A growing number of young people say their mental health diagnosis is an important part of their identity. But by medicalizing imperfection – could young people be losing what makes them uniquely human?
Guests
Laura Delano, author of “Unshrunk: A Story of Psychiatric Treatment Resistance.” Founder of Inner Compass Initiative, a nonprofit that helps people make informed choices about psychiatric diagnoses and medications.
Jo-Ann Finkelstein, clinical psychologist. Author of the book: “Sexism and Sensibility: Raising Empowered, Resilient Girls in the Modern World.”
Also Featured
Freya India, author of the Substack post “Nobody Has a Personality Anymore.”
Laurie Faulkner, a Gen-Z woman who says her ADHD is a big part of her personality.
Transcript
Part I
MEGHNA CHAKRABARTI: More and more young people these days are openly talking about their mental health, and that’s mostly a good thing, but they’re not just talking about it. They say their diagnosis defines the entirety of who they are.
(TIKTOK MONTAGE)
Honestly, I would say 80% of my personality and how it is driven by my ADHD.
Discovering that I am autistic has saved my life. Before I had an understanding of the way that my brain worked, I always thought that there was something wrong with me.
Okay, I need to get a second cart because two is my safe number today, and this first one definitely has some kind of bacteria on it.
When I tell you if you have OCD, I have never in my life felt so seen. This man even picks a second grocery cart. I don’t know. I just feel like his content is so relatable and so needed right now.
Hello, sorry for not texting you back for a month. I got overwhelmed by the number of notifications I had in my messages and avoided checking them until I was pretty positive that all of my friends hated me.
I heard someone say to be autistic is to be misunderstood, and I think that is absolutely spot on. My entire life, I’ve been misunderstood. I have trauma from the fact that I’ve always been misunderstood.
Who am I if I’m not a trauma response? What’s my personality?
CHAKRABARTI: It’s a collection of voices from a few of the many TikTok videos about mental health posted online.
Now according to a 2024 survey, 72% of Gen Z women say that, quote, mental health challenges are an important part of my identity. 72%. The number is also high for Gen Z men, 67%. Now that’s compared to 27% of men, a couple of generations older. Baby boomer men, and for baby boomer women, it’s 34%. Now, that survey was conducted by the Skeptic Research Center, an educational and research nonprofit that applies scientific data analysis to controversial claims.
This trend was something that writer Freya India picked up on and wrote about beautifully in a recent Substack post that was titled, Nobody Has a Personality Anymore. In it, India writes that young girls, quote: Don’t have memories anymore. Only evidence, explanations, timelines of trauma. They don’t have relationships, only attachment figures, caregivers and co-regulators.
And then she says, I think this is it, the cause of so much misery. We taught a generation that the meaning of life is not found outside in the world, but inside their own heads. End quote. And Freya India tells us she was inspired to write the piece because of what she was seeing in herself.
FREYA INDIA: I was pathologizing parts of me that I wasn’t happy with, and that felt different to other people, and I was going inwards rather than looking outward at what was happening in my life.
CHAKRABARTI: And once Freya noticed it in herself, she started seeing it in her friends. And then:
INDIA: Just started noticing it everywhere. That people were being described with medical labels. And then comparing that to some of the older people in my life that would be described in more sentimental ways, like forgetful or thoughtful.
And I just started to realize that we were actually losing the language not only for suffering, but for personalities in general.
I just started to realize that we were actually losing the language not only for suffering, but for personalities in general.
Freya India
CHAKRABARTI: And as Freya writes in her piece, quote: My worry is that after a lifetime spent trying to explain themselves, solve their strong feelings, standardize their personalities, and make sense of every experience, a generation might realize that the only problem they had all along was being human. End quote.
INDIA: And I think what we’ve accidentally done through therapy culture is teach young people that if you have any of these emotions, you are different in some way. And that there’s this kind of baseline of being a human that you’re not meeting. And so it does worry me that there seems to be this assumption online that there’s a perfect person and you need to heal from any flaws, like you’re some sort of product.
There seems to be this assumption online that there’s a perfect person and you need to heal from any flaws, like you’re some sort of product.
