I think this is just incorrect. You are not obligated to seek treatment for most medical problems[1]. The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in and when people enter a situation where they may need external help. One of the diagnostic criteria, which this article mentions, is that your grief is disrupting your life - but despite what this article claims they have misunderstood that criteria. Of course grief changes your routines and life. That change only becomes "disruptive" if you feel the change has somehow gone too far or you are struggling to undo it. This writer is doing neither and therefor does not meet the diagnostic criteria for disordered grief. They are grieving normally and the medical literate supports that understanding.
There are of course medical professionals who use diagnostic criteria as cudgels. Trying to force people to become patients in order to enforce their idea of what someone "should" want. This is a problem but it is a problem that the official diagnostic guidelines try to avoid. For those who are interested in this kind of problem with our medical system might look into the professional philosophy of doctors (generally arrayed around identifying and curing disease) and nursing (generally arrayed around making the patient comfortable as possible). I tend to think the nursing model is the more useful and sensible of the two - even though, of course, if one wants to cure a disease a doctor is helpful.
[1] There are very few diseases, such as tuberculosis, where you can be forced to treat the disease.
> The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in
The problem is that medical diagnoses and therapy speak have spilled over into common language where they’re so diluted that they’re not accurate any more. For many there is no line drawn anywhere because they are self-diagnosing based on flawed understandings as soon as any feeling or symptom arrives.
This is scarily obvious when I’ve worked with college students and early 20s juniors lately: A subset of them speak of everything human nature in medical and therapy speak. Common human experiences like being sad about something or having a tough day are immediately amplified into full-blown medical terms like “I’m having a depressive episode today” (which is gone by tomorrow). Being a little nervous about something is “I’m having a panic attack”. Remembering an unpleasant disagreement at work “gives me PTSD”. When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
This is only a subset of people, but it’s a rapidly growing percentage of younger people I work with. When someone falls into this mindset it only grows: The same people using these terms usually accumulate a lot of different self-diagnoses to cover every element of common human experience: They will claim ADHD, social anxiety, often some variation of Autism despite showing none of the signs, PTSD due to a previous relationship/boss/professor they didn’t get along with, and insomnia or delayed sleep phase syndrome. Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.
I’ve been offered helpful links to TikTok ADHD influencers to help me understand them, because that’s where they think the best information comes from. 20-something engineers confidently tell me they know more than their doctors about ADHD and how to treat it (usually after their doctor refuses to increase their dose of Adderall again or denies them some other controlled substance they think they need like ketamine or perpetual daily Xanax). There’s also a growing culture of casual drug abuse and misuse that gets justified as self-medication, but that’s a topic for another post.
This is a very american trend in my experience. Americans are quite happy to tell you their long list of diagnoses, how that some how gives them some kind of exception to the rule, and how this is some how part of their identity. This kind of oversharing is common across topics from Americans but in particular oversharing of and obsession with psychological conditions seem to be a common modern stereotype of americans amongst my friends who interact with americans regularly.
I mean, I have no data for this, but I think it's a combination of two factors:
- Access to mental healthcare here is HEAVILY gate-kept by a combination of it often costing quite a lot of money, generally having longer waits than most healthcare services, heavy variability in availability by location, and insurance coverage runs the gamut between great or utterly absent, sometimes even in the same policy depending on what you need. Self-diagnosis is for many people the only diagnosis they have access to, and even if it's wrong, you can often use whatever diagnosis it is to find coping mechanisms that help you, or substances that will help you self medicate.
- Naming something medically is the only way to get institutions to pay attention to it, which can mean a number of things by itself, from getting appropriate accommodations at work or school, to getting certain kinds of coworkers or authority figures to treat you in a way that's more amenable to your mental state.
And I don't think its wrong to make it part of your identity either. Some definitely take it to a weird, unhealthy place, and also most of those people are teenagers. Teenagers do tons of stupid shit, I did tons of stupid shit. It's just part of growing up. But ultimately... it is part of you that you're going to be dealing with probably forever, so, some amount of identifying with it is probably healthy.
Edit: Also not sure how to read you calling this "oversharing?" Like I guess it could be depending what it is, but I dunno, my wife has BPD and a touch of Autism, she doesn't announce it when we meet someone but it isn't a secret either.
Everybody wants to be the one who overcame the odds or struggled bravely on. Everybody wants their story to be special because of how hard it was for them compared to everyone else.
I think some of it comes from the value the culture places on underdog stories and some of it comes from the oversaturation of everything in modern life.
I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet.
I guess we'll know when they turn 40 and are still saying things like "I had a panic attack" and "I'm literally shaking rn".
I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that.
Similar to how some people look at raw stats of autism diagnoses and think hugely more people are becoming autistic when in reality it's that we've got better at diagnosing autism; I think we (society, in at least some countries) have got better at being honest about mental health conditions. Meaning that more people, especially younger people who've grown up around less mental health stigma, will talk about having an actual genuine problem even without more diagnoses or more exaggeration. I think studies would be needed (that I'm not aware of) to figure out how many more people are using labels that don't really fit, vs how many more people are being honest about actual serious conditions.
When I was in my 20s, if I needed a day off work because of depression I would always use a bullshit excuse to avoid mentioning the actual reason. I don't any more, most of my colleagues know what issues I do or don't have. And the younger generations are starting from that place, rather than having to grow into it.
The dilution by people with no formal diagnosis become more common is scary because of how it normalizes not seeking help, which is the hardest part of actually having these issues. It creates this illusion that one should be able to treat themselves and that things like sitting at your desk all day thinking it wouldn't be that bad if you died in a car accident, or having your heartrate spike and sweating profusely while you thoughts are paralyzed are normal things that happens regularly to everyone so your inability to deal with them is a personal failing. They are not and if you do feel this way try and seek assistance from a experienced professional.
Those folks are the ones who refuse to acknowledge and accept the fact that they were abused by family members while growing up, where those personality 'symptoms' are common. It is very well known that ADD and ADHD comes from abusive households. Nobody except psychologists and anyone in the mental health field would ever admit such failures in life. They will not accept the fact, and exaggeration and deflection of character faults into false medical diagnosis is what happens. Not very many doctors want to get screamed at by their patients (which would prove the doctor right) for telling them the truth of their own past, and besides, they're not even paid to tell them.
"Truth hurts, don't it" is a very true phrase. It's a very sick trend affecting Millennials and Gen Z alike, and contributes to other worse mental health and criminal outcomes.
What you're describing is a big problem [edit: for the people who get sucked into it] and, to me, is kind of the "other side" of the overmedicalization issue that this blog is complaining about. One way medicalization harms is is when people are forced into conditions they don't agree with (as the author feels they have been). The other way is when people who aren't medical professionals (and wouldn't be in a position to diagnose even if they were) adopt medical language to describe experiences.
I guess my thoughts on the trend you're critiquing is that it happens almost entirely outside of the medical community. As you describe the people who are most impacted by this often find actual medical treatment unhelpful and un-validating and turn to self-medication or other "medically inspired" coping techniques. I think the people who actually don't have these conditions and are applying medicalized treatments and explanations are opportunistically drawing on medical language because people often respect it socially. But also there are lots of people who engage in self-deception (or just normal deception) for social advantage and I don't know that people who use medical language are better or worse? A word is just a word and unless that word is actually on a medical record somewhere it only has the power you give it.
The flip side of this is of course that the medical establishment has many well-studied and documented biases. They offer poor treatment to overweight people, black people, people with mental health diagnoses, basically every vulnerable population that's been studied gets worse service from medical professionals. That very reasonably leads to people distrusting "the system" and searching for coping mechanism outside of it. I think that is generally pretty harmless and helpful - as long as it doesn't get into the realm of serious self-medication like you describe. Basically if you like using a medical term to describe your experience ("I'm being really OCD today") I don't think there's much harm in it and you may find coping mechanisms for people with ODC helpful as a bonus.
>Basically if you like using a medical term to describe your experience ("I'm being really OCD today") I don't think there's much harm in it and you may find coping mechanisms for people with ODC helpful as a bonus.
I was with you up until this point. My wife has C-PTSD, Bipolar type 2 and ADHD, along with what her psychologist describes as "Social OCD". I can't tell you how many times I've had to explain to other people that her mental illnesses are real and some days she and I just can't hang out because she smelled a smell that gave her flashbacks. Because people have normalized the language, they think "triggered" just means upset. For someone with real PTSD, it doesn't mean upset, it means their mind has come unstuck in time and they don't know who to trust or sometimes even what is real. Sometimes this lasts 5 minutes, sometimes it lasts almost all day. She just loses that time, and all I can do is try to calm her down and try to get her to take medication to re-stabilize her.
My wife has been in therapy with a PhD psychologist for 11 years, and only just this year has gotten to the point where it seems like she could probably hold down a job and keep her trauma compartmentalized like most people do all the time. People normalize the language for these debilitating full-blown disabilities and then don't understand the gravity of the situation when somebody with a legitimate mental illness of that sort of degree comes along.
Co-opting medical language for sub-disorder level dysfunctions is bullshit. And that's fine, when you're just bullshitting with your friends or whatever, but how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
I would posit your issue is not in co-option of terminology but in that ableism is still rampant and these are people who wouldn't take your wife seriously even if you described her symptoms. I have conditions that people do not uwu cutesy about on tiktok and people still illegitimate me when it inconveniences them slightly like canceling plans. People playing down disabilities the disabilities of others is extremely common. Being able to be flexible and accommodating to any degree I can to someone's disability has nothing to do with whether or not I think it is legitimate, and gating my flexibility to whether or not I personally judge someone's disability as legitimate is ableism plain and simple.
I upvoted your comment because this is also a huge issue. I just find that the co-opted terminology does worsen the quality of dialogues about the co-opted terms. People need to have the symptoms fully described for them in detail and sometimes don't believe me or think I'm exaggerating because it doesn't match their preconceived notions of what those words mean.
I'm not saying that the problem isn't ableism, it absolutely is, just that the co-opting of the terms is still harmful in that it uses up spoons and makes it harder to communicate clearly, especially with those who are stuck on the pop-culture meanings instead of actual medical meanings.
I'm not sure if this is "human nature" or if it's a specific cultural problem in the modern west. It's certainly true here in Canada too -- everyone uses terms that are really quite heavy duty to describe quite minor things.
I'm deaf. When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too." Now not to go policing people on their identities but -- no you're not.
Like what do I need to say? Clinically deaf. Severe-profoundly deaf. Cannot hear a fire alarm without hearing aids?
It's one thing when it's an elderly person. Yes maybe they are in fact a bit deaf too. But for all the people in their 30s or 40s who have said it to me -- the odds they all have moderate or worse hearing loss is nil! Most of the people who are saying it presumably have normal hearing. I understand that they're trying to identify with and not alienate me. But it's such a strange dynamic.
Conversations are rarely about saying truthful things, and mostly about societal theatre that is supposed to leave both parties feeling better. Nobody cares that you're deaf, what you're expected to do is to react in a way that makes the other person feel good. I don't like this either, but that's how, for the lack of better word, "normies" function.
> When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
I mean, our industry is filled with people of all ages with ADHD (arguably because it’s one of the few industries where you can succeed while having severe ADHD), GenZ folks are just more likely to admit it in public where older millennials are more likely to either be quiet about it or ignore the fact that they are subject to it.
> Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.
