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 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.
"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.
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".
- 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.
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.
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.
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'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.
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.
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.
apparently, any time that you need to politely smile when you dont feel like it is "masking"
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.
That said, the writing really resonated with me and i wish Bess well.
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.
I still miss that guy, though.
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.)
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.
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.
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.
>> 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.
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 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.
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.
If anything, I find religious people are the ones who believe humans are special.
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.
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.
For what it's worth, krapp's comment is better written but is what I'm talking about here.
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.
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.
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"?
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.
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?
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
+ A natural part of life
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.
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 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.
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 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.
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).
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.
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 think you missed the "stereo" in front of your "typical".
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?
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.
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.
https://news.ycombinator.com/item?id=43020983 949 points | 7 months ago | 266 comments
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.
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.
I should not cry at work but damn, I want to.
Correct, secularism can't deal with death, it doesn't work.
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.
I'm still sad sometimes, but I have much more to look forward to now.
"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
https://orphanwisdom.com/die-wise/
Dying is a skill, both for the person doing it and the people around them.
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?