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 point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in
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.
What you're describing is a big problem [edit: for the people who get sucked into it] and, to me, is kind of the "other side" of the overmedicalization issue that this blog is complaining about. One way medicalization harms is is when people are forced into conditions they don't agree with (as the author feels they have been). The other way is when people who aren't medical professionals (and wouldn't be in a position to diagnose even if they were) adopt medical language to describe experiences.
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.
This is a very american trend in my experience. Americans are quite happy to tell you their long list of diagnoses, how that some how gives them some kind of exception to the rule, and how this is some how part of their identity. This kind of oversharing is common across topics from Americans but in particular oversharing of and obsession with psychological conditions seem to be a common modern stereotype of americans amongst my friends who interact with americans regularly.
I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet.
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".
I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that.
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.
Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply).
That said, the writing really resonated with me and i wish Bess well.
I say this with respect and love to the author: it does not sound like you’re handling this just fine. I think you’re right that there’s no way to handle this just fine, and you’re right that you’ve got a very good reason for not being just fine, and it’s in fact very normal and expected for you to not be handling this just fine, but it is also the case that you’re not handling this just fine.
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.)
Yeah, her being confused for an extended amount of time when a friend sits down at the coffee shop instead of her husband is definitely problematic. I think it's weird to write an article attempting to ridicule the DSM in this case.
Not to take away from the article, in the comments she states that her world is filled with the joy of new things with her new baby. She is doing as well as one can be for how much she loved Jake and how much she misses him.
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.
There is a problem with rigid medical definitions. There is a huge difference between the author of this, a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent (as I did earlier this year). Of course it will take her far longer to recover (if at all).
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.
Sorry for your loss, and thank you for your perspective.
>> 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.
I'm surprised by this take, simply because of my own experience, where the further I've gotten from religion over a very long time, the less significant I've found death.
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.
Atheism doesn't presuppose either hedonism or nihilism. This is a common theist libel which is surprisingly popular on this forum of ersatz rational thinkers and logicians. Atheists are perfectly capable of finding value and meaning in their own lives and the world around them, they just don't base that value on a belief in the supernatural. Listen to any astrophysicist, physicist or biologist talk about their field and you'll encounter a wonder and awe that no theologian reciting thousand year old tracts can match.
I think you're right on the word level but I think there's a difference about what significance and insignificance means to these groups.
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.
I'm so sorry for your loss. I agree with what you say about "disordered", the language is hostile.
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"?
I think there's something of a pendulum here, and I agree it's swayed too far to over-diagnosing ourselves. But I also think of my father who passed a couple years ago.
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.
In the west we’re trained to believe that if something happens there should be some sort of tangible reward on the other end, no matter how minute. Death takes and leaves nothing tangible and it’s the absence that drives us crazy. Since we’re trained this way we seek out some solution with the other trained aspect, spending money. Which in turn only temporarily numbs the grief until you deal with it.
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.
> We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”.
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 do not agree. While there may be a flux of people who have therapists, the majority do not and that is why you hear about it on Youtube.
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.
It used to be in the west. The Catholic Church discourages the scattering of ashes for just that reason - so that there is somewhere physical where people can be remembered. There was a tradition of memorial services. People still look after the graves of their loved ones.
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).
> I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
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.
I agree with you on the western religious tradition, but I think it's less true for the secular west today.
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 went ahead and added that "stereo" to my comment. I think you're right, but I also think that stereotype is grounded in reality with a lot of empirical observation. So yes, not exclusive but certainly common.
Well, as a secular individual whose friends group is mostly secular people, I haven't see people express such black and white opinions, but I'm guessing we move in different circles. As far as observation is concerned, we tend to see what we want to see, don't we?
Your made up straw man secular person is, frankly, ridiculous. Like, we all get it, conservative Christians hate the rest of us and look down on us. Duh.
In the way that most people don’t have a routine of that contemplation and remembrance and that individual self, ego, and your future is placed as more important in the day-to-day.
