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.
The fake death thought is very common. My brother drowned at the beach when he was only 17. We all stood there helpless, unable to find him. His body took some time to return to the shore, and a friend of a friend of the family was the one who identified him.
I was very young, only 7, but my cousin, who was 15 at the time, spent years searching for him, convinced the body had been misidentified. Later, when I grew older, I also went through the phase of thinking, "He was too smart and strong for that. Maybe he ran away somehow."
My best friend of 25 years died 4 years ago and I still think of him at least once a week, wishing I could talk to him. It was almost a year before I could even talk about him without completely breaking down. I never once thought: "oh, this is a medical issue". It was just me having the same problems processing my grief that American men have because we're not raised to talk stuff out. Once I did start talking about it, it got easier and easier to deal with.
I still randomly gmail my dear beloved best friend who died of melanoma 18 years ago. It goes into the ether. I hope gmail doesn't reassign his account to someone else for inactivity, they will get my "thinking of you, miss you, this thing happened that you would have found hilarious" emails.
I heard about people that would keep the voice mail of a departed loved one on their phone undeleted. They would replay it from time to time to get the feeling that they are still there. Also they would wear their clothes to feel their presence.
Grief is a very difficult emotion and I like the analogy of it being a deep ocean. When you experience profound grief you are dropped almost immediately into that ocean. If it is your rodeo with grief you don’t know how to swim. You don’t know where you are. You are in an endless night of depth. You may not even know you are in the ocean at first. Your brain is simply drowning. Some constant in the mind’s universe has changed. Abruptly.
I don’t believe, completely in the narrative of American men not taking stuff out, but it is a factor. The underlying issue for not talking stuff out is ensuring you feel understood. That you are not alone in this experience. That grief is okay, normal. That you have been taught a life philosophy that encompasses grief. That it can exist without consuming all. It helps anchor these powerful emotions. There are other ways to achieve this, everyone will have their own strategies. I do think you have to have a philosophy and process to handle grief however you do it.
I believe in acknowledging grief and practicing Stoic style thinking to stay present. It really helps me to acknowledge the moment is precious. Wrenching on a car with a buddy. Sitting at the dinner table with your family. Acknowledge how special that is. That it won’t last forever. Cannot. Tell them and yourself how special it is. Visualize life without that moment anymore. Bring a little grief to the every day and present as a part of our human condition. It is okay! It is not spoiling the moment if you are using that emotion to fully experience the present.
Grief as many people experience and process it is almost always the past. Even simply acknowledging it as the powerful force in our mind can help tame it. Observe the grief so to speak, see it as an observer. I am glad you found your way. Everyone should think about grief and talk about it. Just part of us.
When I first encountered this description of grief it really resonated, but it's felt less poignant as I've gotten older, partly because I find myself grieving people who still live, and are simply too different from how I remember them or how I thought I knew them to support the relationships I want to have with them.
I suppose the principle still holds: the "love" I have for those versions of those people cannot go anywhere, but that feels dissonant with not wanting to know these people as they are, or knowing the relationship I'm wishing for is otherwise ill-fated. In either case, the relationship cannot continue, and that drive the sense of grief anyway, so maybe I'm just splitting hairs.
Such is the complex nature of grief and of human relationships, I suppose.
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.
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.
I find that surprising in turn! What were the beliefs you had around death?
I can sort of see why you found it less significant, but in monotheistic religions it is still pretty final. It is still the end of the one life you get, even if it is also the entry into something completely different and better.
I typed out the response below but I'm not sure I have a coherent response as to why the secular zeitgeist of death is less intimidating to me than the religious context of it. (Though, I'm not who you're replying to.)
I think it comes down to the sheer amount of pressure I felt within religion to be a certain way while also being told I could never be that way enough to achieve satisfaction in the eyes of god, and outside of religion I'm just another person in a flawed world trying to do my best.
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At the risk of being redundant, death within religion isn't an end, but yet another beginning. Eternal life is the reward for being a diligent disciple, where that means internalizing one's inherent flawed nature and inability to be redeemed but through death in devotion to god... which is a hell of a weight to carry throughout ones' life!
The Christian ethos is woven through with constantly being judged. And forgiven, yes, in theory, but still there is a constant undertone of "you cannot avoid making mistakes, and the mistakes you make are so offensive to god he wouldn't want you anywhere near him, but for magic religion reasons you've been redeemed by god doing something so terribly debased that it outweighs all the awful mistakes you've made."
Death (and "everlasting life") is no reprieve from this, but a form of stick that weighs heavy over you all through your days. You must work to save those around you, or they'll be eternally lost. You must cleave to the teachings of god, or at the very least belief in him, or you'll be eternally lost.
Since I left the church so many things of import that I felt I didn't understand now make much more sense; I struggled to comprehend how god could allow suffering, but now I see that the universe is just absurd and uncaring. While that may seem less comforting, I find the notions of bad things happening randomly less upsetting than there being an all-powerful being who cares about me but chooses to let me suffer for reasons that were never convincing, and as I've grown older sound more and more like an abusive relationship.
