The first interesting point is the one-bit yes/no answer.
I would not expect a majority of the general population to self-diagnose itself with a mental disease at any point in their life. However for certain specific groups this changes. One group of interest is high-IQ reflexive self-doubting people. Another group is freaks, that is, people who are clearly weird/strange/different from those around them for whatever reason. Yet another group is borderline cases, those whose symptoms are not strong or pronounced enough for a clinical diagnosis and yet they are not entirely “normal” anyway. And another group is a variety of neurodiverse people.
There are also people who do have a disorder, but have reasons for not seeing a doctor about it. (Lack of funds, not expecting treatment to help, not needing treatment, etc.)
In this context, they don’t have to be good reasons—my point was that a self diagnosis doesn’t necessarily disagree with what a doctor would say if asked.
Okay, that makes sense. And although it might take some clever structuring, I think it might be interesting to try to determine how frequently those self-diagnoses were accurate… something about “confirmed by a medical professional”, perhaps?
something about “confirmed by a medical professional”, perhaps?
This is tricky ground. If you want more follow-up questions, the first probably should be “Have you, of your own will, talked to a mental health professional about an assessment or a diagnosis?”. Again, the majority of the general population would answer “no” to this.
I seem to recall something like 30% of the adult American population being in therapy or having been recently. That’s not a majority, but it’s pretty substantial, and they didn’t get there by magic.
seem to recall something like 30% of the adult American population being in therapy or having been recently.
My impression is that mostly involves people going to their doctor and saying “Doctor, I feel horrible!”. And the good doctor says “Sure, try these antidepressants!” (yes, I know I’m exaggerating).
That’s a different thing from “Doctor, I believe I’m mentally ill”.
Depression is a mental illness. You might not go to the doctor and ask about depression (though I doubt this is anywhere near as uncommon as you’re making it out to be), but going to the doctor and saying “Doc, I can’t sleep, feel sad all the time, everything I do seems pointless, etc.” is as much asking for a consultation on mental illness as “Doc, I’ve got this nasty bullseye-shaped rash on my leg and I’ve got a fever and a bad headache” is asking for a consultation on Lyme disease.
The standards of diagnosis might not be as rigorous, but that’s a separate issue.
“Doctor, I can’t sleep!” “Here, take this Ambien.” “Ambien scares the crap out of me; it makes my friend call me up late at night and ramble incoherently at me, and I’ve heard it makes people have sex and forget it happened.” “Eh. Take it anyway, that doesn’t happen to most people.”
“Doctor, I still can’t sleep, I worry all the time, and it’s wrecking my motivation at work. And the Ambien works, but it makes me trip out more than I probably should most nights.” “You have an anxiety disorder. Here, go to this psychiatrist, Doctor #2. And don’t take so much Ambien.”
“Doctor #2, I can’t sleep, I worry all the time, and it’s wrecking my motivation at work. Oh, and Ambien makes me trip out before I fall asleep.” “You have anxiety and depression. Here, take these antidepressants, and these benzodiazepines if you need them, plus these folates and vitamin D … oh, and replace that Ambien with this Lunesta, and come back every week. And let’s talk about the work situation, something’s messed up there …”
Anecdotal, sure; and pretty recent. But I didn’t start out with the idea “I’m depressed and should seek antidepressants”. I thought I had a sleep disorder, but it turns out our reality doesn’t issue time machines for those.
Yes, if the question were “How many people go to a doctor to complain of symptoms of mental illnesses” then sure, a large chunk of the general American population (still don’t know if a majority) would qualify.
However recall the context. We started with the question “Have you ever self-diagnosed yourself with a mental disorder?” and are talking about the follow-up to it. Here the question about going to the doctor means mostly “Did you take your self-diagnosis seriously enough to talk to a medic about it?” And, still within this context, the question is much more like “I think I’m mentally ill, is that so?” than “I can’t sleep and life is pointless, how do I fix that?”
I was mostly replying to the bit about the general population. In the context of a follow-up question, you might get some quite different results.