Freya India
CHAKRABARTI: Freya’s advice for young women these days is to stop looking inward.
INDIA: I think there’s so much encouragement to withdraw and to ruminate, and I think it’s fueled by social media, but it’s the therapy culture really that tells girls that if they’re in pain or going through something, then the answer is to go further inwards, to find relief.
So to analyze and reflect and talk it through with other people and open up. And so I think therapy culture is actually uniquely damaging for young girls, who have that disposition, who are more anxious and tend to internalize their distress. And so my message is one of agency, which is to resist some of this impulse to go inwards.
You can still suffer and have pain and feel like you’re not understood, but it doesn’t mean that you have to fit a psychological or medical label.
CHAKRABARTI: That’s Freya India, author of the Substack Girls, where she writes about girlhood in the modern world. The piece we’ve been referring to is called Nobody has a Personality Anymore.
And it’s well worth reading. We have a link to it at onpointradio.org. Now, Freya couldn’t join us today, but this issue of social media and young women particularly, but also young men, gen Z in general, and this embrace of mental health as the center part of a human personality. That’s something that many people have been thinking about, including Laura Delano.
She’s the author of “Unshrunk: A Story of Psychiatric Treatment Resistance.” And she’s also the founder of Inner Compass Initiative, a nonprofit that helps people make more informed choices about psychiatric diagnoses. Laura, welcome to On Point.
LAURA DELANO: Thanks Meghna. It’s great to be here.
CHAKRABARTI: Let me just start off, broadly, your first reaction to Freya’s analysis, that not only are we getting better at talking about mental health issues and diagnosis, but that it’s moved to the center of how a huge percentage of Gen Z young people may actually just define their whole beings.
DELANO: I think she’s spot on and as an elder millennial, as someone born in the 1980s, I came of age at the very beginning of this phenomenon that I think is, as Freya puts it so beautifully, ubiquitous now in our culture, especially for young, for girls and young women, I think we are facing a crisis of meaning, a crisis of sense-making when it comes to understanding what it means to be human.
We are facing a crisis of meaning … when it comes to understanding what it means to be human.
Laura Delano
And having watched this phenomenon unfold over the past 15 years, since I myself decided to leave behind my relationship to therapy, I’m just grateful that Freya is drawing, shining a light on this and drawing attention to it in such an articulate way. Because it’s really, it’s one of the crises of our times.
CHAKRABARTI: Your story is critical to helping us understand how we got here, Laura, and we’ll get to that just a little bit later in the show, but I’d love for us to explore a bit more about sort of the dynamics of how some of this therapy culture, as it’s being pejoratively called, is expressed really on, especially in social media.
So first of all, Laura, how would you define as therapy culture actually being?
DELANO: I think therapy culture arises from a deeper phenomenon of medicalization, which, I might describe as the process by which we take ordinary human experiences and struggles and variations and we redefine them as medical problems, as clinical problems, which then opens up a framework that is largely limited to professionals, diagnoses, treatments.
And so I think therapy culture was almost an inevitable byproduct of this rise in medicalizing what it means to be human, that I think really began to take off in the mid 20th century. As the psychiatric profession and its kind of efforts to bring psycho pharmaceutical medications to market really took on a louder and larger presence in our culture.
And I think it really escalated beginning in the ’90s with George Bush the first declaring it the decade of the brain. Kicking off a very concerted effort to conquer this territory of the brain, which we’ve all come to now see as the locus of emotions and thought.
And so I think inevitably within a few decades we’re going to be in a place like this, where as a medicalized framework of understanding ourselves takes on more visibility in our culture, what that leads to is the shrinking down of nonmedical spaces, of non-medicalized frameworks for understanding ourselves.
And so I think kids now grow up immersed in a medicalized stew of understanding themselves, and they don’t even realize there’s another way. There’s so many other ways to.
CHAKRABARTI: Yeah, I mean there’s much to discuss there in terms of how medicalization of what used to actually be considered positive experiences of being alive is also starting to happen.
But let’s just push back right here, right now, Laura, because so many people listening to this would say, no, this is all wrong. What we’re seeing here now is finally the maturation of an advancement in our culture that people can talk about their mental health issues now. They don’t have to be ashamed of it.