The thing is, many people have valid reasons not to trust the medical system. Not so long ago:
1. Homosexuality was considered a mental disease
2. Forced sterilization of minorities was good medical practice
3. FDA ignored warnings about pesticides being potentially harmful because that would be bad for business
4. FDA ignored warnings about pesticides being potentially harmful because that would be bad for international politics
5. Entire field of psychiatry was just basically random shit, it's not until very recently that we have any actual scientific knowledge
6. Pregnant women were presribed medicine that fucked up their fetuses
Not to mention that most likely when you go to a doctor you're not getting state-of-the-art diasgnosis, most likely the doctor is just a random guy doing his job, sometimes better sometimes worse. Personally I don't trust medical system with my mental health because medical system is a product of a society that made me have mental problems in the first place.
I know people like to blame social media and just "the kids these days" in general - but I think there's another reasonable, far more charitable explanation: it's a sort of overcorrection after those illnesses being very heavily stigmatized for practically ever. It's perhaps not ideal, but if a symptom of more people who truly have those illnesses being able to get help is a small portion of people using it as a fashion statement, that's a price I think we can pay. And I'm confident it will correct itself over time.
Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply).
That said, the writing really resonated with me and i wish Bess well.
I think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying
I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.
I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional".
What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc.
We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors.
I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)
One of my best friends died 12 years ago in our late 20s. I know he is dead, and yet a couple times a month I think, "Oh, I haven't talked to him in a while, I should text him!" before my logical brain kicks in and lets me know the deal.
There is a dumb part of me that wants to believe, "Oh, he probably faked his death to get out of debt." He was such a schemer, if anyone would, he would. It was an open casket funeral. I know he is dead.
It's not a disorder. I just have mental pathways built that lead to a person who was integral to my life for many years, a person who does not exist on this plane anymore. I want him back in my life. Death is just difficult.
He was a genuine source of both encouragement and constructive criticism the likes I have had not had before or since. I miss you, Meka.
My best friend of 25 years died 4 years ago and I still think of him at least once a week, wishing I could talk to him. It was almost a year before I could even talk about him without completely breaking down. I never once thought: "oh, this is a medical issue". It was just me having the same problems processing my grief that American men have because we're not raised to talk stuff out. Once I did start talking about it, it got easier and easier to deal with.
There is a problem with rigid medical definitions. There is a huge difference between the author of this, a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent (as I did earlier this year). Of course it will take her far longer to recover (if at all).
I would guess her grief is not "disordered" though. As she says she functions - she works, she looks after her child, she looks after herself.
> We medicalize grief because we fear it.
Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
Sorry for your loss, and thank you for your perspective.
>> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
I never thought about it but it likely stems from loss of religion, like many other problems. If I see my life as insignificant in the chain of generations - as a conduit between ancestors and descendants - and believe in the soul at least as a metaphor - then personal death or that of others is sad, but is in the context of a deeply meaningful existence.
On the other hand, if I am closer to atheistic hedonism/nihilism - there's nothing else but me and my thoughts and experiences, then my existence or non-existence takes on a very heavy weight - and we project that onto others.
Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking. We're used to thinking we control things, and can get anything we want. One thing useful from the religions was having a healthy sense of your own limitations, or you could say a sense of wonder or mystery or perspective. A reminder that you're not the most powerful thing in the universe. Which is true, and healthy to be aware of, whether any god exists or not.
Edit to add: There are few places where that hubris and certainty tend to be more pronounced than among doctors. Part of what this woman is grieving is probably the loss of certainty, of control or the illusion thereof.
> Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
It maybe a factor, but I do not think it was the main one. Death is still very hard to cope with, regardless of religious belief. There are other things behind religious belief, mostly experiences.
> I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking
I'm surprised by this take, simply because of my own experience, where the further I've gotten from religion over a very long time, the less significant I've found death.
Not having "answers" to what comes next has never been a weight for me - at least not since I was a child. Death being a completion, or a finality, is freeing; The end of what has been and what I hope continues to be a wonderful journey. The only weight I carry in regards to death are for those closest to me, and especially those for whom I'm responsible.
I find that surprising in turn! What were the beliefs you had around death?
I can sort of see why you found it less significant, but in monotheistic religions it is still pretty final. It is still the end of the one life you get, even if it is also the entry into something completely different and better.
This is not even slightly true and seems to be based on a profound misunderstanding of atheism. From my perspective as atheist since the age of 11, it's the reverse of the case.
Atheism doesn't presuppose either hedonism or nihilism. This is a common theist libel which is surprisingly popular on this forum of ersatz rational thinkers and logicians. Atheists are perfectly capable of finding value and meaning in their own lives and the world around them, they just don't base that value on a belief in the supernatural. Listen to any astrophysicist, physicist or biologist talk about their field and you'll encounter a wonder and awe that no theologian reciting thousand year old tracts can match.
I think you're right on the word level but I think there's a difference about what significance and insignificance means to these groups.
As a religious person, I see my life as insignificant compared to Gd, and compared to the chain of generations, but what I do with my life is extremely significant. As in, whether I bring children into this world and raise them well, is massively significant.
So maybe the way to say it is - religious people see themselves as insignificant in the context of much greater significance.
The other view of insignificance is that nothing is significant - including myself. I don't subscribe to that.
No, I don't believe that. I valued children just as much when I was an atheist as when I became religion.
What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not. I work in FAANG and previously in finance, so my peers are people who can certainly afford kids and are positioned to take care of them - and yet literally most are choosing to do something else.
I am not commenting on a universal attitude, I am commenting on a significant trend that I think is obvious.
Putting aside the question of whether your own experiences hold for the general population, you must consider why these opinions are so prevalent, either way. One might argue that religion doesn't teach 'values' so much as 'roles', and so people feel they must do these things, not for any significance or with little thought to possible negative repercussions, but simply because... well, that's just what you do, right? Find a partner, have kids, go to church. That's the lifestyle religion teaches. One might also argue that secular people aren't as intent on having kids because they're more willing to accept different lifestyles.
For what it's worth, krapp's comment is better written but is what I'm talking about here.
>What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not.
Do all of your religious friends subscribe to the same religion?
If so, does this religion proscribe having children and raising families as a necessary, or desired, component of the faith or community?
Because you could be confusing religion and culture here. Secular values often abrogate traditional gender and sexual norms, so secular people may not feel compelled to "be fruitful and multiply." I wouldn't ascribe that to lack of religion per se so much as not being affected by the same cultural pressures. After all, plenty of theists are essentially forced into marriage and children because it's what's expected, not because it's what they want.
I am not sure "culture" and "religion" are separable in the long run but I don't think that aligns with the point you're making.
Religious people see "be fruitful and multiply" as a literal command from G-d and one of the fundamental points of religion. So while religious culture can evolve, the evolution of this attitude isn't a flexible point.
On the flip side, secular culture has no intrinsic reason for "family values" - which is why, I think, atheist culture over time devolves to childlessness - because reasons "why not" are more immediate and in your face, vs "why yes."
So yes it's "culture" but what the culture is is obviously determined by your underlying beliefs and that which you consider eternal and that which you consider negotiable.
I'm so sorry for your loss. I agree with what you say about "disordered", the language is hostile.
In a less morbid area, I feel the same way about ADHD - "attention-deficit/hyperactivity disorder". For some people this is problematic, but others can function fine and happily with this.
In those cases, why is it a "disorder"? Why can't it just be "how some people are"?
I think there's something of a pendulum here, and I agree it's swayed too far to over-diagnosing ourselves. But I also think of my father who passed a couple years ago.
We didn't have much of a relationship. He had friends, but never close ones. He was weirdly mean or weirdly seclusive or weirdly awkward at times - and also incredibly intelligent and occasionally gracious and hilarious.
After he passed, I wondered if he might have been somewhere on the spectrum - but his peculiarities were simply ignored. A poor boy, in a poor urban neighborhood, with a dead father, being raised by an immigrant mother and immigrant siblings doesn't get diagnosed with much of anything - if they see doctors at all. And hey, he had a near photographic memory, and did great in school, so what's there to worry about?
It's always been "how he was", and that's probably ok, but I do wonder if he would have had a better or somehow different life if he knew more about _why_ he was the way he was.
In my understanding ADHD is one of the few conditions that is extremely well studied and consistently appears to be a certain % of the population regardless of nationality with very strongly correlated negative outcomes with their suite of symptoms. I'm talking addition, obesity, and a shortened lifespan directly related to their ADHD. This seems like a disorder to me. If someone has attention difficulties and can function fine they obviously don't have a disorder vs someone who has attention difficulties and as a result becomes addicted to cocaine.
Function in what context? I have been diagnosed with ADHD at age seven. I have had many checkups and am currently medicated. I can tell you that I wouldn't need to if I didn't have to work a menial wageslave job. Interestingly I can focus perfectly fine when doing interesting stuff without medication and it has always been this way. What you are saying is that there is some proper definition of disorder, which would sensibly be defined relative to some "normal" human baseline. Tell me you know one "normal" human, why you see this person as "normal" and how it would be useful to use this as a reference for the big spectrum of human personality and mental fitness. I can tell you from experience that I didn't need medication when I wasn't forced to attend 12 useless meetings a week, use inefficient and stupid software and one would just let me get my shit done. I have quite a few friends who have had very similar experiences, and the idea of ADHD is just used to pathologize and medicate someone so he can work and be a "positive contributor" to whoever above them. Add here the necessary disclaimer that my experience is not universal and there may be people gravely suffering from it, etc. I do too, even with medication, but at least I can generate some bucks for management.
And what I know with ADHD is that the incapacity to handle dumb meetings is just one definition of functioning. Maybe you don't need medication to clean yourself enough to prevent skin issues, prevent addiction to substances, compulsive criminal behavior, avoid hoarding behaviors, have a safe living space, have the capacity to maintain friendships/avoid loneliness, engage with social interactions in a mutually respectful manner etc. But most people I know with ADHD severely struggle with at least one of the above and I consider that functioning, not just holding down a job. My understanding is not on the level of "can you do bullshit work" but it is "can you clean your dishes before they stink" and "can you respond to being turned down by a girl without blowing up your life".
>a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent
This isn’t really your point, but this person lost their husband at 40. By some definitions, that is middle aged. In the general view of things, not young.
That doesn’t really change much, but I was thinking of a mid-twenties before I realized who it was.
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
Someone always rocks up to say this in these threads, and then never actually offers any suggestions of what they think an alternative should look like.
It's in the same vein as people who complain no one ever talks about serious subjects, and I'm just wondering why they think I want to get into discussing the meaning of life in the workplace cafeteria.
Seriously, what is the alternative meant to be? A celebration of death? Constantly reminding people that everyone will die and you'll be forgotten completely in about 3 generations? Why focus on the inevitable rather then actually living?
> Someone always rocks up to say this in these threads, and then never actually offers any suggestions of what they think an alternative should look like.
It's a broad observation about culture - there's no "alternative" to a well-established culture, no single forum comment will change society.
> Seriously, what is the alternative meant to be? ... Constantly reminding people that everyone will die and you'll be forgotten completely in about 3 generations?
I think you're on to something here; there's an inherent conflict between ruthless individualism that tells people they can do anything they put their mind to, and the stark, limiting reality of mortality. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
Collectivist cultures already embraces the idea that one's life is more than just about the individual, so grief and talking about death are far less radioactive. Religions that embrace ancestral spirits being presence offer comfort in continuity; her husband isn't really gone, and he may even watch ober their daughter, and even help her in math exams. In that light, dying is less of a big deal - more of a transition really - compared to oblivion, which is super heavy. I'm not saying these are better
+ Yes, allowing people to have a celebration goodbye party before they go
+ Allowing for medically assisted dying on a person's own terms
+ More open conversations about: directives, how people would like to be treated when they near death, wills, inheritances, funerals. These are all taboo topics
> There is a certain cowardice in how we deal with death in the contemporary west.
