Maybe we're already alright: Medicalizing the human experience

Thoughts on the dangers of mental health and the money motive...

Maybe you and I are already alright?

This article started out as an answer to an FAQ in my book How to Stick to Meditation: 

I can NOT stop my mind from wandering. I have a “monkey mind” I just can’t get my mind to settle down. Am I okay? Can I even do meditation?

My answer – it sounds like you’re a human being experiencing being a human being… 

Of course the mind wanders. That’s the nature of mind as it was observed by contemplatives, teachers, and sages for the last 3,000 years. But this experience - like feeling “off”, noticing changes in mood, or lacking energy - has been manipulated so heavily by the modern medical marketing engine that we think we are defunct or mentally ill because of it. 

This essay is meant to suggest that maybe, just maybe, many of us are already alright. 

And I offer a counter-prescription to what I call the medicalization of the human condition. This is the intentional, profit-motivated process of identifying an aspect of the normal human experience and marketing it as an illness [1]. 

I’m sick of the mental health business — a lucrative business — trying to market universal parts of the human experience as “diseases” for which you need to purchase a “cure”. 

To illustrate this, let me share a brief history of the invention of anxiety disorder. That’s correct — it was invented. 

In the late 80s a pharmaceutical company discovered a Xanax style drug that you could take to get that “I don’t give a shit about anything” feeling. Then they realized there could be a massive market for it. So they worked with a top advertising agency to position shyness and nervousness when around people as “social anxiety disorder.” Likely throw in a few million dollars of lobbying money to politicians associated with the FDA – and the rest, as they say, is history [2].

So if you’re like one of the ~25% of Americans who say public speaking is their biggest phobia — or you’re like me, a professional speaker who still gets nervous before speaking — then I’m sorry to tell you (and 100 million other normal Americans) that you must have a very rare disease and need to get help.

When you do something new or difficult you feel anxious. Anxiety is defined as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” Of course you feel uncertain about uncertain situations. You aren’t sick. You don’t need a monthly subscription of prescription tranquilizers.

Your mind – and those of all other humans – has a tendency to wander, especially when you’re bored. That is not necessarily ADHD. You don’t need prescription meth to overcome this. (Interestingly, on a chemical level, meth and Adderall are almost identical – meth has an extra carbon atom and three hydrogen atoms…)

Note that this is not a criticism of doctors or mental health professionals inasmuch as the dynamics of the mental health business currently at work in our culture which these professionals are forced to operate within. What’s more, mental illness is very real and I don’t want to minimize that.

But what constitutes mental illness is largely subjective.

When I broke my nose last year I was covered in blood with my nose on sideways. There was no question of whether or not something was “wrong”. But when I feel down, it’s up to me to interpret how down I feel. Is it “wrong” (in the sense of disease) that some days I wake up feeling pretty energized and extroverted and other days I feel somber and want to keep to myself? I think it’s largely up to me to decide if I’m bipolar in this case.

The problem arises when my self-assessment has been so grotesquely and abusively biased by advertisers. No amount of advertising will convince me my nose is broken when it’s not. But advertising has serious pull when I wonder if it’s normal that some days I feel good and some days I feel kind of lousy. And if we consider the economics of the situation, advertisers have a vested interest in convincing us that something is wrong with us and we need them to fix us.

The danger is this rampant messaging that something is wrong with us becomes a self-fulfilling prophecy. When I feel day-to-day variation in mood I’ve been conditioned to assign the following narrative to it.

I feel kind of low today, am I depressed? Am I bipolar? Now I feel anxious because I think something is wrong with me. Now I have anxiety which makes me feel uneasy and unable to think clearly. Uh oh – brain fog is a symptom of depression – I must certainly be depressed. I have depression. Now I’m not going to be able to do anything. I’m never getting out of this. I need to get help. I feel so anxious now!

Again many people have legitimate depression or anxiety disorder.