A lot! Maybe it's obvious, but I've long thought that religion's primary function is to help people process death (and other suffering). Now that life isn't constant suffering, many of us have discarded religion, but then we are blindsided by death.
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
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
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?
> 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 a broad observation about culture - there's no "alternative" to a well-established culture, no 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've hit on something here; there's an inherent conflict between ruthlessly individualism that tells people they can do anything they put their mind to, and the stark reality of mortality and the limits it imposes[1]. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
+ 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
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?
One of my best friends died 12 years ago in our late 20s. I know he is dead, and yet a couple times a month I think, "Oh, I haven't talked to him in a while, I should text him!" before my logical brain kicks in and lets me know the deal.
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 have been through two very painful deaths, first by brother then my father and both had very similar transitions from shock to acceptance to
grief and finally to the new normal. Both cases took years to heal. I stopped dreaming about my brother after about 10 years of his death. It has been 5 years since my dad passed and I still have very vivid dreams that upset me very much, but they are much less common now than say two years ago and I know at some point, like the dreams about my brother, they will stop. Everything succumbs to time, including grief.
Even before finishing the first paragraph, it all sounded familiar to me. Then I looked at the author’s name and remembered, this is the same person who wrote “The Year I Didn’t Survive”.
I'm pretty sure my dad has chronic grief. My mom passed away from cancer when I was 11. I didn't know how unusual their marriage was until I saw others' marriages. It became particularly clear when I started dating and got married myself.
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.
Having experienced a few hard losses this year (My dad to ALS, and my cat suddenly a week after my dad), the thing that has surprised me the most is how they show up in my dreams. In some dreams, I'm like "I thought you were dead? What am I going to do with all these death certificates now?", in others we're just hanging out at the pool. I never dreamed about my dad before he died. But in these dreams he's just there, and healthier looking than I had seen him in years. My cat shows up too, and many times I remember petting her in her bed, not realizing it was a dream, only to wake up surprised she wasn't still there next to me. In my waking life I fully know they're gone, but at least part of my brain really doesn't want to accept it's true.
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.
> There’s no modern cultural framework for dealing with death.
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.
Reading Jake's[0] and Bess' posts during his illness was both highly enlightening and also very depressing. The news of his death hurt me more than I expected. I simply cannot imagine the pain Bess has felt.
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 experienced a long period of grief as well. I think the grief stayed because I wasn't totally happy with myself.. Then I decided it's time for change and I moved house and changed jobs. That helped me.
I'm still sad sometimes, but I have much more to look forward to now.
She has very clearly articulated what we have lost as a culture as we attempt to eliminate any discomfort or inconvenience in our lives because of death. This book really changed my perspective:
There is a practical utility in medicalizing otherwise normal behaviors. Particularly in the US, you need a medical diagnosis in order to take time off work, receive disability benefits or access mental health supports through insurance.
I lost someone, a good friend and lover, when I was young. 27 years ago now.
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?
> We medicalize grief because we fear it.
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 point of medicalizing something is to draw a line between situations where it would be too soon for medical professionals to step in
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.
What you're describing is a big problem [edit: for the people who get sucked into it] and, to me, is kind of the "other side" of the overmedicalization issue that this blog is complaining about. One way medicalization harms is is when people are forced into conditions they don't agree with (as the author feels they have been). The other way is when people who aren't medical professionals (and wouldn't be in a position to diagnose even if they were) adopt medical language to describe experiences.
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.
This is a very american trend in my experience. Americans are quite happy to tell you their long list of diagnoses, how that some how gives them some kind of exception to the rule, and how this is some how part of their identity. This kind of oversharing is common across topics from Americans but in particular oversharing of and obsession with psychological conditions seem to be a common modern stereotype of americans amongst my friends who interact with americans regularly.
I've seen this too among some younger folks and I wonder how much of this is simply standard, run-of-the-mill teenage attention-seeking and exaggeration that's not fully outgrown yet.
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".
