The question Lumifer raised was if mental illness is really that common.
Not quite. I pointed out that mental illness can be defined in different ways (DSM was not brought back on stone tablets from Mount Sinai) and these different ways will give different answers about the prevalence of mental illness.
Oh, sorry. I misunderstood.
I should hope not, that would make me seriously question a good deal about history and biblicism. That's very true, but narrowing the problem too much causes the same kinds of problems as opening it to everyone. If you give everyone with upcoming life changes a Xanax, you're not letting them learn how to cope. If you refuse to help someone unless their illness is ruining their life, you're letting a lot of people live seriously suboptimal lives. We don't have a good entry barrier for determining if someone is mentally ill or not. We simply don't know enough to make one.
I'm not sure that the term "mental illness" is pretty useful if your goal is to do change work. Part of the societal role of the term is to distinguish mental phenomena where it's legal to take drugs to solve them from mental phenomena where it isn't. To decide what insurance will pay for and where it won't pay. Those concerns dictate how wide or narrow we have our net as to what constitutes "mental illness".
If we talk about anxiety I'm not sure that "mental illness" is a good framing. Every healthy human being sometimes has anxiety. There might be some brain damage that prevents certain people from having anxiety, but it's part of normal human functioning.
That means it's useful to learn how to deal with anxiety in a productive fashion. There are a bunch of emotional management skills that are useful for everyone.
I know little about schizophrenia but my general impression is that it's something that's qualitatively very different from a phobia.
Anxiety transcends a normal thing and enters mental illness when it becomes pervasive and unreasonable. My anxiety about having used a wrong word in a conversation I had last year is unreasonable. My constant feeling of dread is unreasonable because I'm not constantly in a situation that should inspire dread. Mental illness is really hard to define properly- there always seems to be something left out, or something that's implied to be illness when it isn't.
Honestly, I feel like the discussion has been derailed a bit- we're focusing on defining a very vague thing that we don't understand yet. I can't offer answers at to how we should define mental illness because that's a question that would take years to answer. And it seems like one of those questions no one will ever agree on, either. As a utilitarian, I think mental illness is a thinking pattern that causes unhappiness or harm over a period of time, or that blocks someone from being able to view the world realistically. Someone else might have a different set of values that has an entirely different set of "bad thinking patterns."
But people ARE suffering, we know that there ARE diseased thinking patterns, and we know that people want help. Maybe "mental illness" is a bad frame, but at the moment, do we really have another to work with? I don't think so, which is why I think that this is an important question. All of the answers we're getting are mysterious, and thus not answers.
Yes, I want to do change work, and I think that it's impossible to do anything if we refuse to start helping because we don't have a good frame yet. Sometimes you have to explore a problem for a while to even start to figure it out. We have an extremely flawed and basic understanding, and saying, "well, what can we do then?" is like throwing out a hypothesis because of one inconclusive experiment.
Mental illness is pretty clearly defined.
Yes, and that definition leads to a field that's not productive at solving the problem. Plenty of criticism surfaced in the wake of the DSM-5 which currently contains the official definitions for mental illnesses.
I'm aware. I do study psychology, although my personal passion is microbiology. The question Lumifer raised was if mental illness is really that common. It's pretty hard to find any evidence saying it's uncommon, and a LOT of evidence saying it's common. I'm curious- from your comments here, you seem to have a differing point of view than I do. Could you explain what you think mental illness is, and your related opinions? I think that would lead to a more productive discussion.
At our last LW meetup in Berlin one participant A said that he wills anxiety about the upcoming social interaction X. We did a Hamming Circle (spelling for Hemming might be wrong) and I was mainly leading the discussion. At the beginning he was shivering because of anxiety caused by thinking about the issue. Half an hour later he felt courage. I checked up later and he faced situation X in a relaxed way.
Another member of the circle B mentioned that it was like me talking a different language to A. The flow of the whole process was intransparent to B. As such it's unlikely that describing what I did in a LW essay would be much help.
A lot of what's written in the akrasia fighting methods carries little risk. Doing some form of trauma regression to combat your anxiety while you sit alone at home is qualitatively different.
A month ago the loud drilling machine of my neighbors produced an uncomfortable feeling in me. I recognized that having that trigger is stupid and removed most of it. Does that mean I can write a text that teaches you to get rid of it? No.
Of course. I love yoga. It's relaxing and fun. But it's no cure for anxiety. Yoga gives a very short "mental high" and doing it for months had no effect on the anxiety. This approach may work for a lot lf people, but as always, there's a fringe that needs some new approaches.
If I would meet you in person I would have information about your bodily state that helps to put the answer into perspective. Without that it's hard to estimate your state.
It's awesome that you're able to help people so well. At the same time, though, I get the feeling that you're falling into the trap of other-optimizing. In-person support is probably a lot more helpful than internet-based support, I suspect. But when the right people aren't around you, and you can't go to them, having instant communication over the internet is a good second-best. Certainly over the internet there's things you can't do, like determine a physical state. But if people refused to use any method but the absolute best, we'd spend more time trying to find optimal strategies than anything else, and humanity would die out because we'd be too busy designing soylent to eat.
I may be misinterpreting your meaning, but it kind of seems like you're focusing on semantics when the problem here is that common diseased thinking patterns are killing, sickening, and limiting lives.
You are on LW. Clear thinking is valued here and that involves debating how to talk about issues. Semantics matter.
Semantics matter to the extent that everyone is on the same page. Mental illness is pretty clearly defined.
So you think the idea of a rational support group could work?
It's a vague general label. Part of what happens at our LW meetup in Berlin could be called a "rational support group".