It's because we have a dearth of true elders right now.
Not in age, but in temperament and learning.
I got interested in story telling during COVID and managed to find a great author (K.M. Weiland) that went in deep on the archetypes of story.
Her hook was essentially: "What happens after the Hero's Journey/happily ever after?" And then she got real deep on her idea of the 6 phases of life. Her work is properly about how to write a plot, but man does it apply more broadly.
The pertinent one here is the 'Crone' stage of life [0]. You're no longer the 'King' of your little fief, you had to give up the power and make way for the next generation. But now what?
The journey of the Crone is essentially learning that Death is a part of Life, that Death is not Evil, Death is a Friend.
K.M. Weiland admits that less and less people ever make it through the stages as you go along.
But, I think right now in the West, we have a lot of boomers that never really progressed past the Hero stage, let alone the Queen or King stages. There should be more Crone and Mage people around, but the boomers were retarded in their development. Just look at RBG, Feinstein and Pelosi (to name but a few), grappling on to power like the Tyrants or Sorceresses (strong shadow archetypes of the Queen and King) and never letting go, to the classical harm of the kingdom/hearth that such stories tell.
Facing Death is hard, very hard. But is something that we all must do. Realizing that Death is not Evil, but a part of life, and one to be welcomed at times, that is something that very few of us can do.
In the west we’re trained to believe that if something happens there should be some sort of tangible reward on the other end, no matter how minute. Death takes and leaves nothing tangible and it’s the absence that drives us crazy. Since we’re trained this way we seek out some solution with the other trained aspect, spending money. Which in turn only temporarily numbs the grief until you deal with it.
We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”. So our money spending usually doesn’t direct us to a more helpful path.
I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
> We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”.
I think this idea is ~10 years out of date. If anything, we now seem pathologize every behavior and personality quirk into a mental health issue. At least on social media, it's also trendy to have a mental health issue to the point that people will claim to have ADHD because they're easily distracted by their phones. I've also lost count of the number of big "content creators" who casually mention their therapist or going to therapy. If there is a stigma, it's not found among the younger generations.
I think for people over 50, I guess "Gen X" and older, this is still often true. I've never considered therapy or medical help for any way that I was "feeling" and certainly have had times of grief and loss and sadness in my life. In some of those moments, when peers or friends noticed it, the gist of their advice was to “suck it up” or “get over it”.
I am also introverted, procrastinate, am not very organized, and am not very good at housekeeping. My view on how I would change those things would be to just suck it up and do better, if I had to. And when it matters, that's what I do.
I don't mean to say that this is the only correct way to approach life but it is how I look at things.
I do not agree. While there may be a flux of people who have therapists, the majority do not and that is why you hear about it on Youtube.
I do agree that younger people are trying to take more care of their mental health but I do not see healthy reasons for which they are chasing that improvement. For example the “pursuit of happyness” is indoctrinated and people think they always need to be happy. At the same time I think people are self-diagnosing which I do not include as “health care” as I meant it, but rather self care or even passive-hypochondria.
It used to be in the west. The Catholic Church discourages the scattering of ashes for just that reason - so that there is somewhere physical where people can be remembered. There was a tradition of memorial services. People still look after the graves of their loved ones.
I also think its not a simple east-west divide. Different cultures have many different ways of dealing with death. The contemporary west does have a problem, although i doubt it is the only culture for which that is true.
My family follows a mix of Christian tradition (e.g. memorial masses) and Sri Lankan (e.g. donations of food in memory of the dead).
I agree it’s not a simple divide. I was trying to paint that there are many reasons why we handle death poorly in the west and I honestly only know a raindrop about the east. I can only fathom the handling of death and the reasons why gradients across the globe in every direction.
> I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
In what way is this not western as well? Implying that western culture does not remember, contemplate, and revere those that have gone before us is a bad take.
I agree with you on the western religious tradition, but I think it's less true for the secular west today.
With ample exceptions of course, a stereotypical "secular" person thinks of their ancestors as racist people that lived in an irrelevant time, and doesn't feel some sort of connection to them, or an obligation to continue them. So I think the poster you're replying to is kinda correct from a today point of view.
I went ahead and added that "stereo" to my comment. I think you're right, but I also think that stereotype is grounded in reality with a lot of empirical observation. So yes, not exclusive but certainly common.
Well, as a secular individual whose friend group is mostly secular people, I haven't see people express such black and white opinions, but I'm guessing we move in different circles. As far as observation is concerned, we tend to see what we want to see, don't we?
Your made up straw man secular person is, frankly, ridiculous. Like, we all get it, conservative Christians hate the rest of us and look down on us. Duh.
In the way that most people don’t have a routine of that contemplation and remembrance and that individual self, ego, and your future is placed as more important in the day-to-day.
That's moving the goalposts. Implying that people do not go through that remembrance vs implying that they do not do so on a set routine are not the same thing.
Not to mention that such a routine might very well be part of the medical therapy that we are talking about here.
A lot! Maybe it's obvious, but I've long thought that religion's primary function is to help people process death (and other suffering). Now that life isn't constant suffering, many of us have discarded religion, but then we are blindsided by death.
I was very religious for 30 years, and have a very religious family. I've been athiest for more than a decade now, and it's sad to me that to leave religion behind I had to give up all my family traditions to process death. Those traditions are still there, but I can't relate to them since they are based on a belief I no longer agree with
I think that's backwards. I think the problem is that we, the general populace, fear medicalization. The medicalization of grief specifically or other emotional issues generally is unrelated.
These sorts of diagnosis criteria are created for a reason. I highly doubt psychiatric medical practitioners are developing them to pack people up into bins so that they can be marginalized. They create these criteria to be able to have a shared language to speak about issues and try to develop treatment regimens.
And it's not their fault that the lay population takes it out of context and screams, "NO NO NO! I'M NOT BROKEN!" It's that reaction that is the problem. That reaction that, "someone who fits this criteria is by-definition broken", with "and broken people are irredemable" followed closely behind. It belies a belief that they feel this way about other people, too.
The truth is, everyone deals with issues that would fit some criteria in the DSM-5. It's just part of the human condition. Some people are able to manage these issues on their own and some people are not, and that doesn't make them broken anymore than the fact that some people can dunk a basketball and some cannot. But, if you're 5'9" and had a job to put a ball in a basket 10 feet off the ground, wouldn't you want to focus on learning to shoot rather than try techniques you've observed 6'9" people use with ease?
I say this with respect and love to the author: it does not sound like you’re handling this just fine. I think you’re right that there’s no way to handle this just fine, and you’re right that you’ve got a very good reason for not being just fine, and it’s in fact very normal and expected for you to not be handling this just fine, but it is also the case that you’re not handling this just fine.
I think we tend to react to being told there’s a diagnosis name for the thing we’re currently doing, but there are situations in which it is both absolutely normal, understandable, and expected that we behave in a way with the hallmarks of a particular pathology and also we are still behaving in that way and could probably use some support.
(On a more bureaucratic note, the other reason to have an actual DSM-recognized diagnosis is because the ghouls running insurance companies won’t cover counseling without it. Giving your therapist a DSM approved name to apply to your deep, life-impacting, and completely understandable grief means they have a better shot at convincing the claims department you actually do need help right now.)
Not to take away from the article, in the comments she states that her world is filled with the joy of new things with her new baby. She is doing as well as one can be for how much she loved Jake and how much she misses him.
The author is extremely talented at isolating certain feelings and making you feel them with her. I wouldn't use this article as a diagnosis of anything but her writing talent.
> She is doing as well as one can be for how much she loved Jake and how much she misses him.
Again, my point is that that statement is absolutely true and also does not preclude the notion that additional professional help may be warranted.
I went on Prozac earlier this year after a conversation with my doctor that went, roughly: “I think you’ve got anxiety” “well yeah, look at the fucking world!” “…right.” Just because there’s a good reason for what you’re going through doesn’t mean you’re not going through it.
Put another way, if the author had been shot a year ago and was saying things like “most days I’m fine, but some days I literally cannot walk or feel my left arm,” the notion that they should be talking to professionals would not be controversial, even though their symptoms are absolutely utterly explicable given what they’ve been through.
Usually I would agree with your points, especially that wounds on the soul should be treated like wounds on the body - objectively, and with the best practice medical support for proper healing to minimize adverse effects.
But as she so eloquently puts it, the grief is not just a wound, its a lifestyle change. Its the repetition of existing expectations and systems that have to be retrained and rewired.
Professional help can help numb feelings but when it comes to retraining your entire life, as she also implies, professional help is only medically necessary if you are completely debilitated and unable to do the retraining yourself.
Professional help is only as helpful as it can do it better than she can. And I think because it involves lots of instances of processing her own feelings, that kind of help is difficult to provide medically.
Support groups I can understand helping her situation though.
Consider that the author may elect to this suffering as a testament to her love for her partner and as a way to memorialize what he meant to her.
If your partner died and the very next day a doctor said, "Here's a pill that will make you forget you were ever together and erase 100% of the pain. You'll feel amazing." Would you take it?
Yeah, her being confused for an extended amount of time when a friend sits down at the coffee shop instead of her husband is definitely problematic. I think it's weird to write an article attempting to ridicule the DSM in this case.
the reason to NOT have a DSM-recognized diagnosis on your medical record is it can be used to disqualify you for things later in life.
And we cannot predict all of these future changes, either in our interests and/or the law.
"We don't want pilots with depression or anxiety, because duh obvious reasons" and there goes a career option for you. (something very like this happened to my cousin)
In my grief training, it was made pretty clear that typical grieving of a loss takes 3 to 5 years to somehow find to a new normal and start living again, and lasts forever, with phases of varying intensity. It is important to allow all the phases and encourage emotional release so it doesn’t get stuck and somatized. Stuck, unprocessed grief can kill you.
It is common for the first full year to be more in numbness and survival than in strong emotions. The psyche does not want to accept the loss so it pretends it is not real. Anniversaries and such serve as a slow and painful reminder that the person is in fact not there and will never return.
Swinging between emotional denial and waves of anger and intense pain over many years is totally normal, and should be encouraged and supported. Go with your friends into the intensity of their pain. Ask about their loss. Sit with it. Don’t say stuff like “it will pass“. They will love you for it.
I'd just like to clear up a misconception that people seem to have about mental healthcare. Getting a diagnosis isn't related to the 'severity' of the thing you're experiencing. But rather how you're dealing with it, and if it requires professional help to work through. Keyword being 'requires'.
Even if you grief a lot, if you're dealing with it yourself you will not get a diagnosis.
If grief makes you isolate yourself, stop working, start abusing alcohol or drugs, stop you from caring for you children, etc. Then there's a very real chance that this behavior could lead to more problems, making it in turn harder to regain positive mental health. In that case the person should get a diagnosis, which would then unlock treatment and therapy for them.
> The American Psychiatric Association describes “disordered grief,” also known as “prolonged grief,” as a loss that occurred at least one measly year ago for adults
Even though that might be true, it's an excellent example of why you can't just take the written word at face value if you're not well versed in the subject. In the mental health profession it's understood that everybody is going to be different from the norm. Only the treating psychologist can put the clients problem in the proper context to determine if a year is enough or not.
