Mental health issues like depression and anxiety are increasingly affecting young individuals. As a result, there is a surge in demand for treatment, and there has been a noticeable rise in prescriptions for certain psychiatric medications. This increase in prevalence is mirrored by greater public awareness of mental health problems. Both traditional and social media are filled with messages concerning mental health. Organizations and governments are urgently working on creating plans for awareness, prevention, and treatment. The growing focus on mental health in society is advantageous as it raises awareness, decreases stigma, and encourages people to seek help. However, there are potential downsides.
Concerns have been raised that social media might be a breeding ground for mental health issues and that normal feelings of unhappiness are being categorized as medical conditions due to the excessive use of diagnostic terms and therapy-oriented language. British psychologist Lucy Foulkes suggests a connection between the increase in attention and prevalence. Her “prevalence inflation hypothesis” suggests that as awareness of mental health issues grows, some individuals may wrongly diagnose themselves when experiencing minor or temporary problems. Foulkes’ hypothesis indicates that people tend to overextend the definition of mental illness.
Our research aligns with this perspective. In a recent study, we found that mental illness definitions have broadened, a phenomenon we term “concept creep.” Individuals vary in how broadly they define mental illness. In our study, we investigated whether those with broader definitions are more inclined to self-diagnose. Self-diagnosis was defined as someone believing they have a disorder, regardless of professional diagnosis. Participants were considered to have a “broad concept of mental illness” if they viewed a wide array of experiences and behaviors as disorders, even minor ones. We surveyed a representative group of 474 American adults about whether they believed they had a mental disorder and if a healthcare professional had diagnosed them. We also inquired about other potential contributing factors and demographics.
Mental illness was common among participants; 42 percent reported having a self-diagnosed condition, most of whom had a professional diagnosis. Not surprisingly, the main predictor of being diagnosed was experiencing severe distress. The second most significant factor was having a broad concept of mental illness. Among those with similar distress levels, individuals with broader concepts were much more likely to report a diagnosis. The graph below illustrates this, splitting the sample by distress levels and showing diagnosis rates. Those with broad mental health concepts (top quarter) are shown by the dark blue line, and those with narrow concepts (bottom quarter) by the light blue line. The former group was more likely to report a mental illness, especially with high distress levels. Those with greater mental health knowledge and less stigmatizing views were also likelier to report a diagnosis. Two additional interesting findings emerged.
People who self-diagnosed without a professional diagnosis tended to have broader illness definitions than those who got one. Additionally, younger and more politically progressive people were more likely to report diagnoses, in line with previous research, and held broader conceptions of mental health. Their tendency towards wider definitions partly explained their higher diagnosis rates. Our findings suggest that expansive notions of mental illness may encourage self-diagnosis and inflate perceived prevalence.
Individuals with a lower threshold for labeling distress as a disorder are more prone to identify as having a mental illness. Our findings don’t directly prove that those with broad concepts over-diagnose or those with narrow ones under-diagnose, or that broad concepts lead to self-diagnosis or real increases in mental health issues. Nonetheless, the findings highlight key concerns. They indicate that although rising mental health awareness improves literacy, it might also lead to incorrect problem pathologization. Incorrect self-diagnosis can have negative consequences. Diagnostic labels might become integral to someone’s identity and ability to tackle challenges, reinforcing the belief that their problems are unchangeable core aspects of themselves. Unjustified self-diagnosis could lead individuals experiencing minor distress to seek unnecessary, unsuitable, and ineffective help. Recent studies in Australia found individuals with minimal distress who underwent therapy often worsened rather than improved.
These effects might particularly impact young people, who are more prone to having broad conceptions of mental health partly because of social media and who report increasing rates of mental health challenges. Whether these expanded illness definitions contribute to the youth mental health crisis is uncertain. Continuous cultural changes are leading to more expansive interpretations of mental illness, which likely have both positive and negative effects. By normalizing mental health problems, stigma can be reduced. However, if everyday distress is excessively medicalized, there could be unintended negative consequences.