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Are casual references to psychological issues impacting clinical care?
While the broad acceptance of mental health care has reduced stigma, researchers say emotions like sadness are being ‘pathologised, rather than normalised’.
Almost 44% of all Australians aged 16–85 years have experienced a mental disorder at some time in their life.
A new study from the University of Melbourne has shed a light on today’s frequent and casualised talk of mental health, and how it is changing the way patients are presenting in clinical practice.
Researchers say the terms ‘anxiety’ and ‘depression’ are now constantly shared and colloquially discussed on social media, and in everyday conversation, as mental health literacy expands.
Citing the word ‘trauma’ as an example, the study said, ‘once it referred only to life-threatening events, but in everyday language it increasingly refers to almost any adversity’.
Dr Cathy Andronis, Chair of RACGP Specific Interests Psychological Medicine, told newsGP healthy lifestyles and face-to-face support are on the decline, as Australians spend more time online.
‘As a result, we start calling our worry “anxiety” and referring to our normal reactive sadness as “depression”,’ she said.
‘Labels are further disempowering individuals and are potentially damaging.’
In the study, researchers examined the abstracts of more than 800,000 psychology articles published from 1970–2018, together with half a billion words from everyday American English sources, including television shows, fiction, newspapers and spoken language.
The review ultimately found that the concepts of anxiety and depression have broadened, intensified and pathologised, all at the same time.
As a result, they believe the general public is now more likely to refer to anxiety and depression in terms of symptoms and disorders than it did previously.
‘Although anxiety and depression can both be transient and functional everyday mood states, they are increasingly cast as disorders,’ the paper states. ‘They have been pathologised rather than normalised.’
The researchers speculate that if people are using the terms more frequently, and using them with a more pathological meaning, it would not be surprising if they saw themselves as having clinical anxiety and depression, which could lead to excessive self-diagnosis or treatment seeking.
Dr Andronis added that social media is distracting society from building resilience.
‘It is completely normal to grieve losses, worry about uncertainty and it is unrealistic to believe that we can control everything in our lives,’ she said.
The findings come as presentations within clinical practice are on the rise – according to the Australian Institute of Health and Welfare, 12.4% of all general practice encounters are now mental health related, while psychological issues have been cited as the most commonly reported reason for patient presentations for the past six years.
Dr Andronis said there has been a long-standing debate regarding this longitudinal trend of increased anxiety and depression.
‘Is it because we are identifying conditions more frequently due to more awareness and reduced secrecy about psychological problems or are we less personally resilient and more disconnected socially from others?’ she questioned.
‘The likely answer is that both are true; however, we also know that antidepressants are overprescribed in Australia despite these being as equally effective in treating mental distress as counselling and psychotherapy.’
Mental health diagnoses spiked in the wake of the COVID-19 pandemic, with a University of Sydney study finding evidence of significant increases in depression and anxiety compared to pre-pandemic levels.
The latest Australian Bureau of Statistics data also reveals 44% of all Australians aged 16–85 have experienced mental health issues at some time in their life – anxiety disorders being the most common.
But Dr Andronis said mental health conditions are currently being ‘over-diagnosed and over-medicated’.
Instead, she urges fellow GPs to advise patients to look at their lifestyle and consider what they could change to lead a healthier life with less distress.
‘Usually diet, exercise and adequate sleep help immensely in achieving a healthier life balance and less mental distress,’ she said.
‘Repairing and strengthening their personal relationships is also a key factor in wellbeing and interpersonal or relationship counselling can assist them greatly.’
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