Is it time to stop talking about mental illness?

I believe many young people are being encouraged to frame normal experiences as psychiatric conditions.

Let’s face it, in life, sometimes you are sad for good reason. That doesn’t mean you’re suffering depression. Yes, delivering that presentation to a group makes most people anxious. It goes with the territory. It’s not a panic attack.

Facilitating this trend, today’s youth have stunning levels of psychological literacy. Aided by the plethora of online quizzes and symptom checklists, they’re fluent in the language and labels of mental illness. And they’re using this knowledge to self-diagnose.

Today’s prevalence inflation of ADHD is illustrative. Even though the number of diagnoses has skyrocketed, there’s a valid question about whether the actual number of people with the disorder is going up. Part of the problem is that ADHD symptoms blur with ordinary life.

Incentives in government policy, specifically the NDIS, potentially explains the additional growth in Australian (autism) prevalence.

— Maathu Ranjan, ANU researcher

A director of the ADHD Foundation, Christopher Ouizeman, says: “Thanks to Dr Google, everybody thinks they’ve got ADHD. And there’s a lot of people self-diagnosing, and going from clinic to clinic until they get a positive diagnosis.”

It doesn’t help that mental health diagnoses are not as stable and objective as you might think. Many are ambiguous, others come and go with changing times and social fashions. Don’t forget homosexuality was an illness until 1973, when the American Psychiatric Association voted to abolish it from its diagnostic manual.

I stress that I’m not disputing the significant and concerning mental health crisis, especially among the young. It’s just that there’s a grey zone, where some believe they’re unwell, but are merely experiencing life.

It begs the question: what could be motivating so many to seek a diagnosis?

I venture one explanation – that young people are being incentivised to have mental health issues. There’s a pay-off. Students are being excused from having to finish assignments. Workers are given “mental health” days off. There’s definitely enhanced peer group status (and what is more intoxicating to young people than that?). There’s all that unconditional support.

There are even financial motivations.

Take autism, ANU researcher Maathu Ranjan was curious about why the growth rate in autism in children is much steeper in Australia than in comparable countries, including the United States, Canada and the UK.

“Incentives in government policy, specifically the NDIS, is the key factor unique to the Australian context and potentially explains the additional growth in Australian (autism) prevalence,” he writes. Incidentally, Ranjan used to be a NDIS actuary. So that’s from the horse’s mouth.

It all reminds me of a psychological concept called “secondary gain”. This is the reward or benefit a person gets from having certain problems.

Displaying symptoms might be a way of avoiding responsibilities, such as doing chores, or going to school or work. Being unwell may result in financial gains, such as the payment of benefits. It may be that people get more attention and care when they are sick.

Hark back to psych 101: Behaviour that is rewarded tends to happen again.

Peter Quarry is a psychologist and the author of If I Were You – A Psychologist Puts Himself on the Couch (Hardie Grant).