I know someone who was concerned about depression, and went to get checked. The diagnosis was normal. They were having an appropriate emotional response to very challenging situations.
I'm pretty sure my dad has chronic grief. My mom passed away from cancer when I was 11. I didn't know how unusual their marriage was until I saw others' marriages. It became particularly clear when I started dating and got married myself.
They never fought at all. There was zero conflict. It wasn't that they just "hid it from the kids"—there was simply nothing to fight about. They were truly each other's very best friend, and intensely so. My dad tried dating again a few years after her death, but I think he soon realized there was no way anyone could capture the kind of companionship he had with my mom. Some people are able to love more than one partner over the course of their life; I think he decided he could not.
He's a very private person, but I know he constantly thinks about her every day, and I suspect he's pushing off retirement because he doesn't want to be at home without her. They would have just hit their 40th anniversary if she were still alive.
I have been through two very painful deaths, first by brother then my father and both had very similar transitions from shock to acceptance to
grief and finally to the new normal. Both cases took years to heal. I stopped dreaming about my brother after about 10 years of his death. It has been 5 years since my dad passed and I still have very vivid dreams that upset me very much, but they are much less common now than say two years ago and I know at some point, like the dreams about my brother, they will stop. Everything succumbs to time, including grief.
Even before finishing the first paragraph, it all sounded familiar to me. Then I looked at the author’s name and remembered, this is the same person who wrote “The Year I Didn’t Survive”.
> There’s no modern cultural framework for dealing with death.
Indeed. We used to have religion to help us deal with it. In our modern world driven by science, death is just the absence of life. Since all (physical, chemical) reactions have ceased, science has nothing more to say about it. In trying to deal with the ills of organized religion, we may have also disposed of its benefits.
Science has also given us time machine surrogates - photos and videos. I understand this doesn’t work for everyone and can sometimes make things harder, but for me, seeing our common past brings back the smile to my face.
Having experienced a few hard losses this year (My dad to ALS, and my cat suddenly a week after my dad), the thing that has surprised me the most is how they show up in my dreams. In some dreams, I'm like "I thought you were dead? What am I going to do with all these death certificates now?", in others we're just hanging out at the pool. I never dreamed about my dad before he died. But in these dreams he's just there, and healthier looking than I had seen him in years. My cat shows up too, and many times I remember petting her in her bed, not realizing it was a dream, only to wake up surprised she wasn't still there next to me. In my waking life I fully know they're gone, but at least part of my brain really doesn't want to accept it's true.
My dad died of cancer when I was 26, and I had very frequent
dreams where it felt like he was real and present, though never speaking or interacting directly with me. The grief persisted for years.
Nearly 25 years later, my mom passed away this summer, and it's been a totally different experience. The grief was just as intense as when my dad passed, but contained to a few weeks.
The way the author captures grief (not as a pathology, but as a form of learning, unlearning, and continuing to love) is so raw and honest it almost feels invasive to read. The line "grief is a terrible kind of learning" hit me like a freight train. There's such a deep humanity here, and also a quiet indictment of our culture's need to classify, contain, and "resolve" grief like it's a software bug. We talk a lot about resilience, but rarely about the kind that means simply keeping going while carrying a pain that doesn't lessen, only changes shape.
The depth of grief the author feels drove me to tears. I think I’d feel like this if I lost my spouse. But I worry wouldn’t be able to express my feelings as well as she has here, so people wouldn’t know how much she meant to me. What a silly thing to worry about.
The worst part of 5 years and 2 months mourning my baby brother was the day that the dream got me. I dreamt about him a lot but I'm a shit screenwriter so the dreams were always cliched garbage with obvious meaning. Stuff like "We're standing on a bridge that I can't cross, and he says he needs to cross it but I'm trying to convince him not to". The kind of stuff you write for a high school creative writing class that you don't need to pass in order to graduate. But one got me goooooooooood. It was one of those hyper-realistic dudes, I was driving with my wife to a restaurant that I used to go to as a kid, we were picking up takeout to bring back home. As I was loading it into the car I heard his voice behind me say "Aren't you forgetting something?" I turned around and it was him, and everything else about the situation felt so normal and boring that of course he would be there because he was always there every time we did this. But my brain knew that we had been spending the last few years more or less constantly thinking about the fact that he was gone. It almost always results in me realizing that I'm dreaming, but just this one time it went the other way and my brain said "Oh joy, there must have been some sort of years-long misunderstanding and he's actually been here and fine the entire time!" Then I woke up. Cruelest thing I've ever done to myself, but it's a bit comforting to realize that it's in the realm of normality.
The quote "Grief is love with no where to go" has always been fully embodied in my dreams. Since my Dad died I have dreams where he would appear and I would jubilantly (and sometimes angrily) greet him with "Where have you been?! I've been looking everywhere for you!". And it is true, I look for him everywhere.
Waking up from those is so painful but I am grateful I still get to see and hug him once in a while.
These are very typical and normal thoughts when dealing with grief. The thing is, it's a misconception that it "goes away" or becomes lessened. It doesn't, and that's the honest truth, it will always be there. Over time though it becomes less unbearable, and for me anyway, 10+ years removed from it, has become such a core part of my personality I'm unsure of how or who I'd be without it. Not that I prefer it, it's just become ingrained.
"Time heals all wounds" is the biggest trap I think these thoughts are driven from. The simple and difficult truth at this stage of grief is accepting that yes, things are probably always going to feel like this. Yes, when other people have moved on you won't have. Yes, it makes people uncomfortable and you're going to have to learn to navigate those situations gracefully. The hopeful message though is that you adapt to it and it becomes less distressful over time. If it doesn't, and significantly impacts your life years later, is where I think diagnoses come into play.
Reading Jake's[0] and Bess' posts during his illness was both highly enlightening and also very depressing. The news of his death hurt me more than I expected. I simply cannot imagine the pain Bess has felt.
I wish I was half as articulate as they are and could say something that might provide even a modicum of comfort to her or others struggling with their grief.
There is a practical utility in medicalizing otherwise normal behaviors. Particularly in the US, you need a medical diagnosis in order to take time off work, receive disability benefits or access mental health supports through insurance.
I experienced a long period of grief as well. I think the grief stayed because I wasn't totally happy with myself.. Then I decided it's time for change and I moved house and changed jobs. That helped me.
I'm still sad sometimes, but I have much more to look forward to now.
She has very clearly articulated what we have lost as a culture as we attempt to eliminate any discomfort or inconvenience in our lives because of death. This book really changed my perspective:
I lost someone, a good friend and lover, when I was young. 27 years ago now.
Grief still occasionally hits me. Not so often these days, it’s a long time in the past, but after some reminders of that time of life on social media a couple of years ago, I felt the unfairness of it all like a knife twisting in my gut again.
All of which is to say I can’t imagine what it must be like to lose a spouse who you had a life and a child and plans with, and I don’t believe that everyone grieves the same, or that it should just be over when someone tells you that’s ‘normal’ or expected of you.
And also, as said in the blog post, if you’re functioning, if your grief isn’t actually stopping you from living your life, then who is to say it is disordered?
I came across this when I was going through the death of a parent. It helped me process and manage grief, I hope it helps others, and feel it is relevant to share in this thread.
"Alright, here goes. I'm old. What that means is that I've survived (so far) and a lot of people I've known and loved did not. I've lost friends, best friends, acquaintances, co-workers, grandparents, mom, relatives, teachers, mentors, students, neighbors, and a host of other folks. I have no children, and I can't imagine the pain it must be to lose a child. But here's my two cents.
I wish I could say you get used to people dying. I never did. I don't want to. It tears a hole through me whenever somebody I love dies, no matter the circumstances. But I don't want it to "not matter". I don't want it to be something that just passes. My scars are a testament to the love and the relationship that I had for and with that person. And if the scar is deep, so was the love. So be it. Scars are a testament to life. Scars are a testament that I can love deeply and live deeply and be cut, or even gouged, and that I can heal and continue to live and continue to love. And the scar tissue is stronger than the original flesh ever was. Scars are a testament to life. Scars are only ugly to people who can't see.
As for grief, you'll find it comes in waves. When the ship is first wrecked, you're drowning, with wreckage all around you. Everything floating around you reminds you of the beauty and the magnificence of the ship that was, and is no more. And all you can do is float. You find some piece of the wreckage and you hang on for a while. Maybe it's some physical thing. Maybe it's a happy memory or a photograph. Maybe it's a person who is also floating. For a while, all you can do is float. Stay alive.
In the beginning, the waves are 100 feet tall and crash over you without mercy. They come 10 seconds apart and don't even give you time to catch your breath. All you can do is hang on and float. After a while, maybe weeks, maybe months, you'll find the waves are still 100 feet tall, but they come further apart. When they come, they still crash all over you and wipe you out. But in between, you can breathe, you can function. You never know what's going to trigger the grief. It might be a song, a picture, a street intersection, the smell of a cup of coffee. It can be just about anything...and the wave comes crashing. But in between waves, there is life.
Somewhere down the line, and it's different for everybody, you find that the waves are only 80 feet tall. Or 50 feet tall. And while they still come, they come further apart. You can see them coming. An anniversary, a birthday, or Christmas, or landing at O'Hare. You can see it coming, for the most part, and prepare yourself. And when it washes over you, you know that somehow you will, again, come out the other side. Soaking wet, sputtering, still hanging on to some tiny piece of the wreckage, but you'll come out.
Take it from an old guy. The waves never stop coming, and somehow you don't really want them to. But you learn that you'll survive them. And other waves will come. And you'll survive them too. If you're lucky, you'll have lots of scars from lots of loves. And lots of shipwrecks."
> We medicalize grief because we fear it.
I think this is just incorrect. You are not obligated to seek treatment for most medical problems[1]. The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in and when people enter a situation where they may need external help. One of the diagnostic criteria, which this article mentions, is that your grief is disrupting your life - but despite what this article claims they have misunderstood that criteria. Of course grief changes your routines and life. That change only becomes "disruptive" if you feel the change has somehow gone too far or you are struggling to undo it. This writer is doing neither and therefor does not meet the diagnostic criteria for disordered grief. They are grieving normally and the medical literate supports that understanding.
There are of course medical professionals who use diagnostic criteria as cudgels. Trying to force people to become patients in order to enforce their idea of what someone "should" want. This is a problem but it is a problem that the official diagnostic guidelines try to avoid. For those who are interested in this kind of problem with our medical system might look into the professional philosophy of doctors (generally arrayed around identifying and curing disease) and nursing (generally arrayed around making the patient comfortable as possible). I tend to think the nursing model is the more useful and sensible of the two - even though, of course, if one wants to cure a disease a doctor is helpful.
[1] There are very few diseases, such as tuberculosis, where you can be forced to treat the disease.
> The point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in
The problem is that medical diagnoses and therapy speak have spilled over into common language where they’re so diluted that they’re not accurate any more. For many there is no line drawn anywhere because they are self-diagnosing based on flawed understandings as soon as any feeling or symptom arrives.
This is scarily obvious when I’ve worked with college students and early 20s juniors lately: A subset of them speak of everything human nature in medical and therapy speak. Common human experiences like being sad about something or having a tough day are immediately amplified into full-blown medical terms like “I’m having a depressive episode today” (which is gone by tomorrow). Being a little nervous about something is “I’m having a panic attack”. Remembering an unpleasant disagreement at work “gives me PTSD”. When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
This is only a subset of people, but it’s a rapidly growing percentage of younger people I work with. When someone falls into this mindset it only grows: The same people using these terms usually accumulate a lot of different self-diagnoses to cover every element of common human experience: They will claim ADHD, social anxiety, often some variation of Autism despite showing none of the signs, PTSD due to a previous relationship/boss/professor they didn’t get along with, and insomnia or delayed sleep phase syndrome. Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.