But ultimately, what constitutes a “disorder” is up to us. When I feel my mood vary I tend to think that the human experience is like the weather. Some days it’s a little rainy and overcast. Some days it’s nice and sunny. Our personality is the climate – the general range of weather patterns. Our day to day variation in mood is the normal variation in the weather. 

A final element of difficulty in this whole confusion of marketing mental illness is that the symptoms of depression are identical to the symptoms of what we might call “shitty life syndrome” (SLS).

Consider two hypothetical examples – Jane and John.

Jane is a 27 year old senior manager at a large tech firm. For the last five years she has focused on climbing the corporate ladder and hasn’t paid much attention to anything else. She makes a ton of money which is spent almost entirely on her $5,000 per month flat in downtown San Francisco and frequent fine dining. Outside of some nice meals and online shopping she doesn’t have much time for leisure outside of her 60 hour work weeks sitting in front of a screen.

Her company is making a big difference in the world though – it’s a massive distraction engine which systematically diverts users’ attention away from their precious lives into 140 character fodder (which coincidentally is the perfect length to convince people that something is being said without actually saying anything at all). 

Jane feels very anxious, frenetic, and neurotic. She feels as though she’s not contributing a whole lot. She feels a bit burnt out and has trouble focusing at work and can’t sleep.

John is a 40 year old man living in Tuscaloosa, AL. Neither of his parents graduated high school. He grew up in the “bad part of town”. When he was 17 years old he was busted for smoking weed and has a felony charge on his record. This means that despite his work ethic he will probably never be able to transition from hourly to management. Further, he doesn’t have the financial or time resources to pursue further education because he must maintain two full time jobs working minimum wage in order to feed his two young children.

John feels disillusioned with his life. His physical and mental health are deteriorating.

So here’s the question – does Jane have anxiety disorder and ADHD? Does John have depression?

These examples cast a light on our present predicament around mental health. Depression, anxiety, lethargy, and disillusionment are healthy reactions to an unhealthy world [3]. The underlying issue is our brains and nervous systems are reacting to the stressful and often traumatizing world we've built for ourselves. What looks like a disease is really an adaptation to a diseased environment. (Borrowing from some commentary from Andy Johns at clues.life).

Again this madness and lousiness that we often feel is the symptom – not the cause. The medical advertising industry has medicalized the natural human response to the inhumane circumstances that confront us in the modern consumer world.

What Jane and John really need is not a cocktail of pharmaceuticals. They need change. We need change.

So as I wrap up my diagnosis I’ll say one more time that mental health issues are absolutely real and should not be stigmatized. And in all likelihood our attention deficit disorder is a learned adaptation from tuning out of unpleasant childhood experiences, habitual overstimulation from technology, and the natural boredom of meaningless transactional work [5]. Our anxiety is feeling uncertain about things that are uncertain; our bipolar disorder is the day to day variation in the human experience; and our depression is the deepest part of our being telling us that things in our lives and in the world around us need to change.

What many of us have is being a human being disorder (BHBD). And the treatment plan is first, knowing that you’re already alright. To recognize that there are ups and downs in the human experience and that, an “unhealthy” response to incredibly unhealthy circumstances is actually quite healthy. 

To recognize your own suffering and the suffering of others is your birthright.

That brings us to the second phase of treatment. You don’t need a pill to take intentional action towards reducing your own suffering and the suffering of others. In all likelihood you’re either a Jane or a John.

If you’re like Jane you need to overcome the cultural conditioning of hyper-active economic competition at the expense of self-care. Detour towards your health, relationships, and spirit. 

I’ve lived my whole life as a Jane. So if you’re a John the most I can offer you is this: a few of us Janes are working on it. So keep doing the best you can. And know that my heart breaks for you.

Your happiness nerd,

Jackson

[1] A summary of medicalization – https://doi.org/10.1111/j.1467-9566.2008.01145_1.x 

[2] A detailed and formal account of this history -- DOI:10.1007/978-94-007-4276-5_4

[3] A detailed thesis about this – The Myth of Normal by Gabor Mate

[4] An insightful analysis of the origin of ADD search “Is ADHD a disease? by Gabor Mate”