“Those who want to attract attention have always speculated on this”: neurologist Nikita Zhukov on the fashion for mental illness

Is there a fashion for mental disorders

Mods have existed at all times. A few years ago, for example, the media began to talk a lot about celiac disease, and in connection with this, even those who were not indicated to avoid gluten began to avoid it in food. Undoubtedly, people without celiac disease can also be sensitive to this protein, and eliminating it from the diet will really benefit them. But such people are much less than we observe.

And the fashion for mental illness is not something completely new: in the last century, the St. neuroses enjoyed no less demand than now. But in Western countries they started talking about mental health earlier - we in the CIS are 50 years behind this trend. Therefore, now it may seem that the "fashion" for inventing mental disorders appeared quite recently.

Depressive states, "psychogenic" disorders, suicidal tendencies - these have always been speculated by those who want to attract attention, arouse a feeling of pity in others or agree on some specific conditions for yourself, ask for something special for yourself respect.

And the point is not in fashion, but in the fact that mental illness is much easier to simulate than any somatic problem.

All psychiatry is subjective: specialists have virtually no objective way to confirm or rule out any disease.

Therefore, always - both before and now - there were people who just like that hung up diagnoses and, depending on their description, corrected their behavior. However, it is important to clarify here: this is not about the fact that a public statement about depression is always posturing.

How the promotion of mental health is changing society and psychiatry

The age of normal civilized psychiatry in our area (in the CIS) is a maximum of 10 years. Before that, in the days of the USSR, punitive psychiatry was widespread, which did not benefit citizens, but served the repressive apparatus: people were massively put on a sluggish schizophrenia with any hint of trouble with the head. And from then until now, most doctors in the post-Soviet space, for example, believe that antidepressants are terrible and “very strong” drugs that you should stay away from.

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

According to my observations, in the CIS countries there is a new serious peak of appeals to psychiatrists and psychotherapists was during the pandemic. People sat at home, finally able to listen to themselves (or look closely at each other) and understand what worries them and does not suit them.

And it brought clear changes for the better.

If now in the capitals in a public place you 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 problems in the psyche 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 what their diagnosis is and what kind of pills they are eating. Why does this disappoint me personally? Suppose two people are discussing the same antidepressant in the same dosage and find out that it affects their mental state in different ways and causes different side effects. In one, this may reduce the effect due to increased anxiety, and in another, it may lead to independent experimentation with changing the dose or stopping 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, then probably because of his disease." And then it can become an unpredictable snowball.

Yes, we need to be more aware, we need to spread the word, but we do not live in a perfect pink world, where you can expect everyone else to be as aware, informed and virtuous as you are myself.

Is it normal to try on psychiatric diagnoses?

When some popular blogger says that he was given ADHD in adulthood and prescribed therapy really made his life easier, people understand that 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 they will ask some available specialist - most likely, this has more advantages than cons. Thus, attention to one's health increases, albeit in a roundabout way.

I have patients who come in with the statement: “It seems that I have bipolar». And in the end, after explaining the symptoms and course of bipolar affective disorder, the person says: “Ah, I see! Well, yes, I don’t have anything like that.” Nevertheless, the fact that they basically 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 in their 20s and 30s who were not diagnosed with this syndrome in childhood, because in the 90s no one cared before. Only now, thanks to the work of popularizers, they learn that, it turns out, their inability to concentrate on any action for a long time is not a sign of laziness, but a pathological condition that can be treated. And this can dramatically improve their lives if the diagnosis is confirmed and the treatment has an effect.

If you notice anxious or depressive tendencies or any other symptoms in yourself, then the main criterion for contacting a specialist is “Does this interfere with life?”, Not the presence of a symptom.

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

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

Who to contact if you need advice

A psychiatrist is a doctor who diagnoses and prescribes medication.

Psychologist - It's not a doctor. He is educated at a humanitarian institute, bypassing the medical unit. Therefore, he cannot make diagnoses and prescribe pills, but he can conduct psychotherapy.

Psychotherapy is not about “lying on the couch and discussing childhood grievances.” Proper psychotherapy is the real training. 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 do you 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.