I’ve been offered helpful links to TikTok ADHD influencers to help me understand them, because that’s where they think the best information comes from. 20-something engineers confidently tell me they know more than their doctors about ADHD and how to treat it (usually after their doctor refuses to increase their dose of Adderall again or denies them some other controlled substance they think they need like ketamine or perpetual daily Xanax). There’s also a growing culture of casual drug abuse and misuse that gets justified as self-medication, but that’s a topic for another post.
This is a very american trend in my experience. Americans are quite happy to tell you their long list of diagnoses, how that some how gives them some kind of exception to the rule, and how this is some how part of their identity. This kind of oversharing is common across topics from Americans but in particular oversharing of and obsession with psychological conditions seem to be a common modern stereotype of americans amongst my friends who interact with americans regularly.
I mean, I have no data for this, but I think it's a combination of two factors:
- Access to mental healthcare here is HEAVILY gate-kept by a combination of it often costing quite a lot of money, generally having longer waits than most healthcare services, heavy variability in availability by location, and insurance coverage runs the gamut between great or utterly absent, sometimes even in the same policy depending on what you need. Self-diagnosis is for many people the only diagnosis they have access to, and even if it's wrong, you can often use whatever diagnosis it is to find coping mechanisms that help you, or substances that will help you self medicate.
- Naming something medically is the only way to get institutions to pay attention to it, which can mean a number of things by itself, from getting appropriate accommodations at work or school, to getting certain kinds of coworkers or authority figures to treat you in a way that's more amenable to your mental state.
And I don't think its wrong to make it part of your identity either. Some definitely take it to a weird, unhealthy place, and also most of those people are teenagers. Teenagers do tons of stupid shit, I did tons of stupid shit. It's just part of growing up. But ultimately... it is part of you that you're going to be dealing with probably forever, so, some amount of identifying with it is probably healthy.
Edit: Also not sure how to read you calling this "oversharing?" Like I guess it could be depending what it is, but I dunno, my wife has BPD and a touch of Autism, she doesn't announce it when we meet someone but it isn't a secret either.
Everybody wants to be the one who overcame the odds or struggled bravely on. Everybody wants their story to be special because of how hard it was for them compared to everyone else.
I think some of it comes from the value the culture places on underdog stories and some of it comes from the oversaturation of everything in modern life.
I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet.
I guess we'll know when they turn 40 and are still saying things like "I had a panic attack" and "I'm literally shaking rn".
I think it will continue as it's been turned into socially acceptable and even expected behavior now.
Unc “I'm literally shaking rn” is only ever used ironically. In a culture of ever increasing extremes language follows, that’s all that is to this
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I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that.
Similar to how some people look at raw stats of autism diagnoses and think hugely more people are becoming autistic when in reality it's that we've got better at diagnosing autism; I think we (society, in at least some countries) have got better at being honest about mental health conditions. Meaning that more people, especially younger people who've grown up around less mental health stigma, will talk about having an actual genuine problem even without more diagnoses or more exaggeration. I think studies would be needed (that I'm not aware of) to figure out how many more people are using labels that don't really fit, vs how many more people are being honest about actual serious conditions.
When I was in my 20s, if I needed a day off work because of depression I would always use a bullshit excuse to avoid mentioning the actual reason. I don't any more, most of my colleagues know what issues I do or don't have. And the younger generations are starting from that place, rather than having to grow into it.
The dilution by people with no formal diagnosis become more common is scary because of how it normalizes not seeking help, which is the hardest part of actually having these issues. It creates this illusion that one should be able to treat themselves and that things like sitting at your desk all day thinking it wouldn't be that bad if you died in a car accident, or having your heartrate spike and sweating profusely while you thoughts are paralyzed are normal things that happens regularly to everyone so your inability to deal with them is a personal failing. They are not and if you do feel this way try and seek assistance from a experienced professional.
Those folks are the ones who refuse to acknowledge and accept the fact that they were abused by family members while growing up, where those personality 'symptoms' are common. It is very well known that ADD and ADHD comes from abusive households. Nobody except psychologists and anyone in the mental health field would ever admit such failures in life. They will not accept the fact, and exaggeration and deflection of character faults into false medical diagnosis is what happens. Not very many doctors want to get screamed at by their patients (which would prove the doctor right) for telling them the truth of their own past, and besides, they're not even paid to tell them.
"Truth hurts, don't it" is a very true phrase. It's a very sick trend affecting Millennials and Gen Z alike, and contributes to other worse mental health and criminal outcomes.
It's not even new.
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What you're describing is a big problem [edit: for the people who get sucked into it] and, to me, is kind of the "other side" of the overmedicalization issue that this blog is complaining about. One way medicalization harms is is when people are forced into conditions they don't agree with (as the author feels they have been). The other way is when people who aren't medical professionals (and wouldn't be in a position to diagnose even if they were) adopt medical language to describe experiences.
I guess my thoughts on the trend you're critiquing is that it happens almost entirely outside of the medical community. As you describe the people who are most impacted by this often find actual medical treatment unhelpful and un-validating and turn to self-medication or other "medically inspired" coping techniques. I think the people who actually don't have these conditions and are applying medicalized treatments and explanations are opportunistically drawing on medical language because people often respect it socially. But also there are lots of people who engage in self-deception (or just normal deception) for social advantage and I don't know that people who use medical language are better or worse? A word is just a word and unless that word is actually on a medical record somewhere it only has the power you give it.
The flip side of this is of course that the medical establishment has many well-studied and documented biases. They offer poor treatment to overweight people, black people, people with mental health diagnoses, basically every vulnerable population that's been studied gets worse service from medical professionals. That very reasonably leads to people distrusting "the system" and searching for coping mechanism outside of it. I think that is generally pretty harmless and helpful - as long as it doesn't get into the realm of serious self-medication like you describe. Basically if you like using a medical term to describe your experience ("I'm being really OCD today") I don't think there's much harm in it and you may find coping mechanisms for people with ODC helpful as a bonus.
>Basically if you like using a medical term to describe your experience ("I'm being really OCD today") I don't think there's much harm in it and you may find coping mechanisms for people with ODC helpful as a bonus.
I was with you up until this point. My wife has C-PTSD, Bipolar type 2 and ADHD, along with what her psychologist describes as "Social OCD". I can't tell you how many times I've had to explain to other people that her mental illnesses are real and some days she and I just can't hang out because she smelled a smell that gave her flashbacks. Because people have normalized the language, they think "triggered" just means upset. For someone with real PTSD, it doesn't mean upset, it means their mind has come unstuck in time and they don't know who to trust or sometimes even what is real. Sometimes this lasts 5 minutes, sometimes it lasts almost all day. She just loses that time, and all I can do is try to calm her down and try to get her to take medication to re-stabilize her.
My wife has been in therapy with a PhD psychologist for 11 years, and only just this year has gotten to the point where it seems like she could probably hold down a job and keep her trauma compartmentalized like most people do all the time. People normalize the language for these debilitating full-blown disabilities and then don't understand the gravity of the situation when somebody with a legitimate mental illness of that sort of degree comes along.
Co-opting medical language for sub-disorder level dysfunctions is bullshit. And that's fine, when you're just bullshitting with your friends or whatever, but how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
I would posit your issue is not in co-option of terminology but in that ableism is still rampant and these are people who wouldn't take your wife seriously even if you described her symptoms. I have conditions that people do not uwu cutesy about on tiktok and people still illegitimate me when it inconveniences them slightly like canceling plans. People playing down disabilities the disabilities of others is extremely common. Being able to be flexible and accommodating to any degree I can to someone's disability has nothing to do with whether or not I think it is legitimate, and gating my flexibility to whether or not I personally judge someone's disability as legitimate is ableism plain and simple.
I upvoted your comment because this is also a huge issue. I just find that the co-opted terminology does worsen the quality of dialogues about the co-opted terms. People need to have the symptoms fully described for them in detail and sometimes don't believe me or think I'm exaggerating because it doesn't match their preconceived notions of what those words mean.
I'm not saying that the problem isn't ableism, it absolutely is, just that the co-opting of the terms is still harmful in that it uses up spoons and makes it harder to communicate clearly, especially with those who are stuck on the pop-culture meanings instead of actual medical meanings.
I'm not sure if this is "human nature" or if it's a specific cultural problem in the modern west. It's certainly true here in Canada too -- everyone uses terms that are really quite heavy duty to describe quite minor things.
I'm deaf. When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too." Now not to go policing people on their identities but -- no you're not.
Like what do I need to say? Clinically deaf. Severe-profoundly deaf. Cannot hear a fire alarm without hearing aids?
It's one thing when it's an elderly person. Yes maybe they are in fact a bit deaf too. But for all the people in their 30s or 40s who have said it to me -- the odds they all have moderate or worse hearing loss is nil! Most of the people who are saying it presumably have normal hearing. I understand that they're trying to identify with and not alienate me. But it's such a strange dynamic.
Just start speaking ASL (or whichever) when they tell you they are deaf! Let them handle that gracefully.
Conversations are rarely about saying truthful things, and mostly about societal theatre that is supposed to leave both parties feeling better. Nobody cares that you're deaf, what you're expected to do is to react in a way that makes the other person feel good. I don't like this either, but that's how, for the lack of better word, "normies" function.
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> I’ve been offered helpful links to TikTok ADHD influencers to help me understand them
To be fair, giving you an example of someone else who performatively pretends to have a mental illness is a great way to understand them.
> When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
I mean, our industry is filled with people of all ages with ADHD (arguably because it’s one of the few industries where you can succeed while having severe ADHD), GenZ folks are just more likely to admit it in public where older millennials are more likely to either be quiet about it or ignore the fact that they are subject to it.
another therapy-speak term that has spilled over is "masking".
apparently, any time that you need to politely smile when you dont feel like it is "masking"
> Many will have no formal diagnosis at all or even proudly claim that they don’t trust the medical system, they’re just diagnosing themselves.
The thing is, many people have valid reasons not to trust the medical system. Not so long ago:
1. Homosexuality was considered a mental disease
2. Forced sterilization of minorities was good medical practice
3. FDA ignored warnings about pesticides being potentially harmful because that would be bad for business
4. FDA ignored warnings about pesticides being potentially harmful because that would be bad for international politics
5. Entire field of psychiatry was just basically random shit, it's not until very recently that we have any actual scientific knowledge
6. Pregnant women were presribed medicine that fucked up their fetuses
Not to mention that most likely when you go to a doctor you're not getting state-of-the-art diasgnosis, most likely the doctor is just a random guy doing his job, sometimes better sometimes worse. Personally I don't trust medical system with my mental health because medical system is a product of a society that made me have mental problems in the first place.
I know people like to blame social media and just "the kids these days" in general - but I think there's another reasonable, far more charitable explanation: it's a sort of overcorrection after those illnesses being very heavily stigmatized for practically ever. It's perhaps not ideal, but if a symptom of more people who truly have those illnesses being able to get help is a small portion of people using it as a fashion statement, that's a price I think we can pay. And I'm confident it will correct itself over time.
Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply).
That said, the writing really resonated with me and i wish Bess well.
I think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying
I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.
I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional".
What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc.
We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors.
