A Broken Model of Brokenness

This is the second post in (the first annual?) Mental Illness Week at freddiedeboer.substack.com.

I thought that this Reddit post was striking and worth sharing, so I sought and have received permission to post it in full.

Regardless of any internet-level understanding or resentment, the millennial/zoomer understanding of mental health is completely destroying people's lives.

I work and have worked in mental health for my entire adult life (late 20s now). I have my own mental health diagnoses. I was diagnosed with severe OCD when I was 11. Since then I've gone through periods of generalized anxiety, agoraphobia, panic disorder, you name it. It has destroyed my life once every three or four years without fail. Losing jobs, friendships, my grades in college, everything. Just utter ineptitude and catatonic inability to take care of myself. I have been blessed with the most supportive family anyone could ask for. I do not fail to see the differences between myself and those who I now serve. But there is an intense illness that is permeating through our younger generations that is destroying the possibility of recovery for these people suffering through legitimate mental health issues.

I have met and helped and treated numerous individuals now who are my peers in age - anything from 18-early 30s. And so many have internalized a generational "understanding" of mental illness that is toxic and worthless beyond condemnation. Our youngest generations' understanding of mental health enables, encourages, and at worst glorifies mental illness. I can not understate the number of times I've met a young woman who has made being mentally ill, and polysexual, and queer, and autistic, et cetera, their identity.

Accountability is absent to the nth degree. But more importantly, a lack of any accountability has deprived these people of personal empowerment and agency. Mental illness is no longer something to recover from and fight against. It is an identity and a definition of life itself. There is no reason to seek "cures" (which of course is borderline nonexistent in mental health but thats a whole essay ifself), there is no reason to look to better ourselves. There is no reason to fight our internal struggles at a personal level, without feeling the need to informt every last member of the community whom we interact with. This is not only society's problem, but our peers'.

Recently I have been working with a woman a bit older than I am, but she is just an example of something I've seen numerous times. She understands every moment of high anxiety to be a crisis: deserving of calling hotlines devoted to suicidal people. Every second of discomfort is an attack on themselves. "Trauma response" is the only verbiage through which they understand how maybe a parent wasn't so loving, so now a snide comment = mental health crisis. They have no contextual understanding how minor inconveniences can and SHOULD be resolved quietly to themselves by being a little anxious for a night. To them, it is an affront to their character, an affirmation that they are disabled and unable to contribute to society without constant affirmation. And they have the internet to thank.

The culture of mental health amongst millennials and lower glorifies and denies all responsibilities towards people with mental illness. Not to mention the flimsy and extremely thin definitions by which they diagnose themselves and each other. I have never in my life met a they/them who also didn't call themselves "autistic" and "traumatized." This is not a coincidence. The internet community they are a part of is destroying all sense of responsibility and personal understanding of agency and even sexuality. The result is people aged 14-mid 30s who have no grasp of improving themselves or working on their mental health. The aforementioned woman feels zero responsibility for losing now dozens of friends who did something between refusing to be a part of her "crisis plan" or simply not acknowledging her severity of mental illness. But I've seen her dozens of times. She can hold down a job just fine. She shows more initiative than any homeless person (of which I've worked with hundreds) I've ever met. But her understanding of herself and any struggles is so absolutely poisoned by this ridiculous generational attitude towards mental illness that she will never recover. To not be a part of the cult is in of itself a toxic trait to her poisoned mind.

A second of anxiety is a crisis. Two panic attacks in a week merit hospitalization. A close friend refusing to validate these things is valid grounds for terminating the relationship. And so on, it repeats. It is a self-fulfilling prophecy, and I've now met numerous people who would otherwise be functioning members of society who instead have no belief or understanding that they could be just that. Instead they are queer disabled anarchists with trauma response issues unable to hold down a job... because when you surround yourself with enablers and increasingly lenient definitions, something as simple as an anxiety attack once in your life will quickly turn into being "handicapped" and separate you from society in perpetuity. - franzoh7

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Let me tell you some things I don’t do. I don’t police other people’s diagnoses. I don’t assign relative weights of seriousness or legitimacy to various mental disorders. I have no desire to dismiss the mental illness experiences of anyone, and I’m a little annoyed that people sometimes try to recruit me to do so.

However, I do think that self-diagnosis is an inherently fraught process that can cause serious problems for someone’s life, even if - especially if - they are indeed suffering from a mental illness. I do think that, practiced well, mental health diagnosis is a sometimes adversarial process, and that patients who come into it with an overly diagrammed vision of their condition need to be pushed back against. I don’t think that mental illness is an identity, though I am sometimes accused of acting that way myself, and the way people on social media treat having a mental illness as an attractive personality quirk is toxic and misleading. I do think that the endless search for new identity markers to validate people’s status as unique or, worse, to validate their suffering is a road that has no ending. I do think that all of these adolescents who have decided that they have rare and debilitating conditions like dissociative identity disorder are no doubt reacting to real pain and really need help. But I also think that they fail to understand that suffering itself is not a rare condition, but a universal one, and that attempting to represent theirs as deeper because it supposedly stems from very uncommon conditions will do nothing to make them feel better. And that is the point, always, with mental illness, not to publicize it or revel in it or derive identity from it but to manage it, to reduce pain and instability.

I blame not just the bizarre path identity politics have taken in the past decade but also a culture that still romanticizes mental illness as a quest against the constricting force of society’s norms, instead of a set of conditions that cause immense misery to those who suffer from them and their families. Mental illness is not dramatic or a somehow more authentic way to live, but mostly lonely, sad, and pathetic.

More than anything, what these young people fail to understand is the regret. They don’t understand the regret, they don’t know what it means to live with it, all day, every day. They are idealistic and ignorant enough to think that their disorders remove the culpability that produces regret; for many of them, this denial of responsibility appears to be a key part of the attraction. But it doesn’t work that way. Over time, as you age, abstract questions of control and blame fall away, and what you’re left with is the accumulation of broken relationships and things you can never take back. A 19-year-old on TikTok might look at her peers and their talk of borderline personality disorder and see glamour and a kind of pain that society might recognize. But if so afflicted someday that 19-year-old will be in her mid-30s and will look back and see the human wreckage that has accrued, and there will be nothing like glamour or fun, only the grubby slow unfinishable business of trying to stay medicated and alive. They don’t understand the regret, these kids. They don’t understand the regret.

But someday, if they really are sick, they will.