That there are communities that are formed to help people, now organically, on social media. Actually, I’m going to take that back, algorithmically on social media, to give people a sense of community and mutual understanding. That this is actually a positive development in how we view mental health challenges and not a negative one.
DELANO: It’s an important point and I am right there with anyone who thinks that we should feel free and invited and welcome to talk about the struggles that come with being alive. I think that is an incredibly important message that all human beings and especially young people should receive.
It is really hard to be human. We go through hard things in life, and we feel pain, and we should never feel ashamed or silenced in talking about it. I think where I think things can go awry is when the language that we use to talk about our struggles becomes dominated by medicalized language.
Where … things can go awry is when the language that we use to talk about our struggles becomes dominated by medicalized language.
Laura Delano
I think that’s one way of making sense of oneself, and as someone who felt great benefit for a period of time in my life by understanding myself as having a diagnosis, I completely relate to that. But what I think the case I’m trying to make is that we need to expand beyond only having this medicalized framework of mental illness and mental health and reclaim human language, like Freya says.
Part II
CHAKRABARTI: Today we are talking about the fact that a remarkable number of Gen Z women and men say that their mental health diagnosis or conditions, whether or not they’re formally diagnosed, form the most important parts of their personality, of their identities. So let’s give you an example. Laurie Faulkner.
She’s a TikTok influencer who specializes in ADHD content, and she makes videos like this.
TIKTOK VIDEO: My God. Wait. I love your personality. You’re so easy to talk to.
Oh, thank you so much. This is actually not my personality, though. This is a custom built version of me made specifically for you. Yeah. It’s based on your energy, your humor, your social cues, and an internal database of anything you’ve ever responded positively to.
Wait, what do you mean custom built? This is not how you normally act?
Oh, no. I have a different personality for everyone I know. And this was yours. Woo. I’m glad you like it.
Her videos talk about what life is like with ADHD, to spotting the signs of it, to how to better support someone with it. And Laurie has 119,000 followers, nearly 5 million likes.
Her videos get many comments, things like quote, this is me. Or quote, wait, do I have ADHD. And quote, I should get tested for ADHD. Now, Laurie does have ADHD herself, but it’s something she didn’t know about until she was 24, and now she’s 27.
LAURIE FAULKNER: Actually, throughout my teenage years, I felt very different to other people, especially when I was like 15, 16, I really struggled with my mental health, just because I didn’t feel like I really fit in with other people.
And I felt like I was experiencing the world very differently to everybody around me. And nobody mentioned ADHD to me. It wasn’t a thing that was really talked about. And then I went to drama school for my diploma and when I was there, we were told we have to go to a mental health appointment. Everybody had to go to one.
And I was just chatting to her about kind of everything I experience and how I often feel in social situations and how I can find them really hard sometimes. And, you know, how my organization is very bad, and I used to always say to people, I want to be able to switch my brain with someone else’s because I just feel like being in my brain is really hard.
And she just said to me, I really would strongly recommend that you go get an assessment done for ADHD. And that was the first time anyone had ever mentioned it to me. And then I went to get my official diagnosis, and everything started to make sense. Honestly, I would say 80% of my personality and how it is driven by my ADHD.
And I let that, I do let that drive, and I didn’t use to let that drive. And I think that’s something that I did struggle with. And that comes with positives, and it comes with negatives, but I’m happy for it too, to drive, because I think I’m happier when I let it drive.
If I’m listening to music, I hear everything that’s happening in the music.
I hear every sound, every vocal intonation, every instrument. And I used to find that overwhelming in the same way as I find a social situation overwhelming. But now I see that’s amazing that I see that. And I’m really lucky to get to experience music like that. Because a lot of people don’t, and a lot of people will never know what it’s like to experience music like that.
I definitely see it as a core part of my identity and I’m very open with it now.
I will make mistakes, especially socially, and I go into new relationships and old ones with that kind of understanding and it’s really helped me and other people know what’s going on inside my head.
