk about 'their OCD'. Or people who like things to be neat and tidy. Similarly for ADHD, the verbiage is: 'interferes with functioning or development/there is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.' Or ASD, where it's defined as 'caus[ing] clinically significant impairment in social, occupational, or other important areas of current functioning.'
Totally true that the DSM uses concrete cutoff values in an attempt to limit subjectivity, given that, what do you think is driving "overdiagnosis"? Eg. given we have guidelines in place?
> I think it's unhelpful if folks who (for example) like their TV to be set to an even number talk about 'their OCD'.
I guess we can agree that a tiktok mental health awareness is a poor substitute for a proper education (broad, balanced, evidence based etc). The sad thing is tiktok awareness is popular because people just aren't getting good information elsewhere.
At the same time I don't think gatekeeping is particularly good, the folks who struggle the most are often the quietest.
That being said, there is a significant and growing body of evidence which indicates that autism[0], ADHD[1], and OCD[2] are being overdiagnosed, or diagnosed without proper clinical rigour.
How can those who are suffering from these disorders hope to get the best quality help if there are so many challenges around proper diagnosis?
[0]: https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.... [1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042533/ [2]: https://pubmed.ncbi.nlm.nih.gov/26132683/
People who actually have OCD are being misdiagnosed with other more specific disorders due to a poor understanding of the heterogeneity of the condition.