Actually, I’m not at all sure if you’d even get a higher percentage of yes respondents than you would in the general population; there’s a lot of things I get the sense that a self-diagnosis could be pointing to, most of them likely anticorrelated with seeking formal diagnosis. Charitably, it might indicate an attempt to find out what’s going on with one’s head in an absence of resources or motivation, or in the presence of social or communication issues or other life circumstances that make one less likely to immediately seek help. Less charitably, it might indicate attention-seeking behavior of some sort, or a trivial approach to the whole issue.
I agree that self-diagnosis could be pointing to multiple, different things. Don’t know if there’ll be much attention-seeking in the current crowd—“I’m so cool I’m depressed and I’ll say I have MDP to make me extra cool” is a kinda early high school thing and most people grow out of it fairly quickly. People who don’t grow out of it are, um, easily recognizable.
There are a lot of (temporarily) depressed teenagers, but it’s rarely clinical and they rarely go for a formal evaluation to a psychiatrist or a psychotherapist.
How many people, do you think, go to a doctor and say “I think I’m mentally ill”?
How many people, do you think, go to a doctor and say “I think I’m mentally ill”?
Ah, when you phrase it like that I realize that my estimate is rather low. Near vs. Far mode, I guess. Since it’s relatively unlikely that someone would do that if they weren’t actually mentally ill, and some mental illness is mild enough that one wouldn’t bother, and a lot of the severe ones could prevent someone from consulting a doctor on their own, a pretty low proportion of the population seems reasonable.
Does that line up with your reasoning?
edit: I think that part of what was muddling me was that your original phrasing (“talked to a mental health professional about an assessment or a diagnosis”) was sort of unclear, so I resorted to nearby heuristics rather than trying to parse it properly. We might want to fix that up before putting it on the survey.
Well, I meant this in the context of being a follow-up to the previous question about self-diagnosis. So it mostly means “Did you take your self-diagnosis seriously enough to go to a doctor?”
Such a question outside of this context needs to be more precisely formulated, I think. As we were discussing with Nornagest, going to a doctor and saying “I can’t sleep, life sucks, can you help with that?” is sufficiently common.
Would that be interesting enough as a question to be worth including? I imagine there’s a lot of variability in self-diagnosis.
The first interesting point is the one-bit yes/no answer.
I would not expect a majority of the general population to self-diagnose itself with a mental disease at any point in their life. However for certain specific groups this changes. One group of interest is high-IQ reflexive self-doubting people. Another group is freaks, that is, people who are clearly weird/strange/different from those around them for whatever reason. Yet another group is borderline cases, those whose symptoms are not strong or pronounced enough for a clinical diagnosis and yet they are not entirely “normal” anyway. And another group is a variety of neurodiverse people.
There are also people who do have a disorder, but have reasons for not seeing a doctor about it. (Lack of funds, not expecting treatment to help, not needing treatment, etc.)
Do you mean “reasons” or do you mean “rational reasons”?
The opinion of someone who does have a mental disorder on whether treatment will help or is needed, that opinion is… suspect.
In this context, they don’t have to be good reasons—my point was that a self diagnosis doesn’t necessarily disagree with what a doctor would say if asked.
Okay, that makes sense. And although it might take some clever structuring, I think it might be interesting to try to determine how frequently those self-diagnoses were accurate… something about “confirmed by a medical professional”, perhaps?
This is tricky ground. If you want more follow-up questions, the first probably should be “Have you, of your own will, talked to a mental health professional about an assessment or a diagnosis?”. Again, the majority of the general population would answer “no” to this.
I seem to recall something like 30% of the adult American population being in therapy or having been recently. That’s not a majority, but it’s pretty substantial, and they didn’t get there by magic.
My impression is that mostly involves people going to their doctor and saying “Doctor, I feel horrible!”. And the good doctor says “Sure, try these antidepressants!” (yes, I know I’m exaggerating).
That’s a different thing from “Doctor, I believe I’m mentally ill”.
Depression is a mental illness. You might not go to the doctor and ask about depression (though I doubt this is anywhere near as uncommon as you’re making it out to be), but going to the doctor and saying “Doc, I can’t sleep, feel sad all the time, everything I do seems pointless, etc.” is as much asking for a consultation on mental illness as “Doc, I’ve got this nasty bullseye-shaped rash on my leg and I’ve got a fever and a bad headache” is asking for a consultation on Lyme disease.