So I actually get emails from people saying I have this, and this symptom. Do you think I have ADHD? Or here’s your video. And I relate to everything. Does this mean I have ADHD? I’m not a professional. I am only a person that has ADHD, and I can only talk from my experience. If you do think that, you know, you want to go and get a diagnosis and you want to go down that road, you’ll need to speak to a doctor.
I think after being diagnosed with ADHD, I think a lot of people said to me like, oh, now you act way more ADHD. And that is actually very true, and that’s because I’ve accepted it and I’m not trying to be anything else.
CHAKRABARTI: That’s Laurie Faulkner, a TikTok creator who specializes in ADHD content. So Laura, before we get back into where we are now, I’d love for you to tell us a little bit of your story about the kind of similar journey that you went through.
When did you first feel that something was a little off in you that maybe couldn’t easily be explained by the foibles of just being human.
DELANO: My crisis really began at age 13. And on paper, I had everything together. I was a good student. I was an accomplished athlete. I was president of the middle school at this all-girls private school that I attended.
And so I had it all together, quote-unquote, but I ended up having this really profound experience one night in front of the bathroom mirror as I was getting ready before bed. In which I had just started looking into my face in the mirror, looking into my eyes going deeper and deeper until this stranger was looking back at me and I lost touch with space and time, and I was just staring at this girl in the mirror thinking, who is she?
Who is she? Who is this girl? And when I came to, and realized I’d had this terrifying experience here, the only way I could make sense of what had just happened was that I must not have a real self. I’m just programmed to perform and accomplish. But who am I? What do I really care about? What really matters to me?
And because I had no frame of reference to make sense of what this all meant. And I grew up in an affluent town in Connecticut where everything looked, everyone looked happy and put together all the time. I was convinced that I must be the only person who’s had this experience.
And so I think that conviction that I was alone, and this terrifying realization that I didn’t have a self was more than anything what, I think, eventually led me to completely fall apart. Because I was sure that I was the only one who didn’t know who she was. In retrospect, I see of course that this is the kind of fundamental existential trap of adolescence. You’re convinced that what you’re going through is unique to you.
CHAKRABARTI: Nobody understands me. Exactly.
DELANO: Exactly. Exactly. And that began, what ended up being this 14-year relationship with what I like to call the mental health industry. So with doctors, with therapists, with a growing list of diagnoses, a growing list of medications and it really, I think that relationship more than anything was fueled by this fear I had.
Of myself, of my mind, of my emotional pain, which seemed to be getting bigger and bigger as time passed. And I still didn’t know who I was.
CHAKRABARTI: So this is before the era of social media and I think a lot of people who are experiencing what you just described, now the first thing they do is go to social media and perhaps feel far less isolation than you understandably did, and they’d immediately find community.
We can talk about the positives and negatives of that community, but in terms of how this one existentially terrifying teenage moment not only had an impact on you then, but then you said it led to this long-term sort of medicalization or relationship with the world of medicine.
How did that happen? What was the bridge to that? Did you go to your parents and say something doesn’t feel right and then they suggested you go to the doctor? What happened?
DELANO: I tried to keep my inner chaos to myself. I didn’t talk about it with anyone, again, because I was convinced that I was the only one going through it.
And so that compartmentalization eventually wasn’t sustainable anymore. And so while I kept it together at school. At home, I began acting out. I began screaming and yelling. I started cutting myself. I was thinking about death. I just spun out in a way that terrified my parents and confused them.
And so eventually they felt, I think, their own fear and their own confusion, fueled them to conclude, we don’t know what to do to help our daughter here. We need to seek professional help. So I was actually taken against my will, you could say, to my first therapist. I didn’t want to go.
I actually, even though I was in this tremendous pain, I also had the wisdom then to recognize that it was actually the environment that I was in, in this high-pressured private school. In this high-pressured affluent town. That was actually the cause of my breakdown.
So I was upset with my parents originally for sending me there, but eventually with the passage of time, as I continued to not know who I was and feel like a fraud. And I relate so much to Laurie, that TikTok video that you shared, because I too was just, I felt so at the mercy of my mind.
And all the overthinking I was doing and all the overanalyzing and never feeling authentic, always feeling like I was adjusting myself. Eventually, I was just so desperate by this internal experience I felt so trapped in, that I concluded myself, this therapist and eventually this psychiatrist that my parents sent me to as a 14-year-old must be right.