I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)
One of my best friends died 12 years ago in our late 20s. I know he is dead, and yet a couple times a month I think, "Oh, I haven't talked to him in a while, I should text him!" before my logical brain kicks in and lets me know the deal.
There is a dumb part of me that wants to believe, "Oh, he probably faked his death to get out of debt." He was such a schemer, if anyone would, he would. It was an open casket funeral. I know he is dead.
It's not a disorder. I just have mental pathways built that lead to a person who was integral to my life for many years, a person who does not exist on this plane anymore. I want him back in my life. Death is just difficult.
He was a genuine source of both encouragement and constructive criticism the likes I have had not had before or since. I miss you, Meka.
It’s love with nowhere to go
My best friend of 25 years died 4 years ago and I still think of him at least once a week, wishing I could talk to him. It was almost a year before I could even talk about him without completely breaking down. I never once thought: "oh, this is a medical issue". It was just me having the same problems processing my grief that American men have because we're not raised to talk stuff out. Once I did start talking about it, it got easier and easier to deal with.
I still miss that guy, though.
There is a problem with rigid medical definitions. There is a huge difference between the author of this, a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent (as I did earlier this year). Of course it will take her far longer to recover (if at all).
I would guess her grief is not "disordered" though. As she says she functions - she works, she looks after her child, she looks after herself.
> We medicalize grief because we fear it.
Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
Sorry for your loss, and thank you for your perspective.
>> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
I never thought about it but it likely stems from loss of religion, like many other problems. If I see my life as insignificant in the chain of generations - as a conduit between ancestors and descendants - and believe in the soul at least as a metaphor - then personal death or that of others is sad, but is in the context of a deeply meaningful existence.
On the other hand, if I am closer to atheistic hedonism/nihilism - there's nothing else but me and my thoughts and experiences, then my existence or non-existence takes on a very heavy weight - and we project that onto others.
Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking. We're used to thinking we control things, and can get anything we want. One thing useful from the religions was having a healthy sense of your own limitations, or you could say a sense of wonder or mystery or perspective. A reminder that you're not the most powerful thing in the universe. Which is true, and healthy to be aware of, whether any god exists or not.
Edit to add: There are few places where that hubris and certainty tend to be more pronounced than among doctors. Part of what this woman is grieving is probably the loss of certainty, of control or the illusion thereof.
> Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
It maybe a factor, but I do not think it was the main one. Death is still very hard to cope with, regardless of religious belief. There are other things behind religious belief, mostly experiences.
> I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking
I'm surprised by this take, simply because of my own experience, where the further I've gotten from religion over a very long time, the less significant I've found death.
Not having "answers" to what comes next has never been a weight for me - at least not since I was a child. Death being a completion, or a finality, is freeing; The end of what has been and what I hope continues to be a wonderful journey. The only weight I carry in regards to death are for those closest to me, and especially those for whom I'm responsible.
I find that surprising in turn! What were the beliefs you had around death?
I can sort of see why you found it less significant, but in monotheistic religions it is still pretty final. It is still the end of the one life you get, even if it is also the entry into something completely different and better.
This is not even slightly true and seems to be based on a profound misunderstanding of atheism. From my perspective as atheist since the age of 11, it's the reverse of the case.
Atheism doesn't presuppose either hedonism or nihilism. This is a common theist libel which is surprisingly popular on this forum of ersatz rational thinkers and logicians. Atheists are perfectly capable of finding value and meaning in their own lives and the world around them, they just don't base that value on a belief in the supernatural. Listen to any astrophysicist, physicist or biologist talk about their field and you'll encounter a wonder and awe that no theologian reciting thousand year old tracts can match.
> Atheism doesn't presuppose either hedonism or nihilism.
And if the GP thought it did, he would not have bothered to qualify it with those labels.
Since they _did_ specify "atheistic hedonism/nihilism," we know they're talking about those specific stripes of atheism, and can discuss that.
It looks like you were downvoted but for what it's worth you parsed and explained my intention accurately, and I appreciate that.
All the atheistic/agnostic people I know believe they are insignificant in the grand scheme of nature, not just in the chain of generations of people.
If anything, I find religious people are the ones who believe humans are special.
I think you're right on the word level but I think there's a difference about what significance and insignificance means to these groups.
As a religious person, I see my life as insignificant compared to Gd, and compared to the chain of generations, but what I do with my life is extremely significant. As in, whether I bring children into this world and raise them well, is massively significant.
So maybe the way to say it is - religious people see themselves as insignificant in the context of much greater significance.
The other view of insignificance is that nothing is significant - including myself. I don't subscribe to that.
Equating these things with a "Belief in god" belies a narrow view of spirituality.
Thanks, this is clearer.
Do you really believe atheists are incapable of recognizing the significance of children or of caring about them?
No, I don't believe that. I valued children just as much when I was an atheist as when I became religion.
What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not. I work in FAANG and previously in finance, so my peers are people who can certainly afford kids and are positioned to take care of them - and yet literally most are choosing to do something else.
I am not commenting on a universal attitude, I am commenting on a significant trend that I think is obvious.
Putting aside the question of whether your own experiences hold for the general population, you must consider why these opinions are so prevalent, either way. One might argue that religion doesn't teach 'values' so much as 'roles', and so people feel they must do these things, not for any significance or with little thought to possible negative repercussions, but simply because... well, that's just what you do, right? Find a partner, have kids, go to church. That's the lifestyle religion teaches. One might also argue that secular people aren't as intent on having kids because they're more willing to accept different lifestyles.
For what it's worth, krapp's comment is better written but is what I'm talking about here.
>What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not.
Do all of your religious friends subscribe to the same religion?
If so, does this religion proscribe having children and raising families as a necessary, or desired, component of the faith or community?
Because you could be confusing religion and culture here. Secular values often abrogate traditional gender and sexual norms, so secular people may not feel compelled to "be fruitful and multiply." I wouldn't ascribe that to lack of religion per se so much as not being affected by the same cultural pressures. After all, plenty of theists are essentially forced into marriage and children because it's what's expected, not because it's what they want.
I am not sure "culture" and "religion" are separable in the long run but I don't think that aligns with the point you're making.
Religious people see "be fruitful and multiply" as a literal command from G-d and one of the fundamental points of religion. So while religious culture can evolve, the evolution of this attitude isn't a flexible point.
On the flip side, secular culture has no intrinsic reason for "family values" - which is why, I think, atheist culture over time devolves to childlessness - because reasons "why not" are more immediate and in your face, vs "why yes."
So yes it's "culture" but what the culture is is obviously determined by your underlying beliefs and that which you consider eternal and that which you consider negotiable.
I'm so sorry for your loss. I agree with what you say about "disordered", the language is hostile.
In a less morbid area, I feel the same way about ADHD - "attention-deficit/hyperactivity disorder". For some people this is problematic, but others can function fine and happily with this.
In those cases, why is it a "disorder"? Why can't it just be "how some people are"?
I think there's something of a pendulum here, and I agree it's swayed too far to over-diagnosing ourselves. But I also think of my father who passed a couple years ago.
We didn't have much of a relationship. He had friends, but never close ones. He was weirdly mean or weirdly seclusive or weirdly awkward at times - and also incredibly intelligent and occasionally gracious and hilarious.
After he passed, I wondered if he might have been somewhere on the spectrum - but his peculiarities were simply ignored. A poor boy, in a poor urban neighborhood, with a dead father, being raised by an immigrant mother and immigrant siblings doesn't get diagnosed with much of anything - if they see doctors at all. And hey, he had a near photographic memory, and did great in school, so what's there to worry about?
It's always been "how he was", and that's probably ok, but I do wonder if he would have had a better or somehow different life if he knew more about _why_ he was the way he was.
> In those cases, why is it a "disorder"? Why can't it just be "how some people are"?
It often is:
> It can be helpful to think of ADHD not just as a deficit or disorder but as a ‘difference’.
Especially as it seems to come with positive traits! It goes on to list focus, responding well in a crisis and creativity as common ADHD traits.
https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and...
In my understanding ADHD is one of the few conditions that is extremely well studied and consistently appears to be a certain % of the population regardless of nationality with very strongly correlated negative outcomes with their suite of symptoms. I'm talking addition, obesity, and a shortened lifespan directly related to their ADHD. This seems like a disorder to me. If someone has attention difficulties and can function fine they obviously don't have a disorder vs someone who has attention difficulties and as a result becomes addicted to cocaine.
Function in what context? I have been diagnosed with ADHD at age seven. I have had many checkups and am currently medicated. I can tell you that I wouldn't need to if I didn't have to work a menial wageslave job. Interestingly I can focus perfectly fine when doing interesting stuff without medication and it has always been this way. What you are saying is that there is some proper definition of disorder, which would sensibly be defined relative to some "normal" human baseline. Tell me you know one "normal" human, why you see this person as "normal" and how it would be useful to use this as a reference for the big spectrum of human personality and mental fitness. I can tell you from experience that I didn't need medication when I wasn't forced to attend 12 useless meetings a week, use inefficient and stupid software and one would just let me get my shit done. I have quite a few friends who have had very similar experiences, and the idea of ADHD is just used to pathologize and medicate someone so he can work and be a "positive contributor" to whoever above them. Add here the necessary disclaimer that my experience is not universal and there may be people gravely suffering from it, etc. I do too, even with medication, but at least I can generate some bucks for management.
And what I know with ADHD is that the incapacity to handle dumb meetings is just one definition of functioning. Maybe you don't need medication to clean yourself enough to prevent skin issues, prevent addiction to substances, compulsive criminal behavior, avoid hoarding behaviors, have a safe living space, have the capacity to maintain friendships/avoid loneliness, engage with social interactions in a mutually respectful manner etc. But most people I know with ADHD severely struggle with at least one of the above and I consider that functioning, not just holding down a job. My understanding is not on the level of "can you do bullshit work" but it is "can you clean your dishes before they stink" and "can you respond to being turned down by a girl without blowing up your life".
I think it’s medicalized because often this set of symptoms is associated with inability to function and it can be treated medically with eg therapy.
>a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent
This isn’t really your point, but this person lost their husband at 40. By some definitions, that is middle aged. In the general view of things, not young. That doesn’t really change much, but I was thinking of a mid-twenties before I realized who it was.
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
Someone always rocks up to say this in these threads, and then never actually offers any suggestions of what they think an alternative should look like.
It's in the same vein as people who complain no one ever talks about serious subjects, and I'm just wondering why they think I want to get into discussing the meaning of life in the workplace cafeteria.
Seriously, what is the alternative meant to be? A celebration of death? Constantly reminding people that everyone will die and you'll be forgotten completely in about 3 generations? Why focus on the inevitable rather then actually living?
> Someone always rocks up to say this in these threads, and then never actually offers any suggestions of what they think an alternative should look like.
It's a broad observation about culture - there's no "alternative" to a well-established culture, no single forum comment will change society.
> Seriously, what is the alternative meant to be? ... Constantly reminding people that everyone will die and you'll be forgotten completely in about 3 generations?
I think you're on to something here; there's an inherent conflict between ruthless individualism that tells people they can do anything they put their mind to, and the stark, limiting reality of mortality. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
Collectivist cultures already embraces the idea that one's life is more than just about the individual, so grief and talking about death are far less radioactive. Religions that embrace ancestral spirits being presence offer comfort in continuity; her husband isn't really gone, and he may even watch ober their daughter, and even help her in math exams. In that light, dying is less of a big deal - more of a transition really - compared to oblivion, which is super heavy. I'm not saying these are better
An alternative would be:
+ Yes, allowing people to have a celebration goodbye party before they go
+ Allowing for medically assisted dying on a person's own terms
+ More open conversations about: directives, how people would like to be treated when they near death, wills, inheritances, funerals. These are all taboo topics
+ A natural part of life
> There is a certain cowardice in how we deal with death in the contemporary west.