Through that lens, death is just a natural consequence of the world. Scary, yes, in the sense that I may not live up to all I want to be before my time is up, but I'm not pre-marked as eternally flawed and only redeemable through processes that do not make sense to me. Instead I know that I can only do my best, and that has to be enough, because I can't possibly do more.
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.
You're welcome. I'm glad I was able to clarify it.
It's not the first time I've made such a clarification - it's a very human impulse to defend your belief system from unjust attacks that aren't actually there.
Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking. We're used to thinking we control things, and can get anything we want. One thing useful from the religions was having a healthy sense of your own limitations, or you could say a sense of wonder or mystery or perspective. A reminder that you're not the most powerful thing in the universe. Which is true, and healthy to be aware of, whether any god exists or not.
Edit to add: There are few places where that hubris and certainty tend to be more pronounced than among doctors. Part of what this woman is grieving is probably the loss of certainty, of control or the illusion thereof.
> Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
It maybe a factor, but I do not think it was the main one. Death is still very hard to cope with, regardless of religious belief. There are other things behind religious belief, mostly experiences.
> I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking
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.
No, I don't believe that. I valued children just as much when I was an atheist as when I became religion.
What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not. I work in FAANG and previously in finance, so my peers are people who can certainly afford kids and are positioned to take care of them - and yet literally most are choosing to do something else.
I am not commenting on a universal attitude, I am commenting on a significant trend that I think is obvious.
>What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not.
Do all of your religious friends subscribe to the same religion?
If so, does this religion proscribe having children and raising families as a necessary, or desired, component of the faith or community?
Because you could be confusing religion and culture here. Secular values often abrogate traditional gender and sexual norms, so secular people may not feel compelled to "be fruitful and multiply." I wouldn't ascribe that to lack of religion per se so much as not being affected by the same cultural pressures. After all, plenty of theists are essentially forced into marriage and children because it's what's expected, not because it's what they want.
I am not sure "culture" and "religion" are separable in the long run but I don't think that aligns with the point you're making.
Religious people see "be fruitful and multiply" as a literal command from G-d and one of the fundamental points of religion. So while religious culture can evolve, the evolution of this attitude isn't a flexible point.
On the flip side, secular culture has no intrinsic reason for "family values" - which is why, I think, atheist culture over time devolves to childlessness - because reasons "why not" are more immediate and in your face, vs "why yes."
So yes it's "culture" but what the culture is is obviously determined by your underlying beliefs and that which you consider eternal and that which you consider negotiable.
>which is why, I think, atheist culture over time devolves to childlessness
I don't think the data supports this, yet. Religiously affiliated completed TFR is 2.2 while unaffiliated is 1.8. However, completed TFR means this is looking at those older than 60, so expect those numbers to drop in the future.
From my observations, TFR is not much different between most people who describe themselves as religious and most people who describe themselves as non religious. However, the TFR is different for those who I would describe as the most religious, compared to the "casually" religious/non religious.
Totally agree, even without reading your links. What matters is the actual faith in Gd. I see this myself. We're members of two temples - one more orthodox and one more what you'd call casual.
The people that show up to the casual one once a year or even a few times a year aren't really "different" than someone who doesn't bother to show up. It's good they are there but the religion isn't influencing how they think and act - which is why the TFR is similar between casually religious and casually non-religious.
Where things differentiate is on the extremes. Someone explicitly atheistic (vs just non-religious) has a TFR around 1 from what I remember, while orthodox and ultra-orthodox have 3.3 and 6.6 respectively. What makes the difference is the degree to which they allow the religion to permeate their mundane existence, which is a factor of faith.
This doesn't seem to track with broader sociological trends. For example, let's compare the USA, one of the most religious Western countries, with the USSR, where 60%+ of the population was atheistic, and where the state promoted atheism. Between 1960 and 1980, the US population grew from 179M to 226M (a 26% increase). The USSR population grew from 208M to 262M (a 25% increase). So, despite massive differences in religiosity, the population rate was pretty similar. China, another largely atheistic state, grew from 582M to 1B in roughly the same period - a 73% increase.
So while it may be true that certain small deeply religious populations are more incentivized to have children, this doesn't seem like a significant effect at population levels overall. You'll also find small non-religious groups with similar behaviors.
Putting aside the question of whether your own experiences hold for the general population, you must consider why these opinions are so prevalent, either way. One might argue that religion doesn't teach 'values' so much as 'roles', and so people feel they must do these things, not for any significance or with little thought to possible negative repercussions, but simply because... well, that's just what you do, right? Find a partner, have kids, go to church. That's the lifestyle religion teaches. One might also argue that secular people aren't as intent on having kids because they're more willing to accept different lifestyles.
For what it's worth, krapp's comment is better written but is what I'm talking about here.
I probably agree with most of what you wrote, but at the end of the day, the difference between 'values' and 'roles' seems insignificant to quibble about in the face of the result we're talking about here.