And I had been given, I should say, at age 14, a diagnosis of bipolar disorder. And just really quickly to give some context to that, this was the mid 1990s. And if you pan out and look at what was happening within psychiatry at the time, in psychiatric research, there was a very concerted effort to expand the market of treatment to kids.
And so a lot of this was happening with the juvenile bipolar diagnosis. Which doctors were saying was a little different than adult bipolar, in kids, mania looks like anger and irritability and outbursts and emotion dysregulation. And there I was, an angry, irritable, self-injuring girl.
So it was fate really in many ways that I would be given that diagnosis and I did eventually buy into it.
CHAKRABARTI: Okay. And then, as you said, you spent years in the sort of therapeutic pharmaceutical world, and I’m going to, I promise I’ll ask you a little bit later about how that actually changed how you saw yourself.
But there’s one critical question I feel like I have to ask. Because I’m thinking about, I’m a parent myself, so I’m feeling a huge amount of sympathy and empathy for your parents when they’re like, we have to do something. Because what you’re talking about, Laura, is more than just what might seem to be the understandable outbursts of a teenage soul trying to figure itself out.
Especially the self-harm part. So for young people who are demonstrating those kinds of behaviors. I don’t think we’re necessarily over medicalizing the condition. How do you respond to that?
DELANO: It’s a really good question, and as a parent now myself, I get emotional thinking about it.
My poor parents. And any poor parent out there who loves your child, especially your teenager, and is just perplexed and shocked and confused by the pain they’re exhibiting, I completely get why my parents did what they did, why any parent sends their kid to a mental health professional.
I think what ended up happening for me, that I think is the critical piece here, is that, as I said, my emotions, my behaviors, they were all arising in the context of my life. It was about my relationship to school, to the social circle I was in, to the pressures I felt as a girl. And what medicalizing my experiences eventually ended up doing was stripping that context away from how I was understanding myself.
And so you can’t, my view is that it’s really hard to simultaneously see your teenaged girls angst and despair and expressions of pain as both a response to her environment and a symptom of an illness living inside of her. They can’t, those frameworks can’t really exist at the same time in a cohesive way.
And I’m not saying that one is right, and one is wrong, and one is good, and one is bad. But for me, what happened is that medicalized framework came to take dominance over everything else, until I forgot that there was a context at all. And as Freya puts it, I was just totally focused on my brain, my mind, my internal self, and not the world around me.
CHAKRABARTI: Okay. That is the perfect way for us to bring in another voice. Jo-Ann Finkelstein joins us now. She’s a clinical psychologist and author of the book, Sexism and Sensibility: Raising Empowered, Resilient Girls in the Modern World. Jo-Ann Finkelstein, welcome to On Point.
JO-ANN FINKELSTEIN: Hi, Meghna. I’m glad to be here.
CHAKRABARTI: First of all, let me get your take on the bigger picture that Laura and I have been discussing. And I think to me, it gels around a voice that we heard at the very top of the show, again, from TikTok. And we have to talk about social media in a moment, this young person who says, who am if I’m not my trauma response? That seems to me to be categorically different than I’m dealing, I’m learning how to deal with a traumatic experience in my life, to my life, my personality doesn’t exist without it. Should we be finding that troubling?
FINKELSTEIN: Yeah. I think we should, because as a clinical psychologist, as somebody who believes in the good of therapy, which isn’t to say there aren’t therapies that go awry and therapists that treat symptoms over the whole person.
But I think that we want to believe that people can change, that people can manage their trauma and transform it into something that makes them, that helps them outgrow it.
CHAKRABARTI: Has it become harder as a therapist to do that? What you’re saying is think, look at the whole person rather than focusing on the diagnosis? And I’m asking this because, again, social media is such a huge part in this, that when, you know, once people stumble into content that they feel might explain themselves. The algorithm does nothing but amplify how much of that content and the intensity of it that they’re seeing. So I don’t know if that’s changed how maybe, young girls or women come into your office and what they actually want to talk about.