I'm sure the numbers of people wrongly using those terms has risen at least a bit, but I think the anecdotal evidence you have is likely to be a mixture of that and also not that.
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.
Yes! While I really like the article as an expression and exploration of the authors grief, a professional would not pathologize based on DSM criteria alone. If a person does not feel sick or want‘s not to be diagnosed for psychological illness, then they won‘t be (some limitations may apply).
That said, the writing really resonated with me and i wish Bess well.
I say this with respect and love to the author: it does not sound like you’re handling this just fine. I think you’re right that there’s no way to handle this just fine, and you’re right that you’ve got a very good reason for not being just fine, and it’s in fact very normal and expected for you to not be handling this just fine, but it is also the case that you’re not handling this just fine.
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.)
Yeah, her being confused for an extended amount of time when a friend sits down at the coffee shop instead of her husband is definitely problematic. I think it's weird to write an article attempting to ridicule the DSM in this case.
Not to take away from the article, in the comments she states that her world is filled with the joy of new things with her new baby. She is doing as well as one can be for how much she loved Jake and how much she misses him.
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.
There is a problem with rigid medical definitions. There is a huge difference between the author of this, a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent (as I did earlier this year). Of course it will take her far longer to recover (if at all).
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.
Sorry for your loss, and thank you for your perspective.
>> 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.
I'm surprised by this take, simply because of my own experience, where the further I've gotten from religion over a very long time, the less significant I've found death.
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.
Atheism doesn't presuppose either hedonism or nihilism. This is a common theist libel which is surprisingly popular on this forum of ersatz rational thinkers and logicians. Atheists are perfectly capable of finding value and meaning in their own lives and the world around them, they just don't base that value on a belief in the supernatural. Listen to any astrophysicist, physicist or biologist talk about their field and you'll encounter a wonder and awe that no theologian reciting thousand year old tracts can match.
> Atheism doesn't presuppose either hedonism or nihilism.
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.
All the atheistic/agnostic people I know believe they are insignificant in the grand scheme of nature, not just in the chain of generations of people.
If anything, I find religious people are the ones who believe humans are special.
I think you're right on the word level but I think there's a difference about what significance and insignificance means to these groups.
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.
Equating these things with a "Belief in god" belies a narrow view of spirituality.
Do you really believe atheists are incapable of recognizing the significance of children or of caring about them?
I think it’s medicalized because often this set of symptoms is associated with inability to function and it can be treated medically with eg therapy.
I'm so sorry for your loss. I agree with what you say about "disordered", the language is hostile.
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"?
I think there's something of a pendulum here, and I agree it's swayed too far to over-diagnosing ourselves. But I also think of my father who passed a couple years ago.
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.
In the west we’re trained to believe that if something happens there should be some sort of tangible reward on the other end, no matter how minute. Death takes and leaves nothing tangible and it’s the absence that drives us crazy. Since we’re trained this way we seek out some solution with the other trained aspect, spending money. Which in turn only temporarily numbs the grief until you deal with it.
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.
> We also stigmatize mental health care in the west, telling people to “suck it up” or “get over it”.
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 do not agree. While there may be a flux of people who have therapists, the majority do not and that is why you hear about it on Youtube.
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.
It used to be in the west. The Catholic Church discourages the scattering of ashes for just that reason - so that there is somewhere physical where people can be remembered. There was a tradition of memorial services. People still look after the graves of their loved ones.
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).
> I often wonder how dealing with death compares to the east where ancestors are commonly remembered, contemplated, and revered.
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.
I agree with you on the western religious tradition, but I think it's less true for the secular west today.
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.
> a typical "secular" person thinks of their ancestors as racist people that lived in an irrelevant time,
I think you missed the "stereo" in front of your "typical".
I went ahead and added that "stereo" to my comment. I think you're right, but I also think that stereotype is grounded in reality with a lot of empirical observation. So yes, not exclusive but certainly common.
Well, as a secular individual whose friends group is mostly secular people, I haven't see people express such black and white opinions, but I'm guessing we move in different circles. As far as observation is concerned, we tend to see what we want to see, don't we?