This is not even slightly true and seems to be based on a profound misunderstanding of atheism. From my perspective as atheist since the age of 11, it's the reverse of the case.
> 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 single forum 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're on to something here; there's an inherent conflict between ruthless individualism that tells people they can do anything they put their mind to, and the stark, limiting reality of mortality. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
Collectivist cultures already embraces the idea that one's life is more than just about the individual, so grief and talking about death are far less radioactive. Religions that embrace ancestral spirits being presence offer comfort in continuity; her husband isn't really gone, and he may even watch ober their daughter, and even help her in math exams. In that light, dying is less of a big deal - more of a transition really - compared to oblivion, which is super heavy. I'm not saying these are better
+ 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'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 my understanding ADHD is one of the few conditions that is extremely well studied and consistently appears to be a certain % of the population regardless of nationality with very strongly correlated negative outcomes with their suite of symptoms. I'm talking addition, obesity, and a shortened lifespan directly related to their ADHD. This seems like a disorder to me. If someone has attention difficulties and can function fine they obviously don't have a disorder vs someone who has attention difficulties and as a result becomes addicted to cocaine.
Function in what context? I have been diagnosed with ADHD at age seven. I have had many checkups and am currently medicated. I can tell you that I wouldn't need to if I didn't have to work a menial wageslave job. Interestingly I can focus perfectly fine when doing interesting stuff without medication and it has always been this way. What you are saying is that there is some proper definition of disorder, which would sensibly be defined relative to some "normal" human baseline. Tell me you know one "normal" human, why you see this person as "normal" and how it would be useful to use this as a reference for the big spectrum of human personality and mental fitness. I can tell you from experience that I didn't need medication when I wasn't forced to attend 12 useless meetings a week, use inefficient and stupid software and one would just let me get my shit done. I have quite a few friends who have had very similar experiences, and the idea of ADHD is just used to pathologize and medicate someone so he can work and be a "positive contributor" to whoever above them. Add here the necessary disclaimer that my experience is not universal and there may be people gravely suffering from it, etc. I do too, even with medication, but at least I can generate some bucks for management.
And what I know with ADHD is that the incapacity to handle dumb meetings is just one definition of functioning. Maybe you don't need medication to clean yourself enough to prevent skin issues, prevent addiction to substances, compulsive criminal behavior, avoid hoarding behaviors, have a safe living space, have the capacity to maintain friendships/avoid loneliness, engage with social interactions in a mutually respectful manner etc. But most people I know with ADHD severely struggle with at least one of the above and I consider that functioning, not just holding down a job. My understanding is not on the level of "can you do bullshit work" but it is "can you clean your dishes before they stink" and "can you respond to being turned down by a girl without blowing up your life".
I'd be willing to bet that there's some percentage of people who don't have ADHD, but they're also not capable of adapting to and meeting the unnatural demands school and work place on everyone and so they struggle in those environments where most people don't. ADHD medication still helps them overcome that difficultly and those medications can make a huge positive impact on their lives as a result. I'm okay with that.
Maybe we should have a different diagnosis for those kinds of people entirely and leave ADHD to the folks who couldn't accomplish what they wanted to do even if they never had to work, go to school, or follow a schedule set by another person. In the end though, what you call it doesn't matter. Both situations are thankfully improved through the use of the same types of medications. Medications which are pretty safe and can mean the difference between being able to support yourself or failing to.
I'm okay with a wider spectrum of people falling under the ADHD umbrella even if some of them don't like being lumped in with people who really do have an executive function disorder. Odds are good those people wouldn't like whatever new label doctors came up with to describe them either. It'll pretty much always carry negative connotations because ultimately, it means that you don't have it in you to do what most people are able to do just fine.
I'm autistic which is also a disorder. Like ADHD it's a neurodevelopmental disorder because from a scientific and medical POV the brain developed abnormally compared to a neurotypical person's brain.
I guess your point is why does it require a label at all but science abhors a taxonomic vacuum, everything must be classified and if so I'd rather it be a disorder than a disease or illness.
Of course this opinion is just mine, I have no idea how other autistic or adhd people see this as I don't keep up with the neurodiverse community and what words are considered good or bad.
The DSM-5 defines ADHD as "A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or
development". If you're functioning fine, then by definition you don't have ADHD.
>> For some people this is problematic, but others can function fine and happily with this.
In that case I would say it’s not ADHD, which as its name suggests is disordered. If the ADH part isn’t negatively impacting your life why would it require a diagnosis?
>a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent
This isn’t really your point, but this person lost their husband at 40. By some definitions, that is middle aged. In the general view of things, not young.
That doesn’t really change much, but I was thinking of a mid-twenties before I realized who it was.
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
This is one of my favourite topics.
I had forgotten to bring "cowardice" to the table when thinking about death (etc) I've mostly thought of it as some kind if vague unspecified fear, thank you for injecting this word and concept into my jumble of thoughts.
I've been using "dignity" to try and make my thoughts more clear, but cowardice clearly has a place at the table too.