Meetups are a little too far and few to be really effective, I think.
I don't think that's true. If there's no LW meetup nearby, start one. Bootstrapping trust is easier when one meets in person.
A meetup sort of requires more than one person. There aren't even any other HPMoR readers in my area, except the person I introduced to it. I'm sure this is a problem for others, too. Being the sole LWer in your area that you can find is frustrating. I'm in central Oklahoma, and according to surveys and the like, I'm pretty much the only Oklahoman here. And I'm pretty sure this is a common plight- Berlin is a big city full of interesting people with interesting viewpoints. What if you're from, say, Ukiah, Oregon, or Mobile, Alabama, or a place even smaller or further out of the way? Physical meetups are most effective, but kind of a luxury.
Why should LW be a mental consuler? No offense intended - but I bet there are people out there who will help more than anyone one LW can.
You're right that LW is definitely not going to be a cure-all, and obviously I'm not asking for everyone on LW to band together to fight this one problem. A lot of the people here have their own projects. But I think that LW could be a great help to people who are trying to get help and can't- either because they can't afford mental health care, or because their health care isn't helping. LW is a brilliant educational place that bases a lot on science and cognitive studies. I think this could easily extend to helping with mental illness.
Mental illness is a complex thing, and everyone who has one is complex in a different way. That's why mental illness is so hard to treat. Most of the theories about what the causes are (genetics, brain chemistry, etc.) aren't supported well enough by science to help. It can take years to find the right cocktail of drugs to fight a specific mental illness a person has, and that same cocktail won't work for someone else with the same problem. LW sort of has a talent for sorting out bad science.
There are rationalists talking about mental illness, but mostly offsite. Ozy talks about BPD among others, Kate and theunitofcaring talk about eating disorders among other things, I'm probably forgetting some.
Thank you! I'll see if I can start compiling resources like this. If you think of any more, I'd appreciate it if you could message me.
mental illness is still really common
That is entirely a function of how widely do you define "mental illness". You set the bounds of normality narrowly and you get that mental illness is common, you set them far out and mental illness becomes a rarity.
Mayoclinic defines mental illness as such: "Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors." This seems to be the standard definition.
The statistic of 1 in 5 that I used seems to pretty much only refer to diagnosed people with specific, named disorders. I don't think it was including "I feel sad sometimes" as a mental illness. And considering it was only used statistics based on diagnostics, it seems pretty clear to me that a LOT of people got left out. Many people can't get help. This also only covered the U.S.A., and statistics could vary widely in other areas of the world and based on methods.
If you like, we can taboo the "mental illness" phrase and instead use something like "badly defined and illogically based thinking patterns." That would cover the schizophrenic fantasy/reality disconnect, anxiety, depression, etc. Then it becomes pretty clear that "badly defined and illogically based thinking patterns" are really common and often not as specific as biases. I don't think anyone would claim mental illness is rare. According to the American Foundation for Suicide Prevention, 12.6 people out of 100,000 successfully committed suicide in 2013. That means over 41,000 people died, in one year, in the U.S. alone, not counting the suicides ruled as accidents or disappearances. The AFSP says it's not easy to get a good number for suicide attempts, but they believe based on self-harm caused hospitalizations that it easily exceeds 600,000 people a year. And that's just the people who want to die. Eating disorders are gaining attention as one of the more common kinds. Addictive disorders are so common almost everyone knows one or more people struggling. Depression, the same. There's a trend among students where anxiety and stress are causing serious issues.
Also, there's a difference between commonality and normality. Urine fetishes, for instance, are considered abnormal and uncommon. BDSM would be considered normal but uncommon (though 50 Shades of Grey seems to be making it a more common thing.) The urge to eat is normal and common. Mental illness, I would say, are considered common but abnormal.
Honestly, I can't think of a single definition of mental illness that would say it's uncommon. I may be misinterpreting your meaning, but it kind of seems like you're focusing on semantics when the problem here is that common diseased thinking patterns are killing, sickening, and limiting lives.
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There are two battling narratives of mental illness. The first narrative says that mental illness is a disease of the mind, the second that it is a disease of the brain.
The "mind" story is that these illnesses come from bad ways of thinking, whether this be childhood trauma, diseased patterns of thoughts, etc. The treatment is therefore in psychotherapy, CBT, or other such. To the extent that this narrative is true, discussion of mental illness is likely relevant to rationality.
However, the other narrative is that mental illnesses come from chemical imbalances or other defects in the brain. The cure is therefore lithium, SNRIs, etc. To the extent that this narrative is true, rationality doesn't have a lot to say about mental illness.
Your post suggests you like the "mind" narrative. But to the extent that LW is a hive of reductionism, it may be that the "brain" story is considered more appealing here, and this may explain why there is less discussion of mental illness than you find conducive.
My opinion is that saying that all mental illness falls into one camp is oversimplifying. Someone who's schizophrenic is definitely in the brain category, according to the current consensus I've seen. Depression is moving into that camp. Anxiety is on the fence- it can be chemical or mental.
If I were to answer "is mental illness a mind thing or a brain thing?" my answer would be "neither, both, one, or the other" because the brain is a complex thing and breaks in a lot of different ways.
Anxiety, for instance, is typically treated with temporary medication and long-term therapy. We treat it as "mostly mind, hint of brain."
Depression is treated with long-term therapy AND medication, or just medication. It can be a product of thinking patterns, but the consensus now seems to be that it's mostly a hormone thing.
It feels, to me, like if two groups were arguing "grass is yellow" or "grass is blue" when most grass is green but there are weird variants that are yellow or blue.