FINKELSTEIN: Yeah, I think, I do think social media has made the people, especially the younger people who come into my office, they’re coming in with their own self diagnoses. Because mental health lingo has been commodified and the complex psychological concepts have been compressed into these sort of bite-sized digestibles.
And it’s a very slippery slope. So internet discourse, it cheapens and diminishes powerful ideas, right? So terms like trauma, gaslighting or attachment style have really gotten watered down and misused. But if that makes them understand themselves when they’re coming into therapy, fine.
But that isn’t something that we focus on, right? I’m focused on the whole person. So I think that generally in a good therapy does fall by the wayside. What has made therapy harder in the last couple of decades, in my experience, and I’ve been doing this for almost 30 years now. Is that, we, therapy is really about listening, attunement and human care. But neo-capitalism and insurance companies in particular have brought this culture of efficiency, with the thought that we can treat symptoms separately from the person.
Neo-capitalism and insurance companies, in particular, have brought this culture of efficiency, with the thought that we can treat symptoms separately from the person.
Jo-Ann Finkelstein
Part III
CHAKRABARTI: We got a lot of response from On Point listeners about this. Let’s listen to a few of them. Leah’s from Boston, Massachusetts and she says she used to suppress her anxiety and depression, but now that she’s accepted it, she’s much freer.
LEAH: I don’t let it necessarily define me anymore, but it’s part of building who I am, and the big parts of my life revolve around it.
So if I were to hide that, I think I’d be hiding part of myself.
CHAKRABARTI: Now this is Cleo from Florida, and Cleo says her anxiety disorder does define her.
CLEO: It influences and shapes how I move about the world, my relationships, what activities I engage in. And once I realized that, it’s hard to see it as anything but who I am and part of what makes me.
CHAKRABARTI: One more. This is Matthew White, 26 from New Orleans, and he says he thinks the rise of therapeutic culture is a good thing.
MATTHEW WHITE: I claim it in order to take power over it. Like many things, I claim, like, my poor behaviors are my trauma responses and then I work to address them, and I think that’s something that makes me more confident, less anxious.
An overall more well-rounded human being. Cringe culture dominates our entire society. Everything is posted on the internet, so we are very afraid of shame, and I think owning some of your vulnerability with your mental health is an absolutely courageous thing to do in the culture that we live in.
CHAKRABARTI: So those are some On Point listeners.
I’m joined today by Jo-Ann Finkelstein and Laura Delano. And, Laura, I just wanted to come back to this issue about therapeutic culture and how it has really informed the entirety of how young people even just view what is normal, quote-unquote normal in this world.
Because I’m starting to hear things in the voices of our listeners and the conversation we’ve had, that it’s hard not to wonder if Gen Z has been raised in a way such that anything and everything they expect should be able to be explained through some sort of medical framework. Like you were saying earlier, okay, you have fallen madly in love with someone. That just used to be what it was, but now it’s, no, you were expressing a trauma response that’s forming attachment issues with somebody.
Did you get what I’m saying, Laura?
DELANO: I totally do, and I think there’s a lot of, this is about the relationship we have to the unknown, to uncertainty, to mystery, to the unspeakable. And as someone who spent the most formative years of my life, just so afraid of the unknown and so convinced that if I can just define myself and explain myself and capture myself in words and categories then I’ll feel okay. Then I’ll feel safe, I’ll feel rooted in myself.
I can now see in retrospect that desperate quest to understand myself through definition, it was about this need for control. And a lot of it was because I didn’t, I missed the opportunity as a young person to learn how to be in relationship with the unknown.
And I do think, and Freya writes about that so well in her piece too, I think a lot of what young people are struggling with is a world that is confusing and scary and it’s painful and people are yearning to feel safe and rooted in themselves, and confident in themselves and confident in the world around them.
And the more you can define it and define yourself, the more you grow convinced that you’ll eventually be okay. But what I found is that has this paradoxical effect of the more I searched for answers and resolution to my pain, the more pain I felt. And then 14 years later, there I was basically a professional psychiatric patient whose sole purpose in life was focusing on what was happening inside my head and then talking about it. … Forgotten the world around me.