When thinking about suicide I have thought of that way to die as potentially needing bravery (as in being able to do something you fear).
The topic of death is dear to me me not only for personal reasons but I also think this relates to quite a few aspects of our societies and not only the obvious ones like how (if we can afford it) seem to overtreat people medically rather than give them proper palliative care and their close ones time and space to be there at this grand moment in life, that death ultimately is :)
It feels weird to use words like: bravery, cowardice, dignity and fear, they feel like from another era, possibly only a fictional era of knights, damsels and dragons.
And somehow I sense that that feeling of weirdness somehow is connected to the medicalisation of "everything" and also our longer work hours and expected increased efficiency. As if we hide and disallow the big important things in life only then will we agree to work the way we do.
But then in the other hand we can cure a lot of disease and I can type this on a tiny screen keyboard and post this to the internet, so...
I don't know, I only know that there is something wrong with death.
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 think for people over 50, I guess "Gen X" and older, this is still often true. I've never considered therapy or medical help for any way that I was "feeling" and certainly have had times of grief and loss and sadness in my life. In some of those moments, when peers or friends noticed it, the gist of their advice was to “suck it up” or “get over it”.
I am also introverted, procrastinate, am not very organized, and am not very good at housekeeping. My view on how I would change those things would be to just suck it up and do better, if I had to. And when it matters, that's what I do.
I don't mean to say that this is the only correct way to approach life but it is how I look at things.
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 or even passive-hypochondria.
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 agree it’s not a simple divide. I was trying to paint that there are many reasons why we handle death poorly in the west and I honestly only know a raindrop about the east. I can only fathom the handling of death and the reasons why gradients across the globe in every direction.
> 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 friend 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.
That's moving the goalposts. Implying that people do not go through that remembrance vs implying that they do not do so on a set routine are not the same thing.
Not to mention that such a routine might very well be part of the medical therapy that we are talking about here.
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
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?
> There is a certain cowardice in how we deal with death in the contemporary west.
It's because we have a dearth of true elders right now.
Not in age, but in temperament and learning.
I got interested in story telling during COVID and managed to find a great author (K.M. Weiland) that went in deep on the archetypes of story.
Her hook was essentially: "What happens after the Hero's Journey/happily ever after?" And then she got real deep on her idea of the 6 phases of life. Her work is properly about how to write a plot, but man does it apply more broadly.
The pertinent one here is the 'Crone' stage of life [0]. You're no longer the 'King' of your little fief, you had to give up the power and make way for the next generation. But now what?
The journey of the Crone is essentially learning that Death is a part of Life, that Death is not Evil, Death is a Friend.
K.M. Weiland admits that less and less people ever make it through the stages as you go along.
But, I think right now in the West, we have a lot of boomers that never really progressed past the Hero stage, let alone the Queen or King stages. There should be more Crone and Mage people around, but the boomers were retarded in their development. Just look at RBG, Feinstein and Pelosi (to name but a few), grappling on to power like the Tyrants or Sorceresses (strong shadow archetypes of the Queen and King) and never letting go, to the classical harm of the kingdom/hearth that such stories tell.
Facing Death is hard, very hard. But is something that we all must do. Realizing that Death is not Evil, but a part of life, and one to be welcomed at times, that is something that very few of us can do.
I've always been averse to this sort of Jungian schema (it's a Freudian baggage I have -- Mourning and Melancholia has much value on the present topic!), but more and more I'm seeing how much wisdom was lost in the historic disavowal of myth and archetypal thought. Since having a child, my wife and I have been repeatedly stunned at how incapable our own parents are. I don't mean a mere absence of help with babysitting (although they suck at this, too), I mean they just have no idea how to deal with us or our kid as living beings. They shrink at the first sign of difficulty. They want absolutely no relationship with death. We've had to find new elders elsewhere; they really aren't easy to find but they do exists.
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.)
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.
> She is doing as well as one can be for how much she loved Jake and how much she misses him.
Again, my point is that that statement is absolutely true and also does not preclude the notion that additional professional help may be warranted.
I went on Prozac earlier this year after a conversation with my doctor that went, roughly: “I think you’ve got anxiety” “well yeah, look at the fucking world!” “…right.” Just because there’s a good reason for what you’re going through doesn’t mean you’re not going through it.
Put another way, if the author had been shot a year ago and was saying things like “most days I’m fine, but some days I literally cannot walk or feel my left arm,” the notion that they should be talking to professionals would not be controversial, even though their symptoms are absolutely utterly explicable given what they’ve been through.
Consider that the author may elect to this suffering as a testament to her love for her partner and as a way to memorialize what he meant to her.
If your partner died and the very next day a doctor said, "Here's a pill that will make you forget you were ever together and erase 100% of the pain. You'll feel amazing." Would you take it?