It's because we have a dearth of true elders right now.
Not in age, but in temperament and learning.
I got interested in story telling during COVID and managed to find a great author (K.M. Weiland) that went in deep on the archetypes of story.
Her hook was essentially: "What happens after the Hero's Journey/happily ever after?" And then she got real deep on her idea of the 6 phases of life. Her work is properly about how to write a plot, but man does it apply more broadly.
The pertinent one here is the 'Crone' stage of life [0]. You're no longer the 'King' of your little fief, you had to give up the power and make way for the next generation. But now what?
The journey of the Crone is essentially learning that Death is a part of Life, that Death is not Evil, Death is a Friend.
K.M. Weiland admits that less and less people ever make it through the stages as you go along.
But, I think right now in the West, we have a lot of boomers that never really progressed past the Hero stage, let alone the Queen or King stages. There should be more Crone and Mage people around, but the boomers were retarded in their development. Just look at RBG, Feinstein and Pelosi (to name but a few), grappling on to power like the Tyrants or Sorceresses (strong shadow archetypes of the Queen and King) and never letting go, to the classical harm of the kingdom/hearth that such stories tell.
Facing Death is hard, very hard. But is something that we all must do. Realizing that Death is not Evil, but a part of life, and one to be welcomed at times, that is something that very few of us can do.
[0] https://www.helpingwritersbecomeauthors.com/archetypal-chara...
In the west we’re trained to believe that if something happens there should be some sort of tangible reward on the other end, no matter how minute. Death takes and leaves nothing tangible and it’s the absence that drives us crazy. Since we’re trained this way we seek out some solution with the other trained aspect, spending money. Which in turn only temporarily numbs the grief until you deal with it.
We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”. So our money spending usually doesn’t direct us to a more helpful path.
I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
> We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”.
I think this idea is ~10 years out of date. If anything, we now seem pathologize every behavior and personality quirk into a mental health issue. At least on social media, it's also trendy to have a mental health issue to the point that people will claim to have ADHD because they're easily distracted by their phones. I've also lost count of the number of big "content creators" who casually mention their therapist or going to therapy. If there is a stigma, it's not found among the younger generations.
I think for people over 50, I guess "Gen X" and older, this is still often true. I've never considered therapy or medical help for any way that I was "feeling" and certainly have had times of grief and loss and sadness in my life. In some of those moments, when peers or friends noticed it, the gist of their advice was to “suck it up” or “get over it”.
I am also introverted, procrastinate, am not very organized, and am not very good at housekeeping. My view on how I would change those things would be to just suck it up and do better, if I had to. And when it matters, that's what I do.
I don't mean to say that this is the only correct way to approach life but it is how I look at things.
I tol am unfortunately also introverted, prone to procrastination and seem quite unable to keep my house as spotless as I would like
Do you have any advice for overcoming my problem with atleast procrastination (i suspect that it is probably causing the other two issues).
I do not agree. While there may be a flux of people who have therapists, the majority do not and that is why you hear about it on Youtube.
I do agree that younger people are trying to take more care of their mental health but I do not see healthy reasons for which they are chasing that improvement. For example the “pursuit of happyness” is indoctrinated and people think they always need to be happy. At the same time I think people are self-diagnosing which I do not include as “health care” as I meant it, but rather self care or even passive-hypochondria.
It used to be in the west. The Catholic Church discourages the scattering of ashes for just that reason - so that there is somewhere physical where people can be remembered. There was a tradition of memorial services. People still look after the graves of their loved ones.
I also think its not a simple east-west divide. Different cultures have many different ways of dealing with death. The contemporary west does have a problem, although i doubt it is the only culture for which that is true.
My family follows a mix of Christian tradition (e.g. memorial masses) and Sri Lankan (e.g. donations of food in memory of the dead).
I agree it’s not a simple divide. I was trying to paint that there are many reasons why we handle death poorly in the west and I honestly only know a raindrop about the east. I can only fathom the handling of death and the reasons why gradients across the globe in every direction.
> I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
In what way is this not western as well? Implying that western culture does not remember, contemplate, and revere those that have gone before us is a bad take.
I agree with you on the western religious tradition, but I think it's less true for the secular west today.
With ample exceptions of course, a stereotypical "secular" person thinks of their ancestors as racist people that lived in an irrelevant time, and doesn't feel some sort of connection to them, or an obligation to continue them. So I think the poster you're replying to is kinda correct from a today point of view.
> a typical "secular" person thinks of their ancestors as racist people that lived in an irrelevant time,
I think you missed the "stereo" in front of your "typical".
I went ahead and added that "stereo" to my comment. I think you're right, but I also think that stereotype is grounded in reality with a lot of empirical observation. So yes, not exclusive but certainly common.
Well, as a secular individual whose friend group is mostly secular people, I haven't see people express such black and white opinions, but I'm guessing we move in different circles. As far as observation is concerned, we tend to see what we want to see, don't we?
Your made up straw man secular person is, frankly, ridiculous. Like, we all get it, conservative Christians hate the rest of us and look down on us. Duh.
I also think seeking mental health is more popular in the west than the east where it's even less of a thing to seek.
In the way that most people don’t have a routine of that contemplation and remembrance and that individual self, ego, and your future is placed as more important in the day-to-day.
That's moving the goalposts. Implying that people do not go through that remembrance vs implying that they do not do so on a set routine are not the same thing.
Not to mention that such a routine might very well be part of the medical therapy that we are talking about here.
I wonder how traditions around death help us to deal with it. I feel completely incapable of handling death.. I do not know how to comport myself.
A lot! Maybe it's obvious, but I've long thought that religion's primary function is to help people process death (and other suffering). Now that life isn't constant suffering, many of us have discarded religion, but then we are blindsided by death.
I was very religious for 30 years, and have a very religious family. I've been athiest for more than a decade now, and it's sad to me that to leave religion behind I had to give up all my family traditions to process death. Those traditions are still there, but I can't relate to them since they are based on a belief I no longer agree with
> We medicalize grief because we fear it.
I think that's backwards. I think the problem is that we, the general populace, fear medicalization. The medicalization of grief specifically or other emotional issues generally is unrelated.
These sorts of diagnosis criteria are created for a reason. I highly doubt psychiatric medical practitioners are developing them to pack people up into bins so that they can be marginalized. They create these criteria to be able to have a shared language to speak about issues and try to develop treatment regimens.
And it's not their fault that the lay population takes it out of context and screams, "NO NO NO! I'M NOT BROKEN!" It's that reaction that is the problem. That reaction that, "someone who fits this criteria is by-definition broken", with "and broken people are irredemable" followed closely behind. It belies a belief that they feel this way about other people, too.
The truth is, everyone deals with issues that would fit some criteria in the DSM-5. It's just part of the human condition. Some people are able to manage these issues on their own and some people are not, and that doesn't make them broken anymore than the fact that some people can dunk a basketball and some cannot. But, if you're 5'9" and had a job to put a ball in a basket 10 feet off the ground, wouldn't you want to focus on learning to shoot rather than try techniques you've observed 6'9" people use with ease?
I say this with respect and love to the author: it does not sound like you’re handling this just fine. I think you’re right that there’s no way to handle this just fine, and you’re right that you’ve got a very good reason for not being just fine, and it’s in fact very normal and expected for you to not be handling this just fine, but it is also the case that you’re not handling this just fine.
I think we tend to react to being told there’s a diagnosis name for the thing we’re currently doing, but there are situations in which it is both absolutely normal, understandable, and expected that we behave in a way with the hallmarks of a particular pathology and also we are still behaving in that way and could probably use some support.
(On a more bureaucratic note, the other reason to have an actual DSM-recognized diagnosis is because the ghouls running insurance companies won’t cover counseling without it. Giving your therapist a DSM approved name to apply to your deep, life-impacting, and completely understandable grief means they have a better shot at convincing the claims department you actually do need help right now.)
Not to take away from the article, in the comments she states that her world is filled with the joy of new things with her new baby. She is doing as well as one can be for how much she loved Jake and how much she misses him.
The author is extremely talented at isolating certain feelings and making you feel them with her. I wouldn't use this article as a diagnosis of anything but her writing talent.
> She is doing as well as one can be for how much she loved Jake and how much she misses him.
Again, my point is that that statement is absolutely true and also does not preclude the notion that additional professional help may be warranted.
I went on Prozac earlier this year after a conversation with my doctor that went, roughly: “I think you’ve got anxiety” “well yeah, look at the fucking world!” “…right.” Just because there’s a good reason for what you’re going through doesn’t mean you’re not going through it.
Put another way, if the author had been shot a year ago and was saying things like “most days I’m fine, but some days I literally cannot walk or feel my left arm,” the notion that they should be talking to professionals would not be controversial, even though their symptoms are absolutely utterly explicable given what they’ve been through.
Usually I would agree with your points, especially that wounds on the soul should be treated like wounds on the body - objectively, and with the best practice medical support for proper healing to minimize adverse effects.
But as she so eloquently puts it, the grief is not just a wound, its a lifestyle change. Its the repetition of existing expectations and systems that have to be retrained and rewired.
Professional help can help numb feelings but when it comes to retraining your entire life, as she also implies, professional help is only medically necessary if you are completely debilitated and unable to do the retraining yourself.
Professional help is only as helpful as it can do it better than she can. And I think because it involves lots of instances of processing her own feelings, that kind of help is difficult to provide medically.
Support groups I can understand helping her situation though.
Consider that the author may elect to this suffering as a testament to her love for her partner and as a way to memorialize what he meant to her.
If your partner died and the very next day a doctor said, "Here's a pill that will make you forget you were ever together and erase 100% of the pain. You'll feel amazing." Would you take it?
Yeah, her being confused for an extended amount of time when a friend sits down at the coffee shop instead of her husband is definitely problematic. I think it's weird to write an article attempting to ridicule the DSM in this case.
the reason to NOT have a DSM-recognized diagnosis on your medical record is it can be used to disqualify you for things later in life.
And we cannot predict all of these future changes, either in our interests and/or the law.
"We don't want pilots with depression or anxiety, because duh obvious reasons" and there goes a career option for you. (something very like this happened to my cousin)
In my grief training, it was made pretty clear that typical grieving of a loss takes 3 to 5 years to somehow find to a new normal and start living again, and lasts forever, with phases of varying intensity. It is important to allow all the phases and encourage emotional release so it doesn’t get stuck and somatized. Stuck, unprocessed grief can kill you.
It is common for the first full year to be more in numbness and survival than in strong emotions. The psyche does not want to accept the loss so it pretends it is not real. Anniversaries and such serve as a slow and painful reminder that the person is in fact not there and will never return.
Swinging between emotional denial and waves of anger and intense pain over many years is totally normal, and should be encouraged and supported. Go with your friends into the intensity of their pain. Ask about their loss. Sit with it. Don’t say stuff like “it will pass“. They will love you for it.
I'd just like to clear up a misconception that people seem to have about mental healthcare. Getting a diagnosis isn't related to the 'severity' of the thing you're experiencing. But rather how you're dealing with it, and if it requires professional help to work through. Keyword being 'requires'.
Even if you grief a lot, if you're dealing with it yourself you will not get a diagnosis.