CHAKRABARTI: I know we have to let you go in a couple of minutes, Laura. So there’s two more questions if I could. So the other thing that I was wondering about is how much you started off our discussion by saying, look, there’s a major business push in the ’90s that may have led to what we’re seeing now, in terms of the pharmaceutical industry. But now we also have an equally, no, actually, probably even a greater, a more gargantuan industry of social media.
Both of these things are ubiquitous in the lives of Gen Z. So for them, what is your advice or maybe even your own story on how you began to see the world differently outside of these frameworks that are imposed on young people now?
DELANO: Oh, it’s such a good question, and it’s such a hard one, and I cannot imagine growing up on social media, I’m really lucky that I just missed that.
What I’d say for myself is my journey away from all of this happened in my late twenties. And a lot of it began with me stepping back and beginning to ask questions about the stories I was telling myself about who I was and what my pain meant. And for me, because this huge part of my story involved being on many different medications, literally five at a time, a lot of my own process was about beginning to educate myself about the medications that I was on too.
And what I began to realize was, I’ve spent all of these years of my life reducing the complexity of myself into these lists of symptoms and where has it brought me? I’m actually more disconnected, more hopeless, more afraid, in more pain than ever before. Is it possible that there’s a link here between medicalizing myself and seeking pharmaceutical and professional solutions, and the worsening of these problems that I was seeking help for in the first place.
And I realized for myself there was, and everyone has a different story here, and I’m by no means saying that’s the case for everyone, but I think a lot of this is about what it means to be human and when you grow up, not realizing that to be human is to feel pain. The purpose of life is not about the absence of pain and perfection and having your act together all the time.
It’s about having a sense of belonging and purpose and meaning and community and that can happen within the diagnostic world. You can find a sense of belonging there, but there’s so much beyond that. I think that helped me connect with curiosity, like what could my life become if I could be something beyond just a professional patient?
And so that’s the journey I went on. Laura Delano’s book is Shrunk: A Story of Psychiatric Treatment Resistance, and she’s also founder of the Inner Compass Initiative. Laura, it’s been so great to talk with you. Thank you so much.
DELANO: Oh, Meghna. It’s an honor to be here. Thank you.
CHAKRABARTI: Jo-Ann Finkelstein let’s pick up this thought that Laura left us with, which is are we medicalizing just what is the normal spectrum of the human experience? That in fact, maybe we have become so afraid of emotional pain that young people are very understandably drawn towards saying, I’m feeling this discomfort of this pain. Here’s a framework to explain it.
And if so, again, I come back to, is that a bad thing or are we denying ourselves? Are young people denying themselves something about just the process of living?
FINKELSTEIN: Oh, I so agree with Laura, right? People can be concrete and drawn to really simple explanations, and I think that can water down some really important therapy concepts. And it breaks my heart.
People can be … drawn to really simple explanations, and I think that can water down some really important therapy concepts.
Jo-Ann Finkelstein
It absolutely breaks my heart when I think about 13-year-old Laura, who potentially could have gotten into a therapy that really helped her dive into those questions without pathologizing them without medicalizing them. And it is true that a lot of teenagers say, no way, I’m not doing that.
But if I really believe that effective therapists tend to treat the whole person, and they’re not all that interested in symptoms and diagnoses. And then you see on the internet, right?
All of this like heavy interest in labeling yourself. And in part, that’s because we’ve been given more permission in this culture to be a little more forgetful, right? And so people are clamping onto that. And so I understand why girls are defensive of their diagnoses, right? Because in Freya’s wonderful piece, she says that you can’t just be lovably forgetful, right?
But the truth is, in this culture, you really can’t be lovably forgetful. The early bird still gets the worm. The outgoing one still gets the worm. And so I think people really, I guess I come at it with some empathy, of why these girls are holding on.
CHAKRABARTI: But can I just jump in here.
I’ll let you get back, but I want to emphasize what you just said. So a lot of what you’re hearing and seeing is understandably, young people, young girls especially, trying to find a reason that they don’t feel like they are who they are supposed to be, is what you’re saying. Or they think they’re supposed to be, because of all the pressures that they’re under.