I would very much like for the author to be able to memorialize her partner in a way that she feels offers a testimonial to someone who was such a big part of her life. If she's able to do that right now, that's fantastic (and this post is certainly a well-rendered testimonial). The point of getting additional help (and, again, as stated above, I mean therapy, not necessarily drugs) is to ensure she can do that - to provide the support, structures, framework, and understanding that she can make those choices consciously and in a way that allows her to feel as though she's honoring his memory in the best way she can.
Usually I would agree with your points, especially that wounds on the soul should be treated like wounds on the body - objectively, and with the best practice medical support for proper healing to minimize adverse effects.
But as she so eloquently puts it, the grief is not just a wound, its a lifestyle change. Its the repetition of existing expectations and systems that have to be retrained and rewired.
Professional help can help numb feelings but when it comes to retraining your entire life, as she also implies, professional help is only medically necessary if you are completely debilitated and unable to do the retraining yourself.
Professional help is only as helpful as it can do it better than she can. And I think because it involves lots of instances of processing her own feelings, that kind of help is difficult to provide medically.
Support groups I can understand helping her situation though.
To be clear, I'm not advocating for chemical intervention - I think a competent therapist/grief counselor can help process and metabolize the change. I also am not suggesting that the ideal goal is that the author feels no grief, rather that she is able to move in a productive and healing direction, as opposed to feeling like she's being battered beyond her control.
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.
the reason to NOT have a DSM-recognized diagnosis on your medical record is it can be used to disqualify you for things later in life.
And we cannot predict all of these future changes, either in our interests and/or the law.
"We don't want pilots with depression or anxiety, because duh obvious reasons" and there goes a career option for you. (something very like this happened to my cousin)
That's an interesting example. On the one hand, we really don't want actively suicidal pilots. On the other, are the current guidelines too stringent? I can't imagine you're saying that actively suicidal pilots should be allowed to fly hundreds of people, so the argument seems to be more that private corporations have too much information and too much power and are willing to blacklist qualified candidates just to reduce examination costs.
That seems more like an argument against corporate overreach than anything else.
The problem is that the policy incentivizes pilots who develop problems to hide them. So pilots who should take time off to work through problems are instead flying planes, because the alternative is losing their career.
The pilot restrictions definitely need a revamp. Any diagnosis or medication can greatly restrict you for a long time after, incentivizing avoiding treatment completely.
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.
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.
Assuming the days you took off from work because of depression were unexpected and not planned in advance, why did you feel you had to explain anything?
Why couldn't you say: "I'm sick and won't be at work today."
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 mean, I have no data for this, but I think it's a combination of two factors:
- Access to mental healthcare here is HEAVILY gate-kept by a combination of it often costing quite a lot of money, generally having longer waits than most healthcare services, heavy variability in availability by location, and insurance coverage runs the gamut between great or utterly absent, sometimes even in the same policy depending on what you need. Self-diagnosis is for many people the only diagnosis they have access to, and even if it's wrong, you can often use whatever diagnosis it is to find coping mechanisms that help you, or substances that will help you self medicate.
- Naming something medically is the only way to get institutions to pay attention to it, which can mean a number of things by itself, from getting appropriate accommodations at work or school, to getting certain kinds of coworkers or authority figures to treat you in a way that's more amenable to your mental state.
And I don't think its wrong to make it part of your identity either. Some definitely take it to a weird, unhealthy place, and also most of those people are teenagers. Teenagers do tons of stupid shit, I did tons of stupid shit. It's just part of growing up. But ultimately... it is part of you that you're going to be dealing with probably forever, so, some amount of identifying with it is probably healthy.
Edit: Also not sure how to read you calling this "oversharing?" Like I guess it could be depending what it is, but I dunno, my wife has BPD and a touch of Autism, she doesn't announce it when we meet someone but it isn't a secret either.
Everybody wants to be the one who overcame the odds or struggled bravely on. Everybody wants their story to be special because of how hard it was for them compared to everyone else.
I think some of it comes from the value the culture places on underdog stories and some of it comes from the oversaturation of everything in modern life.
I think some of it also is an overcorrection from how taboo it used to be to discuss mental health previously... so now oversharing is encouraged vs suffering in silence.
Americans, and I am speaking in stereotypes and not about a particular person, don't respect personal boundaries on topics that other cultures would not discuss openly with someone they don't know well. Like for example, you tell me, a stranger on the internet, that your wife has borderline personality disorder. That would be oversharing if we had just met in a social setting and were discussing this topic together.
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".
There’s also that linguistic phenomenon where you have to use stronger and stronger language to signify the same thing. Maybe we just think it’s ridiculous because we’re the older generation. Or at least that could be part of it.
> 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.
The thing is, many people have valid reasons not to trust the medical system. Not so long ago:
1. Homosexuality was considered a mental disease
2. Forced sterilization of minorities was good medical practice
3. FDA ignored warnings about pesticides being potentially harmful because that would be bad for business
4. FDA ignored warnings about pesticides being potentially harmful because that would be bad for international politics
5. Entire field of psychiatry was just basically random shit, it's not until very recently that we have any actual scientific knowledge
6. Pregnant women were presribed medicine that fucked up their fetuses
Not to mention that most likely when you go to a doctor you're not getting state-of-the-art diasgnosis, most likely the doctor is just a random guy doing his job, sometimes better sometimes worse. Personally I don't trust medical system with my mental health because medical system is a product of a society that made me have mental problems in the first place.