Your made up straw man secular person is, frankly, ridiculous. Like, we all get it, conservative Christians hate the rest of us and look down on us. Duh.
I also think seeking mental health is more popular in the west than the east where it's even less of a thing to seek.
In the way that most people don’t have a routine of that contemplation and remembrance and that individual self, ego, and your future is placed as more important in the day-to-day.
I wonder how traditions around death help us to deal with it. I feel completely incapable of handling death.. I do not know how to comport myself.
A lot! Maybe it's obvious, but I've long thought that religion's primary function is to help people process death (and other suffering). Now that life isn't constant suffering, many of us have discarded religion, but then we are blindsided by death.
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
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
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?
> 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 a broad observation about culture - there's no "alternative" to a well-established culture, no 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've hit on something here; there's an inherent conflict between ruthlessly individualism that tells people they can do anything they put their mind to, and the stark reality of mortality and the limits it imposes[1]. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
An alternative would be:
+ 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 medicalize grief because we fear it.
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?
One of my best friends died 12 years ago in our late 20s. I know he is dead, and yet a couple times a month I think, "Oh, I haven't talked to him in a while, I should text him!" before my logical brain kicks in and lets me know the deal.
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 have been through two very painful deaths, first by brother then my father and both had very similar transitions from shock to acceptance to grief and finally to the new normal. Both cases took years to heal. I stopped dreaming about my brother after about 10 years of his death. It has been 5 years since my dad passed and I still have very vivid dreams that upset me very much, but they are much less common now than say two years ago and I know at some point, like the dreams about my brother, they will stop. Everything succumbs to time, including grief.
Even before finishing the first paragraph, it all sounded familiar to me. Then I looked at the author’s name and remembered, this is the same person who wrote “The Year I Didn’t Survive”.
https://news.ycombinator.com/item?id=43020983 949 points | 7 months ago | 266 comments
I'm pretty sure my dad has chronic grief. My mom passed away from cancer when I was 11. I didn't know how unusual their marriage was until I saw others' marriages. It became particularly clear when I started dating and got married myself.
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.
Having experienced a few hard losses this year (My dad to ALS, and my cat suddenly a week after my dad), the thing that has surprised me the most is how they show up in my dreams. In some dreams, I'm like "I thought you were dead? What am I going to do with all these death certificates now?", in others we're just hanging out at the pool. I never dreamed about my dad before he died. But in these dreams he's just there, and healthier looking than I had seen him in years. My cat shows up too, and many times I remember petting her in her bed, not realizing it was a dream, only to wake up surprised she wasn't still there next to me. In my waking life I fully know they're gone, but at least part of my brain really doesn't want to accept it's true.
I'm sorry for your losses.
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.
> There’s no modern cultural framework for dealing with death.
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.
> Sometimes, I’ll go ahead and dial Jake’s phone number in case the laws of entropy have changed, and he picks up
I should not cry at work but damn, I want to.
[delayed]
Reading Jake's[0] and Bess' posts during his illness was both highly enlightening and also very depressing. The news of his death hurt me more than I expected. I simply cannot imagine the pain Bess has felt.
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.
https://news.ycombinator.com/user?id=jseliger
I experienced a long period of grief as well. I think the grief stayed because I wasn't totally happy with myself.. Then I decided it's time for change and I moved house and changed jobs. That helped me.
I'm still sad sometimes, but I have much more to look forward to now.
Damn this is so sad
She has very clearly articulated what we have lost as a culture as we attempt to eliminate any discomfort or inconvenience in our lives because of death. This book really changed my perspective:
https://orphanwisdom.com/die-wise/
Dying is a skill, both for the person doing it and the people around them.
There is a practical utility in medicalizing otherwise normal behaviors. Particularly in the US, you need a medical diagnosis in order to take time off work, receive disability benefits or access mental health supports through insurance.
I lost someone, a good friend and lover, when I was young. 27 years ago now.
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?