FINKELSTEIN: And to Laura’s point, right? She said she started looking outside of herself at all of the pressure, right? There’s a huge discrepancy between what we’ve told girls they can be, right? The whole girl power, girl boss culture, and yet that’s not true, right? It is true that girls are graduating college at higher rates, yet women barely register in the boardroom.
Or look at all the blockbusters from last year, only one in five featured more women than men. So I think a big part of it too is these very mixed messages that we’re giving girls. And so it’s leading to a lot of depression and anxiety.
A big part of it … is these very mixed messages that we’re giving girls. And so it’s leading to a lot of depression and anxiety.
Jo-Ann Finkelstein
CHAKRABARTI: I just want to take a moment to say that I don’t want anyone to listen to this conversation and think that any of us, but me especially, we’re minimizing the pain that people experience in their lives, or the genuine mental health diagnoses that have really helped people. Under no circumstances are we minimizing that, but what we’re talking about is how much this has pushed into, what is the sort of tumultuous experience of living a normal life? And Jo-Ann, what I’m wondering about is, again, in that realm, if young people are growing up thinking, or in a world, in a stew where, okay, they had a breakup with someone they loved and cared about and it hurt.
They go to social media, and they find out that they may have rejection sensitive dysphoria, or they’re sitting in the middle of class and suddenly they have a quote-unquote intrusive thought, because they’re thinking about the fact that their desk back at home is a mess. And they actually want to clean it up.
They’re having an intrusive thought driven by their OCD. What I think people are now wondering is with all of this extreme amplification of small things that maybe in the past might’ve been just okay, I had that thought. I got to go clean my desk when I get home.
Does it actually make people more narcissistic and more fragile and then therefore less able to perhaps, through therapy, process or grow through these normal experiences?
FINKELSTEIN: I think that it is possible that people are more fragile because they’re confusing diagnosing with meaning making. But I think if you can do the meaning making, which is what happens in a good therapy, then the diagnosis almost doesn’t matter. And that’s not true in every case, but it is true in a lot of cases. And when it comes to people who come to therapy, yes.
I have had girls in my office who are crying because they did not get the autism diagnosis that they feel they deserve. But that doesn’t, they’ll cry hot tears and we’ll talk about it and we’ll make meaning of it. And what does that mean to them? And it is true. Some people can use their anxiety disorders to get a 504 plan or an IEP and never have to get up in front of a classroom. And then they never get to build that muscle.
But I do think therapy, which is very different than therapy speak, right, can really widen that lens. And in my experience, the kids who come in with their diagnoses, they let that fall away and they don’t become more fragile.
They become much more resilient.
CHAKRABARTI: Yeah. I should say those are the kids who are able to come to you, to actually to get good high-quality therapy, which we’ve done a lot of conversations about how, especially for young people, that’s harder and harder to find these days, especially if you’re in an underserved community.
I want to acknowledge that.
FINKELSTEIN: Yes, absolutely.
CHAKRABARTI: We’ve got time enough for one more question here, Jo-Ann. And for folks listening, Freya India, who we started this show with, she ends her piece in Substack saying, her advice is just stop looking inward so much.
Let yourself, you’re not a diagnosis, you’re a human experiencing. Look outward. I also think that at the same time, might be difficult given all the pressures that we just talked about. So especially if someone has genuine trauma, that is having an impact on their lives. So in the last minute or so, what would you advise young people who are listening to this and saying, no, I am my diagnosis. I mean is there a different way of looking at the world you might suggest?
FINKELSTEIN: I would say you’re absolutely not your diagnosis. That is one part of you. And it is something that you have to manage and you find, if you have ADHD, right?
There are ways, there are so many ways to manage ADHD now, that we know about that can be helpful. But you are also, you have, as Freya says, you have a whole personality, and that is one aspect of it, right? It’s the same with gender, right? Like one of the things that we, and this does connect, one of the things that we do to girls is that we see them as girl before we see them as human.
So I want people to see themselves as human before they see themselves as ADHD.
The first draft of this transcript was created by Descript, an AI transcription tool. An On Point producer then thoroughly reviewed, corrected, and reformatted the transcript before publication. The use of this AI tool creates the capacity to provide these transcripts.