I mean I live in Germany where Hans Asperger oversaw the mass killing of autistic children. He decided which one were to be murdered or which had the "right kind of autism" i.e. Asperger syndrome and could serve the fatherland. (Just to be clear, the differentiation between autism and Asperger has not and had never any scientific leg to stand on.)
The term Asperger syndrome was only removed from the DSM in 2013.
For autistic children something called Applied Behavior Therapy is still the most common treatment. It is the same thing they use in gay conversation camps. Yes, literally. It can be super traumatizing to autistic children.
The way we treat neurodivergent people is absolutely abhorrent.
That said, the main issue people don't get a diagnosis is not lack of trust but lack of access. Most people can't afford it or are not able to jump over the bureaucratic hurdles to get it.
Germany is notorious for being shitty to people with mental illness. Even people with something as common as ADHD struggle to get the care they need there!
On the subject of Asperger syndrome, after learning about the history I was surprised that there are people previously diagnosed with Asperger's syndrome who were (and still are) very angry about the term being removed resulting in them being lumped in with everyone else diagnosed as autistic.
Being labeled as "autistic" could mean anything from seeming a bit strange but being highly intelligent and perfectly capable, to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care. Some "Aspies" saw Asperger's as a very convenient way to differentiate their particular flavor of autism. Convenient enough that the usefulness of that distinction far outweighed the shadow of the terrible origin of the name itself and also the fact that it hilariously sounds like "ass burgers".
Personally, I'm glad that Asperger's was removed but I have to agree with the Aspie crowd that they got screwed over when no new term was given to replace what they had. The still grossly overbroad "3 level" system is trash. The spectrum of autism is so wide that the term is nearly useless.
> could mean anything from seeming a bit strange but being highly intelligent and perfectly capable
No, everyone that is diagnosed under ASD has some sort of care needs. If you are just a bit strange and it is not disabling in any form, then you are just strange.
People see autistic people on the internet and seem to miss that video editing exists and that the they are seeing just a very specific and carefully chosen part of this person. They are seeing the highlight reel not daily life that can look very differently.
One of the fears with removing Aspergers was indeed that some people diagnosed under Asperger might not be diagnose under ASD as it is arguably stricter.
> to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care.
The problem is that many people see things as single line from low care needs to high care when in reality it is multi dimensional. Just being non-verbal does not mean that one is not intelligent, that is a huge stigma that non-verbal autistic people suffer. Many autistic people struggle with sensory issues but some don't. You might struggle heavily in one area but not so much in another.
If you know one autistic person, you know one autistic person.
> The still grossly overbroad "3 level" system is trash.
It is a step in the right direction because it realizes that care needs can change over the course of a persons life. You are born autistic but how disabling it is for you can change depending on how much help you get. It can get better or worse depending on your life situation.
Otherwise you have a current situation where people assume it isn't worth giving a non-verbal autistic child a proper education because they they think that they will never be able to life on their own anyway, acting like their outcomes are already predetermined. Or when someone with Asperger is assumed to never have serious care needs.
That said, people that have been diagnosed as Asperger, I don't correct them if they cling to their diagnosis. It is the diagnosis they have identified with for years or decades and if it what works for them then that is fine.
Still the new system is a good step in the right direction. Not perfect but better.
The dilution by people with no formal diagnosis become more common is scary because of how it normalizes not seeking help, which is the hardest part of actually having these issues. It creates this illusion that one should be able to treat themselves and that things like sitting at your desk all day thinking it wouldn't be that bad if you died in a car accident, or having your heartrate spike and sweating profusely while you thoughts are paralyzed are normal things that happens regularly to everyone so your inability to deal with them is a personal failing. They are not and if you do feel this way try and seek assistance from a experienced professional.
Standard among previous generation was to not seek help, stigmatize those who do, mock the issues and generally not even have vocabulary to talk about them.
This is very true, we are in a better place than the previous generation but there is still room for improve and a over abundance of something can be a problem just as easily as the absence of something.
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.
>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.
I was with you up until this point. My wife has C-PTSD, Bipolar type 2 and ADHD, along with what her psychologist describes as "Social OCD". I can't tell you how many times I've had to explain to other people that her mental illnesses are real and some days she and I just can't hang out because she smelled a smell that gave her flashbacks. Because people have normalized the language, they think "triggered" just means upset. For someone with real PTSD, it doesn't mean upset, it means their mind has come unstuck in time and they don't know who to trust or sometimes even what is real. Sometimes this lasts 5 minutes, sometimes it lasts almost all day. She just loses that time, and all I can do is try to calm her down and try to get her to take medication to re-stabilize her.
