Comment by faeriechangling | Hacker News Reader

Comment by faeriechangling | Hacker News Reader

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faeriechangling

I find it bizarre how uncritically the social construct of doubling the ranks of the mentally ill/disordered in the course of decades has been introduced. There is no way in the last few decades the amount of mentally disordered people has expanded so greatly, it must be the case we're simply calling more people disordered. The growth of mental disorders is starting to plateau now but things are still growing.

I find it all to be part of a modern fetishization of victimhood as as something that ought to give you entitlements without responsibilities, and consequently has greatly expanded the ranks of victims in society. I find it straight up bizarre in some sense that a student in an elite school will get academic accommodations and access to amphetamines on the pretence they just can't be as successful as other students when it has to be the case many of these students would end up at community college or state school without the drugs and be fine. It's kind of like to me an athlete playing for a crappy school team getting diagnosed with "strength deficit disorder" getting on steroids and breaking records and this is justified with all sorts of pseudoscience about how steroids actually have the opposite effect on muscletypicals (proving steroids are a drug for only those with legitimate medical need) when the entire sports team is on steroids. We also give them a headstart in all races to ensure that they don't have any performance anxiety.

Re: Experts, The expert she's referring to, more than anybody, is Simon Baron Cohen and his research has been replicated many times yet only applies to MOST but not ALL autistic children. He famously applied the Sally-Anne test to autistic children https://en.wikipedia.org/wiki/Sally%E2%80%93Anne_test to demonstrate "mind blindness". I would say the biggest issue with the research is that it took place is 1988 and autistics are not remotely the same group of people that they were in 1988, so it wouldn't even surprise me if autistics were no longer mind blind in this way, since autism is not even remotely consistent in its definition across time. I sympathize with any criticism of "Experts on autism" because they have shown nothing but incompetence as a group.

I think this chart expresses my opinion better than I could. https://www.washingtonpost.com/blogs/wonkblog/files/2015/09/...

Using that as a reference point, maybe we're at "1910" with regards to our awareness of neurodivergence, or maybe we're at "1950", but certainly there are many people who will be better off once we hit "1960".

Your argument only holds water if you presuppose that everyone who would have met the diagnostic criteria of 20-50 years ago was also evaluated against those diagnostic criteria. I have far better than typical access to diagnostic services, and it took a referral, several appointments, and thousands of dollars to get a formal diagnosis. If I had that same access 25 years earlier, I probably would have been far better supported through my education.

Do you have a problem with the words "disorder" or "illness"? Because it comes across to me that it rubs you the wrong way that so many people can be considered flawed in some way. I don't think that way of looking at people is untruthful or wrong, it's just a lot more nuanced to look at it than a person being either "sane" or "insane".

I really do wonder this as you so explicitly put "mentally ill" and "disordered" as interchangeable, which they clearly are not. Pretty much everyone has some kind of disorder, which they can address. Only a few have a mental illness, which they can learn to cope with.

Your example also serves to reduce attempts at nuance even further, by trying to make mental illness only understandable through the lens of a physical one. So one has got to wonder: maybe you are lumping way too many things onto one pile?

First, I’ll say the APA defines mental disorders as a subset of mental illness which contradicts your definition [1]. In my experience, people tend to define these terms incredibly inconsistently and I don’t get caught up in the semantics.

Second, I would say I have both social and scientific objections to the concept of mental disorders.

Scientifically, the definition of what is considered a disorder is INCREDIBLY subjective. The DSM-V definition includes language like “impairment in an IMPORTANT area of functioning” and “reflects a dysfunction”. Being gay and transgender are two things that were considered disorders and no longer are. Generally the reasoning as to why these are not mental disorders is that being gay/trans does not make somebody intrinsically unhealthy and some of the things we see like higher suicide rates in those groups are a result of social stigma… which are ALL things I can rather trivially claim about many cases of autism.

Socially, it’s just unnecessarily insulting to call people dis-ordered. In the context of autism, it is well known it can present as a combination of strengths and weaknesses, but the mere existence of weaknesses gets the insulting label of “disorder”. This shows a condescending sense of superiority among the doctors who coined “Autism spectrum disorder”. I don’t feel medical language like disorder or illness is very nuanced at all, I feel it’s reflective of blasé and thoughtless generalization and the language mostly serves to stigmatize which is why people got mad about it being used to describe trans people.

[1] https://www.psychiatry.org/patients-families/what-is-mental-...

I’m not too surprised if there were tons of people who historically would’ve been just considered crazy or possessed or the village idiot or “retarded” or a thousand other things that we now have more specific categories for. Now how much schizophrenia and anxiety and autism have in common as a umbrella category of “mentally ill” — probably not much.

The discussion around “academic doping” seems spot-on to me.

Regarding the increase in diagnoses of autism-spectrum, I think a few decades ago, those people would have just been called “weirdos” or “creepy” or “special”. They might not have had a diagnostic label, but it was not as if they were unlabeled by those around them.

The amount of people that allegedly have ADHD, the U.S is a big outliner when you compare it with other, similarly developed nations. I believe it will be looked back at some point like opioid crisis.

My prediction is that the whole song and dance where you need to prove you have ADHD will fade away, and people will be able to basically just be able to get ADHD drugs from a doctor on the condition you get your blood pressure checked and such.

I think if the culture can normalize coffee, it certainly can normalize amphetamines and methylphenidate. Like to me it's hilarious in a way how offices will literally provide drugs (coffee, tea) to their employees for people to self-medicate with.

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