Has our increasingly therapeutic culture impacted upon our understanding of suffering, and our ability to withstand it?<\/p>\n
At the Battle of Ideas Festival in Dublin at the weekend, that question was explored at a session called, \u2018Over-Diagnosis? Mental Health\u2019s Expanding Empire.\u2019<\/p>\n
On the panel was Professor Patricia Casey, a consultant psychiatrist in liaison psychiatry in the Hermitage Clinic in Dublin. Prof Casey previously worked in the Mater Hospital for several decades in her role as professor of psychiatry at University College Dublin. Also speaking at that session was\u00a0 Stella O\u2019Malley, a psychotherapist and author of several books, including What Your Teen is Trying to Tell You. O\u2019Malley is also the author of the book Cotton Wool Kids, and her private practice focuses on parenting, family dynamics and mental health in adolescents.<\/p>\n
The session was designed to outline and debate a number of ideas. Firstly, that the language of illness is steadily replacing the language of ordinary hardship. Has sadness, a normal human emotion, now become \u201cdepression?\u201d It\u2019s a good question, isn\u2019t it?<\/p>\n
Is pressure being replaced with \u201ctrauma,\u201d and is normal emotional struggle now treated as pathology? The audience of around 400 people heard from both O\u2019Malley and Casey that diagnoses are rising sharply among children and young adults, while services remain under strain from demand that simply cannot be met amid an explosion in people seeking treatment for mental health struggles.<\/p>\n
The audience were asked to consider: Is this a crisis of mental illness, or a crisis of interpretation? Are we now living in a culture which has taught people to see adversity as a medical category? The argument can reasonably be made that if we begin medicalising ordinary distress, something which is simply part and parcel of the human experience, then those in genuine crisis end up paying the price, as does society\u2019s capacity to endure hardship at all in the first place.<\/p>\n
I found the arguments fascinating. As a woman in my late twenties, we are engulfed in a culture where just about every woman my age and younger, as well as older, seems to be seeing a therapist. You\u2019re almost an outlier if you don\u2019t go to therapy or counselling, or if you\u2019re not actively dealing with \u201cyour trauma.\u201d<\/p>\n
It was so refreshing to hear that maybe, there\u2019s nothing wrong with you \u2013 suffering is normal, and you\u2019re normal. You\u2019re simply subject to the human condition and the ups and downs of life. Our therapeutic culture has made that seem alien. There\u2019s a liberation in that which we\u2019re rarely able to enjoy in a cultural climate where we are trained to embrace self-pity rather than resilience.<\/p>\n
Stella O\u2019Malley herself recalled how she is told rather frequently that she may have ADHD. This is a suggestion, she said, which has cropped up in the last three or four years, but which she had never heard before. She thinks its due to a diagnosis of such a condition now being more desirable.<\/p>\n
\u201cYou should see someone,\u201d she is often told.<\/p>\n
THE STEPHEN FRY EFFECT<\/p>\n
Prof Patricia Casey spoke of the phenomenon seen sometime around 2010, of bipolar self-diagnosis increasing due to what was known in the media as the \u201cStephen Fry effect.\u201d<\/p>\n
She explained that Fry, as a genius and a high-profile bipolar disorder sufferer, showed a willingness to talk about his condition publicly. When he came out as bipolar \u2013 (previously known as manic depression, is a condition affecting people\u2019s mood) in her own experience, the diagnosis became more desirable to people. Indeed, researchers around that time claimed that Fry\u2019s advocacy led to more people diagnosing themselves with the illness.<\/p>\n
Writing in The Psychiatrist in 2010, Dr Diana Chan and Dr Lester Sireling said: \u201dThe increasing popularity of bipolar disorder may be attributed to increased media coverage, coupled with the high social status associated with celebrities such as Stephen Fry talking about their own personal experiences of mental illness.<\/p>\n
\u201dThis appears to have promoted the disorder as less stigmatising and acceptable to the public, a phenomenon that may have an evolutionary basis.\u201d<\/p>\n
According to Casey, it is now the case that more people wish to get a diagnosis of ADHD \u2013 a condition which, she acknowledges, exists. However, she feels it is grossly overdiagnosed. Casey said there are a number of reasons people want such a diagnosis. In the case of ADHD, it relates to the term neurodiversity \u2013 a term which she says has crept into our lexicon as \u201csomething that makes us different from everybody else.\u201d<\/p>\n
In the case of Bipolar disorder, the medic says, an increase in diagnoses around the time of Fry\u2019s advocacy, stemmed in some cases from a desire to be perceived as genius or different from others.<\/p>\n
The psychiatrists said that pharmaceuticals play a factor in relation to ADHD, but not to the same extent as things like parental expectations and the individual\u2019s desire to be different in a world that is very challenging for young people.<\/p>\n
Referring to a study which took place in 2024, Casey said: \u201c49 per cent of people in Ireland, in the past year, have seen either a GP or a psychiatrist or a therapist, and half of those have seen therapists. So we are living in a therapy culture.\u201d<\/p>\n