My wife has been in therapy with a PhD psychologist for 11 years, and only just this year has gotten to the point where it seems like she could probably hold down a job and keep her trauma compartmentalized like most people do all the time. People normalize the language for these debilitating full-blown disabilities and then don't understand the gravity of the situation when somebody with a legitimate mental illness of that sort of degree comes along.
Co-opting medical language for sub-disorder level dysfunctions is bullshit. And that's fine, when you're just bullshitting with your friends or whatever, but how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
I would posit your issue is not in co-option of terminology but in that ableism is still rampant and these are people who wouldn't take your wife seriously even if you described her symptoms. I have conditions that people do not uwu cutesy about on tiktok and people still illegitimate me when it inconveniences them slightly like canceling plans. People playing down disabilities the disabilities of others is extremely common. Being able to be flexible and accommodating to any degree I can to someone's disability has nothing to do with whether or not I think it is legitimate, and gating my flexibility to whether or not I personally judge someone's disability as legitimate is ableism plain and simple.
I upvoted your comment because this is also a huge issue. I just find that the co-opted terminology does worsen the quality of dialogues about the co-opted terms. People need to have the symptoms fully described for them in detail and sometimes don't believe me or think I'm exaggerating because it doesn't match their preconceived notions of what those words mean.
I'm not saying that the problem isn't ableism, it absolutely is, just that the co-opting of the terms is still harmful in that it uses up spoons and makes it harder to communicate clearly, especially with those who are stuck on the pop-culture meanings instead of actual medical meanings.
I flagrantly disagree that disbelieving someone's disability or believe someone is exaggerating because it doesn't mean their preconceived notions is something that can be helped if the culturally known depictions were specific to your wife's depictions. This is the mental health equivalent of yelling at someone in a wheelchair who can stand for short periods of time. Disbelieving someone about a disability assumes I am even capable of telling who is "really" disabled, which is an ableist belief that will not go away even if all the TikToks that say they were triggered by a minor toe stub disappeared.
In fairness, I believe that people who make jokes and light of disability suck in that I also believe this is an ableist activity. And I fully believe you that this kind of uwu-ification of disability is used as justification for ableist people to behave shittility towards your loved one.
It's not really a matter of it entirely solving the issue. As the other commenter is trying to stress, these are 2 separate issues, even if 1 underpins the other. We can and should try to solve for both. The thing is, 1 is a heck of a lot easier to solve. So why wouldn't we?
I don't think the position of "Having more accurate pop culture depictions of mental health issues and disabilities would enable better understanding from non-disabled people" is an entirely crazy one, and you haven't really made any arguments as to why we shouldn't do that.
I am so sorry to hear about what you and your wife have gone through. It sounds extremely frustrating and aggravating. I also suspect that when it comes up the people who downplay your wifes' conditions often act as if they are the insulted party.
We have an epidemic of not taking psychological conditions seriously. As my depression has worsened I've understood better the depth to which someone can fall and re-thought when it makes sense to say that I'm having a "depressive episode." I think there's a real issue of people mis-understanding diagnoses (in the way the comment I was replying to spoke about) and describing themselves as having them when their symptoms would not rise to the level of a diagnosis. Un-restrained by medicine and popularized by social media, watered-down understandings of disorders proliferate.
> Co-opting medical language for sub-disorder level dysfunctions is bullshit.
However, this I disagree with. Someone invoking PTSD or Bipolar to characterize their experience is not the same as claiming that label for themselves. I am not bipolar, but I mention the condition to talk about cyclic moods that I do experience (that are neither major depressive or manic but impact me). I think it's common to talk about a disease condition with the understanding that the condition has a range of severity.
I have a friend who was institutionalized for depression for a time. I don't think I am co-opting them to talk about my much less serious case - even though there's a similar "flattening" effect. If people hear my mental health journey first they might assume my friend is putting on airs about their situation. My friend has constantly had people imply or accuse them of overplaying their condition to get special treatment, which is gross.
> how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
My hope - and it is just a hope - is that on balance the social spread of broad and vague understandings of mental disorders is a net positive overall. The alternative feels like locking these terms away in the medical field - where when your wife (or anyone) says they're having a panic attack and the person who's there to help her has never heard of it. People are often shitty when you are going through a serious illness through ignorance and selfishness and I think medical conditions are the same as physical[1] in this case. I do not think that talking or identifying less with disorders is a net-positive.
All of these conditions have a spectrum of severity and, I believe, many people have sub-diagnostic versions of medical conditions. Those people will often improve their lives by recognizing patterns in their lives and using coping mechanisms developed for people with more severe cases. On balance I think that practice increases empathy for more severe conditions - because once people recognize a trend outside normative experience I think they often can extend it. I've also known far too many people who had life-changing adult diagnoses of conditions ("you mean this isn't what everyone is dealing with") to be set against the popularization of considering if you have a diagnosis.
[1] Mental conditions are, of course, also physical conditions but the dichotomy is widespread.
