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About Everything Wiki » Health » "It has always been speculated by those who want to attract attention to themselves": neurologist Nikita Zhukov — on the fashion for mental illness

"It has always been speculated by those who want to attract attention to themselves": neurologist Nikita Zhukov — on the fashion for mental illness

03 Jun 2023, 00:00, parser
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Is there a fashion for mental disorders

Fashionistas have existed at all times. A few years ago, for example, the media began to talk a lot about celiac disease, and in this regard, even those who were not shown gluten rejection, began to avoid it in food. Undoubtedly, people without celiac disease may also have sensitivity to this protein, and excluding it from the diet will really benefit them. But there are much fewer such people than we observe.

And the fashion for mental illness is not something completely new: in the last century St.‑The St. Petersburg clinic of neuroses was in no less demand than now. But in Western countries, they started talking about mental health earlier — we in the CIS lagged behind this trend by 50 years. Therefore, now it may seem that the "fashion" for inventing mental disorders has appeared quite recently.

Depressive states, "psychogenic" disorders, suicidal tendencies — these have always been speculated by those who want to attract attention to themselves, cause a feeling of pity from others or agree on certain conditions for themselves, ask for a special attitude towards themselves.

And it's not about fashion, but the fact that mental illness is much easier to simulate than any somatic problem.

All psychiatry is subjective: specialists have practically no objective ways to confirm or exclude any disease.

Therefore, always — before and now — there were people who just hung diagnoses on themselves and adjusted their behavior depending on their description. However, it is important to clarify here: we are not talking about the fact that a public statement about depression is always posturing.

How the popularization of the topic of mental health is changing society and psychiatry

The age of normal civilized psychiatry in our region (in the CIS) is a maximum of 10 years. Before that, during the Soviet era, punitive psychiatry was widespread, which did not benefit citizens, but served the repressive apparatus: people were massively diagnosed with sluggish schizophrenia at any hint of trouble with their heads. And since then to the present day, most doctors in the post—Soviet space, for example, believe that antidepressants are terrible and "very strong" medications that you should stay away from.

At the same time, thanks to the popularization of the topic of mental health, there are more psychiatrists and doctors of somatic specialties who understand that mental disorders exist and can be controlled. People, in turn, realize that suffering is not normal, and try to improve their lives.

According to my observations, in the CIS countries, a new serious peak in referrals to psychiatrists and psychotherapists was during the pandemic. People settled down at home, finally were able to listen to themselves (or stare at each other) and understand what is bothering them and not satisfied.

And it brought obvious changes for the better.

If now in the capitals in a public place to say that you have a psychiatric diagnosis, then no one will be surprised and, most likely, will not even pay attention.

It turns out that the stigmatization of mental disorders is obviously decreasing. People accept the possibility of both their own mental problems and the problems of others in the form of a diagnosis, and not "weakness" or laziness.

However, there are also negative effects. Very often I observe how people freely tell everyone around them what their diagnosis is and what kind of pills they eat. Why does this disappoint me personally? Let's say two people discuss the same antidepressant in the same dosage and find out that it affects their mental state differently and causes different side effects. For one, this may reduce the effect due to increased anxiety, and for another, it may lead to independent experiments to change the dose or cancel the drug.

In addition, people often do not think about the social consequences of such openness. If you tell your boss that you take three different psychopharmacological drugs a day, then even without any stigmatization, the manager will put a tick for himself: "Yeah, if the next time a person does not come to work, it's probably because of his illness." And then it can become an unpredictable snowball.

Yes, we need to be more aware, we need to spread information, but we don't live in a perfect pink world where you can expect everyone else to be as aware, informed and virtuous as you are.

Is it normal to try on psychiatric diagnoses

When some popular blogger says that he was diagnosed with ADHD in adulthood and prescribed therapy really made his life easier, people understand: going to a psychiatrist is not so scary, and psychotherapy is not useless.

They will look at this blogger, try to try on his diagnosis by tracking similar symptoms, then ask any available specialist ‑ most likely, there are more pros than cons from this. This increases the attentiveness to your health, albeit in a roundabout way.

I have patients who come with a statement: "I think I have bipolar." And as a result, after explaining the symptoms and course of bipolar affective disorder, the person says: "Ah, I see! Well, yes, I don't have anything close to that." But nevertheless, the fact that they, in principle, asked such a question and brought it to the doctor speaks of increased medical literacy.

For example, with the same ADHD: there is a layer of people 20-30 years old who were not diagnosed with this syndrome in childhood, because in the 90s no one cared about it. Only now, thanks to the work of popularizers, they learn that, it turns out, their inability to concentrate on some action for a long time is not a sign of laziness, but a pathological condition that can be treated. And it can dramatically improve their lives if the diagnosis is confirmed and the treatment has an effect.

If you notice anxiety or depressive tendencies or any other symptoms, then the main criterion for contacting a specialist is "Does it interfere with life?", and not the presence of a symptom.

That is, if some feature of your psyche affects your studies, work, leisure, relationships with other people, then it makes sense to go to the doctor.

And if, having "tried on" someone's diagnosis, you notice that he is close to you, then there is nothing shameful in coming to a psychiatrist and consulting on this topic.

Who to go to if you need a consultation

A psychiatrist is a doctor who diagnoses and prescribes medication.

A psychologist is not a doctor. He gets an education at the humanitarian institute bypassing the medical part. Therefore, he cannot diagnose and prescribe pills, but he can conduct psychotherapy.

Psychotherapy is not about "lying on the couch and discussing childhood grievances." Proper psychotherapy is a real workout. Just as a person pumps muscles, you can "pump" the psyche and nervous system, developing skills that will protect against anxiety, depressive and suicidal tendencies.

So who should I go to? To any specialist who is in sight and seems adequate. If he is adequate, but this is not his topic, he will be able to route the patient correctly, and not into the void.

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