The standards of diagnosis might not be as rigorous, but that’s a separate issue.
Then there’s me.
“Doctor, I can’t sleep!” “Here, take this Ambien.” “Ambien scares the crap out of me; it makes my friend call me up late at night and ramble incoherently at me, and I’ve heard it makes people have sex and forget it happened.” “Eh. Take it anyway, that doesn’t happen to most people.”
“Doctor, I still can’t sleep, I worry all the time, and it’s wrecking my motivation at work. And the Ambien works, but it makes me trip out more than I probably should most nights.” “You have an anxiety disorder. Here, go to this psychiatrist, Doctor #2. And don’t take so much Ambien.”
“Doctor #2, I can’t sleep, I worry all the time, and it’s wrecking my motivation at work. Oh, and Ambien makes me trip out before I fall asleep.” “You have anxiety and depression. Here, take these antidepressants, and these benzodiazepines if you need them, plus these folates and vitamin D … oh, and replace that Ambien with this Lunesta, and come back every week. And let’s talk about the work situation, something’s messed up there …”
Anecdotal, sure; and pretty recent. But I didn’t start out with the idea “I’m depressed and should seek antidepressants”. I thought I had a sleep disorder, but it turns out our reality doesn’t issue time machines for those.
Yes, if the question were “How many people go to a doctor to complain of symptoms of mental illnesses” then sure, a large chunk of the general American population (still don’t know if a majority) would qualify.
However recall the context. We started with the question “Have you ever self-diagnosed yourself with a mental disorder?” and are talking about the follow-up to it. Here the question about going to the doctor means mostly “Did you take your self-diagnosis seriously enough to talk to a medic about it?” And, still within this context, the question is much more like “I think I’m mentally ill, is that so?” than “I can’t sleep and life is pointless, how do I fix that?”
I was mostly replying to the bit about the general population. In the context of a follow-up question, you might get some quite different results.
Actually, I’m not at all sure if you’d even get a higher percentage of yes respondents than you would in the general population; there’s a lot of things I get the sense that a self-diagnosis could be pointing to, most of them likely anticorrelated with seeking formal diagnosis. Charitably, it might indicate an attempt to find out what’s going on with one’s head in an absence of resources or motivation, or in the presence of social or communication issues or other life circumstances that make one less likely to immediately seek help. Less charitably, it might indicate attention-seeking behavior of some sort, or a trivial approach to the whole issue.
I agree that self-diagnosis could be pointing to multiple, different things. Don’t know if there’ll be much attention-seeking in the current crowd—“I’m so cool I’m depressed and I’ll say I have MDP to make me extra cool” is a kinda early high school thing and most people grow out of it fairly quickly. People who don’t grow out of it are, um, easily recognizable.
Are you sure about that?
I don’t have data, but my prior is fairly strong.
There are a lot of (temporarily) depressed teenagers, but it’s rarely clinical and they rarely go for a formal evaluation to a psychiatrist or a psychotherapist.
How many people, do you think, go to a doctor and say “I think I’m mentally ill”?
Ah, when you phrase it like that I realize that my estimate is rather low. Near vs. Far mode, I guess. Since it’s relatively unlikely that someone would do that if they weren’t actually mentally ill, and some mental illness is mild enough that one wouldn’t bother, and a lot of the severe ones could prevent someone from consulting a doctor on their own, a pretty low proportion of the population seems reasonable.
Does that line up with your reasoning?
edit: I think that part of what was muddling me was that your original phrasing (“talked to a mental health professional about an assessment or a diagnosis”) was sort of unclear, so I resorted to nearby heuristics rather than trying to parse it properly. We might want to fix that up before putting it on the survey.
Well, I meant this in the context of being a follow-up to the previous question about self-diagnosis. So it mostly means “Did you take your self-diagnosis seriously enough to go to a doctor?”
Such a question outside of this context needs to be more precisely formulated, I think. As we were discussing with Nornagest, going to a doctor and saying “I can’t sleep, life sucks, can you help with that?” is sufficiently common.