A new paradigm for health is emerging. Movies, TV shows and celebrities are raising awareness for mental health. As an antidepressant crisis unfolds, growing awareness is causing a shift from treatment to prevention. Moreover, new narratives are appearing about the nature of mental health. Consequently, a wide range of consumption may help people become mentally healthy.
Our Observations
- JWT Intelligence has found that while 77% of respondents associate health with physical condition, nearly as many (75%) say that when they think about health, they think about mental health.
- The Centers for Disease Control and Prevention (CDC) track changing attitudes towards mental health, and they have found that stigma is diminishing: people increasingly consider mental health to be a fundamental component of wellbeing. For example, a larger percentage of people endorsed the benefits of treatment by a physician for people with depression in 2006 (91%) than in 1996 (78%).
- Popular culture is also reducing stigma by increasingly exploring mental health issues (e.g. 13 Reasons Why, BoJack Horseman, Robot). Meanwhile, famous people are also increasingly opening up about their mental health (e.g. Elon Musk, Andres Iniesta, Kevin Love, Kanye West, Mariah Carey, Demi Lovato, Beyoncé, Adele).
- As the stigma diminishes, the use of antidepressants is surging in the U.S., according to an analysis by The New York Times. Some 15.5 million Americans have been taking this type of medication for at least five years. The number has almost doubled since 2010, and more than tripled since 2000. Nearly 25 million adults have been on antidepressants for at least two years, a 60% increase since 2010. The NYT also presents an unanticipated and growing problem: many who try to quit say they cannot because of withdrawal symptoms they were never warned about.
- Vox documents the growing “anxiety economy”: an increasing amount of products are designed to calm us down (e.g. fidget spinners, weighted blankets, meditation apps, videogames). According to the National Institute of Mental Health, anxiety (i.e. an unpleasant state of inner turmoil) is the most commonly diagnosed mental health disorder in the U.S., affecting 18.1% of Americans each year and nearly one-third of Americans in the course of their lifetimes.
- New definitions of the nature of mental health are emerging. In The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Illness, professors Horwitz and Wakefield argue that mental illness is being overdiagnosed (as did Trudy Dehue in De depressie-epidemie). They note that studies that use the same criterion for diagnosis over time reveal no change in the prevalence of depression. Belief to the contrary emerged in the 1980’s when mental health professionals began diagnosing depression based on symptoms (such as a somber mood, loss of appetite, and fatigue) that lasted for at least two weeks. This system is fundamentally flawed, the authors argue, because it fails to take into account the context of the person displaying these symptoms.
Connecting the dots
A more holistic view of health is emerging, in which the focus is increasingly shifting from physical health to mental health. Our inner psyche, by being able to cause physical discomfort, is increasingly taken into consideration for our understanding of health. But within this new paradigm for health, the nature of mental health is also changing.
Through growing awareness about mental health, new narratives about its nature are appearing. From the perspective of the traditional narrative, which focuses on symptoms (e.g. mood, fatigue) and treats them with medications, there is a mental health crisis (as people are increasingly seeking therapy and prescriptions). Widespread media attention for potential culprits (e.g. technology, work pressure, sleep, crowdedness) has reinforced the belief that mental health disorders are becoming more common, as have popular culture and celebrities that raise awareness. However, other experts are reframing the nature of mental health. Horowitz and Wakefield (and Dehue) argue that among experts and patients alike, intense sadness is being confused with depression. Consequently, there is a “medicalization of sadness”. Instead of a depression epidemic, there is a growing presence of mental health in popular culture, media and scientific literature, more people are seeking treatment (without suffering from a serious condition), and doctors are prescribing pills more frequently. From their perspective, mental health issues have two emotional dimensions, normal and disordered, and growing awareness is leading to confusion of the former with the latter. Indeed, people could also be succumbing to a powerful placebo effect (e.g. perception of lack of sleep is a stronger pathogen than lack of sleep itself). Another (contrarian) perspective sees mental health disorders as carrying underappreciated strengths (e.g. autism, bipolar). It shows that people that have been diagnosed with disorders are discovering ways to cope and are also reframing the debate. All in all, we are becoming more aware of mental wellbeing.
These new narratives of mental health are already changing how people act with respect to their wellbeing. In the initial phase of mental health awareness, its nature was primarily considered neurobiological and focused on symptoms, and therefore treatment was centralized on medicine (e.g. antidepressants). However, growing awareness is changing the nature of mental health into psychological wellbeing. New narratives pay more attention to context instead of symptoms. Consequently, treatment is expanding beyond medical intervention. Most importantly, awareness will cause a shift from treatment to prevention: even people without any mental health complaints will adapt, which we’re already seeing in debates about sleep, exercise, work pressure and digital technology. Furthermore, while it is tempting to be cynical about the effectiveness of the “anxiety economy”, the fact that many people believe they are suffering from disorders (even triggering placebo effects), while actually experiencing (normal) intense emotions, means that certain types of consumption may actually truly help them ‘get out of their heads’. As such, growing awareness about mental health is a major boost to the Hyper-experience Economy, as hyper-experiences break destructive patterns of thinking by transforming the sense of self and time.
Implications
- A new paradigm of health is emerging, which will transform how people seek healthcare. The shift within mental health from treatment to prevention will lead people to change their attitudes towards sleep, work-home balance, physical exercise, and the use of digital technology. Optimizing these aspects of life could increasingly become a vital component of a healthy lifestyle.
- A wide range of consumption can be understood from the perspective of people trying to “get out of their heads”: the popularity of psychedelic drugs, chatbot therapy, meditation apps, and hyper-experiences such as videogames and festivals.
- The “medicalization of sadness” is amplified by the free flow of information in the digital age. Research shows that Google triggers cyberchondria: when people look for information about their health online, they become more anxious about their wellbeing. Horowitz and Wakefield provide a possible explanation: online search results present a wide range of symptoms, but naturally do not take into account the context of the person’s life, leading people to confuse their symptoms with serious conditions.