If grief makes you isolate yourself, stop working, start abusing alcohol or drugs, stop you from caring for you children, etc. Then there's a very real chance that this behavior could lead to more problems, making it in turn harder to regain positive mental health. In that case the person should get a diagnosis, which would then unlock treatment and therapy for them.
> The American Psychiatric Association describes “disordered grief,” also known as “prolonged grief,” as a loss that occurred at least one measly year ago for adults
Even though that might be true, it's an excellent example of why you can't just take the written word at face value if you're not well versed in the subject. In the mental health profession it's understood that everybody is going to be different from the norm. Only the treating psychologist can put the clients problem in the proper context to determine if a year is enough or not.
I know someone who was concerned about depression, and went to get checked. The diagnosis was normal. They were having an appropriate emotional response to very challenging situations.
I'm pretty sure my dad has chronic grief. My mom passed away from cancer when I was 11. I didn't know how unusual their marriage was until I saw others' marriages. It became particularly clear when I started dating and got married myself.
They never fought at all. There was zero conflict. It wasn't that they just "hid it from the kids"—there was simply nothing to fight about. They were truly each other's very best friend, and intensely so. My dad tried dating again a few years after her death, but I think he soon realized there was no way anyone could capture the kind of companionship he had with my mom. Some people are able to love more than one partner over the course of their life; I think he decided he could not.
He's a very private person, but I know he constantly thinks about her every day, and I suspect he's pushing off retirement because he doesn't want to be at home without her. They would have just hit their 40th anniversary if she were still alive.
I have been through two very painful deaths, first by brother then my father and both had very similar transitions from shock to acceptance to grief and finally to the new normal. Both cases took years to heal. I stopped dreaming about my brother after about 10 years of his death. It has been 5 years since my dad passed and I still have very vivid dreams that upset me very much, but they are much less common now than say two years ago and I know at some point, like the dreams about my brother, they will stop. Everything succumbs to time, including grief.
Even before finishing the first paragraph, it all sounded familiar to me. Then I looked at the author’s name and remembered, this is the same person who wrote “The Year I Didn’t Survive”.
https://news.ycombinator.com/item?id=43020983 949 points | 7 months ago | 266 comments
> There’s no modern cultural framework for dealing with death.
Indeed. We used to have religion to help us deal with it. In our modern world driven by science, death is just the absence of life. Since all (physical, chemical) reactions have ceased, science has nothing more to say about it. In trying to deal with the ills of organized religion, we may have also disposed of its benefits.
Very sorry for your loss.
> science has nothing more to say about it
Science has also given us time machine surrogates - photos and videos. I understand this doesn’t work for everyone and can sometimes make things harder, but for me, seeing our common past brings back the smile to my face.
Having experienced a few hard losses this year (My dad to ALS, and my cat suddenly a week after my dad), the thing that has surprised me the most is how they show up in my dreams. In some dreams, I'm like "I thought you were dead? What am I going to do with all these death certificates now?", in others we're just hanging out at the pool. I never dreamed about my dad before he died. But in these dreams he's just there, and healthier looking than I had seen him in years. My cat shows up too, and many times I remember petting her in her bed, not realizing it was a dream, only to wake up surprised she wasn't still there next to me. In my waking life I fully know they're gone, but at least part of my brain really doesn't want to accept it's true.
I'm sorry for your losses.
My dad died of cancer when I was 26, and I had very frequent dreams where it felt like he was real and present, though never speaking or interacting directly with me. The grief persisted for years.
Nearly 25 years later, my mom passed away this summer, and it's been a totally different experience. The grief was just as intense as when my dad passed, but contained to a few weeks.
Our bodies and brains are complicated.
The way the author captures grief (not as a pathology, but as a form of learning, unlearning, and continuing to love) is so raw and honest it almost feels invasive to read. The line "grief is a terrible kind of learning" hit me like a freight train. There's such a deep humanity here, and also a quiet indictment of our culture's need to classify, contain, and "resolve" grief like it's a software bug. We talk a lot about resilience, but rarely about the kind that means simply keeping going while carrying a pain that doesn't lessen, only changes shape.
Both Bess and Jake's writing is all very much like this. "Almost feels invasive" is certainly how it felt reading their posts during Jake's illness.
The depth of grief the author feels drove me to tears. I think I’d feel like this if I lost my spouse. But I worry wouldn’t be able to express my feelings as well as she has here, so people wouldn’t know how much she meant to me. What a silly thing to worry about.
> Sometimes, I’ll go ahead and dial Jake’s phone number in case the laws of entropy have changed, and he picks up
I should not cry at work but damn, I want to.
The worst part of 5 years and 2 months mourning my baby brother was the day that the dream got me. I dreamt about him a lot but I'm a shit screenwriter so the dreams were always cliched garbage with obvious meaning. Stuff like "We're standing on a bridge that I can't cross, and he says he needs to cross it but I'm trying to convince him not to". The kind of stuff you write for a high school creative writing class that you don't need to pass in order to graduate. But one got me goooooooooood. It was one of those hyper-realistic dudes, I was driving with my wife to a restaurant that I used to go to as a kid, we were picking up takeout to bring back home. As I was loading it into the car I heard his voice behind me say "Aren't you forgetting something?" I turned around and it was him, and everything else about the situation felt so normal and boring that of course he would be there because he was always there every time we did this. But my brain knew that we had been spending the last few years more or less constantly thinking about the fact that he was gone. It almost always results in me realizing that I'm dreaming, but just this one time it went the other way and my brain said "Oh joy, there must have been some sort of years-long misunderstanding and he's actually been here and fine the entire time!" Then I woke up. Cruelest thing I've ever done to myself, but it's a bit comforting to realize that it's in the realm of normality.
The quote "Grief is love with no where to go" has always been fully embodied in my dreams. Since my Dad died I have dreams where he would appear and I would jubilantly (and sometimes angrily) greet him with "Where have you been?! I've been looking everywhere for you!". And it is true, I look for him everywhere.
Waking up from those is so painful but I am grateful I still get to see and hug him once in a while.
These are very typical and normal thoughts when dealing with grief. The thing is, it's a misconception that it "goes away" or becomes lessened. It doesn't, and that's the honest truth, it will always be there. Over time though it becomes less unbearable, and for me anyway, 10+ years removed from it, has become such a core part of my personality I'm unsure of how or who I'd be without it. Not that I prefer it, it's just become ingrained.
"Time heals all wounds" is the biggest trap I think these thoughts are driven from. The simple and difficult truth at this stage of grief is accepting that yes, things are probably always going to feel like this. Yes, when other people have moved on you won't have. Yes, it makes people uncomfortable and you're going to have to learn to navigate those situations gracefully. The hopeful message though is that you adapt to it and it becomes less distressful over time. If it doesn't, and significantly impacts your life years later, is where I think diagnoses come into play.
Reading Jake's[0] and Bess' posts during his illness was both highly enlightening and also very depressing. The news of his death hurt me more than I expected. I simply cannot imagine the pain Bess has felt.
I wish I was half as articulate as they are and could say something that might provide even a modicum of comfort to her or others struggling with their grief.
https://news.ycombinator.com/user?id=jseliger
There is a practical utility in medicalizing otherwise normal behaviors. Particularly in the US, you need a medical diagnosis in order to take time off work, receive disability benefits or access mental health supports through insurance.
Damn this is so sad
I experienced a long period of grief as well. I think the grief stayed because I wasn't totally happy with myself.. Then I decided it's time for change and I moved house and changed jobs. That helped me.
I'm still sad sometimes, but I have much more to look forward to now.
Off the front page within minutes, how odd.
>There’s no modern cultural framework for dealing with death
Correct, secularism can't deal with death, it doesn't work.
She has very clearly articulated what we have lost as a culture as we attempt to eliminate any discomfort or inconvenience in our lives because of death. This book really changed my perspective:
https://orphanwisdom.com/die-wise/
Dying is a skill, both for the person doing it and the people around them.
I find some comfort in Seneca's letter myself, simple words that takes days to digest: https://en.wikisource.org/wiki/Moral_letters_to_Lucilius/Let...
Thank you for sharing.
I lost someone, a good friend and lover, when I was young. 27 years ago now.
Grief still occasionally hits me. Not so often these days, it’s a long time in the past, but after some reminders of that time of life on social media a couple of years ago, I felt the unfairness of it all like a knife twisting in my gut again.
All of which is to say I can’t imagine what it must be like to lose a spouse who you had a life and a child and plans with, and I don’t believe that everyone grieves the same, or that it should just be over when someone tells you that’s ‘normal’ or expected of you.
And also, as said in the blog post, if you’re functioning, if your grief isn’t actually stopping you from living your life, then who is to say it is disordered?
I came across this when I was going through the death of a parent. It helped me process and manage grief, I hope it helps others, and feel it is relevant to share in this thread.
"Alright, here goes. I'm old. What that means is that I've survived (so far) and a lot of people I've known and loved did not. I've lost friends, best friends, acquaintances, co-workers, grandparents, mom, relatives, teachers, mentors, students, neighbors, and a host of other folks. I have no children, and I can't imagine the pain it must be to lose a child. But here's my two cents.
I wish I could say you get used to people dying. I never did. I don't want to. It tears a hole through me whenever somebody I love dies, no matter the circumstances. But I don't want it to "not matter". I don't want it to be something that just passes. My scars are a testament to the love and the relationship that I had for and with that person. And if the scar is deep, so was the love. So be it. Scars are a testament to life. Scars are a testament that I can love deeply and live deeply and be cut, or even gouged, and that I can heal and continue to live and continue to love. And the scar tissue is stronger than the original flesh ever was. Scars are a testament to life. Scars are only ugly to people who can't see.
As for grief, you'll find it comes in waves. When the ship is first wrecked, you're drowning, with wreckage all around you. Everything floating around you reminds you of the beauty and the magnificence of the ship that was, and is no more. And all you can do is float. You find some piece of the wreckage and you hang on for a while. Maybe it's some physical thing. Maybe it's a happy memory or a photograph. Maybe it's a person who is also floating. For a while, all you can do is float. Stay alive.
In the beginning, the waves are 100 feet tall and crash over you without mercy. They come 10 seconds apart and don't even give you time to catch your breath. All you can do is hang on and float. After a while, maybe weeks, maybe months, you'll find the waves are still 100 feet tall, but they come further apart. When they come, they still crash all over you and wipe you out. But in between, you can breathe, you can function. You never know what's going to trigger the grief. It might be a song, a picture, a street intersection, the smell of a cup of coffee. It can be just about anything...and the wave comes crashing. But in between waves, there is life.
Somewhere down the line, and it's different for everybody, you find that the waves are only 80 feet tall. Or 50 feet tall. And while they still come, they come further apart. You can see them coming. An anniversary, a birthday, or Christmas, or landing at O'Hare. You can see it coming, for the most part, and prepare yourself. And when it washes over you, you know that somehow you will, again, come out the other side. Soaking wet, sputtering, still hanging on to some tiny piece of the wreckage, but you'll come out.
Take it from an old guy. The waves never stop coming, and somehow you don't really want them to. But you learn that you'll survive them. And other waves will come. And you'll survive them too. If you're lucky, you'll have lots of scars from lots of loves. And lots of shipwrecks."
Source: https://web.archive.org/web/*/https://np.reddit.com/r/Assist... | https://archive.today/CkLxT
Hey, I was going to post this!
But yeah, I read this when it was initially posted and it has stuck with me ever since. It's a really great expression of the struggle with grief.
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