Someone can see their cyclic moods resemble bipolar disorder, use coping mechanisms developed for bipolar disorder, and gain empathy for people with bipolar disorder. Or someone can see their normal post traumatic stress resembles PTSD, use coping mechanisms developed for normal post traumatic stress, and lose empathy for people with PTSD.
I'm not sure if this is "human nature" or if it's a specific cultural problem in the modern west. It's certainly true here in Canada too -- everyone uses terms that are really quite heavy duty to describe quite minor things.
I'm deaf. When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too." Now not to go policing people on their identities but -- no you're not.
Like what do I need to say? Clinically deaf. Severe-profoundly deaf. Cannot hear a fire alarm without hearing aids?
It's one thing when it's an elderly person. Yes maybe they are in fact a bit deaf too. But for all the people in their 30s or 40s who have said it to me -- the odds they all have moderate or worse hearing loss is nil! Most of the people who are saying it presumably have normal hearing. I understand that they're trying to identify with and not alienate me. But it's such a strange dynamic.
>When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too."
I think that is just people being people, and that's the first "acceptable" thing that pops into their mind when they hear that. They are just trying to relate to you. They are socially conditioned to not say things like, "that's too bad", or "I'm sorry", etc.. They were probably prepping to say something about the latest weather trends or something equally banal, and now you've hit them with something out of left field that they've never encountered before. How would you like people to respond? I am a migraine sufferer, and get the same types of responses, like "oh, I get headaches too", and "my sister in-law cured her migraines with mint oil!". I mean, most of the things that most people say are rather dopey.
Conversations are rarely about saying truthful things, and mostly about societal theatre that is supposed to leave both parties feeling better. Nobody cares that you're deaf, what you're expected to do is to react in a way that makes the other person feel good. I don't like this either, but that's how, for the lack of better word, "normies" function.
This is an excellent summary of the issues I have faced, where if you inform someone in the middle of a conversation of an experience you had in the past where someone else has done something bad, they tell me I am being negative... But it wasn't me who did the bad deed. It is completely baffling to me, and you summarised very well how people just want to effectively be tickled instead of dealing with facts. It is very isolating.
> When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
I mean, our industry is filled with people of all ages with ADHD (arguably because it’s one of the few industries where you can succeed while having severe ADHD), GenZ folks are just more likely to admit it in public where older millennials are more likely to either be quiet about it or ignore the fact that they are subject to it.
You’re right and it’s actually wild how many people lack the ability to just deal with it. I think they do it because having a medicalized identity gives you a kind of framework or structure to lean on in social situations. You don’t need to learn the complex social rules to get grace from other people, instead you can do this easy thing and demand it. I think it is downstream of social media displacing face-to-face social interactions.
I know people like to blame social media and just "the kids these days" in general - but I think there's another reasonable, far more charitable explanation: it's a sort of overcorrection after those illnesses being very heavily stigmatized for practically ever. It's perhaps not ideal, but if a symptom of more people who truly have those illnesses being able to get help is a small portion of people using it as a fashion statement, that's a price I think we can pay. And I'm confident it will correct itself over time.
> 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”.
Somewhat unrelated, but I complain about the same thing in software parlance. Our work gets divided up into "sprints". A SPRINT is traditionally something you do a handful of times in your life, like when you're fleeing for your life, pursued by a bear. And then when you're a safe distance away and the adrenaline wears off, you collapse from exhaustion and rest. The idea that your employer would use that term to describe how they envision their employees structuring every day of the rest of their lives is either painfully tone-deaf, or even worse, is a brutally honest view of how they regard employee burnout.
Some of us do sprint workouts every week or two as part of sports training. Those are exhausting and require some recovery but you won't get faster unless you put in work.
But your point about misleading terminology is correct. That's why modern methodologies such as Scaled Agile Framework (SAFe) have adopted the more neutral term "iterations" which doesn't imply anything about velocity.
Those folks are the ones who refuse to acknowledge and accept the fact that they were abused by family members while growing up, where those personality 'symptoms' are common. It is very well known that ADD and ADHD comes from abusive households. Nobody except psychologists and anyone in the mental health field would ever admit such failures in life. They will not accept the fact, and exaggeration and deflection of character faults into false medical diagnosis is what happens. Not very many doctors want to get screamed at by their patients (which would prove the doctor right) for telling them the truth of their own past, and besides, they're not even paid to tell them.
"Truth hurts, don't it" is a very true phrase. It's a very sick trend affecting Millennials and Gen Z alike, and contributes to other worse mental health and criminal outcomes.
ADHD is something you are born with it. If one biological parent has ADHD there is a 40% chance the child will have it as well. We already know there is a strong genetic link. It is NOT caused by trauma.
There is a huge overlap in symptoms between ADHD and complex PTSD. Yes, one needs to be careful to not confuse the two. That is why when I was diagnosed with ADHD, I was also checked for trauma or any other conditions that could explain my symptoms better. This is the recommended and required procedure for diagnosis.
Furthermore many ADHD people also often have (C)PTSD because living with ADHD can in itself be very traumatic, especially when undiagnosed. And neurodivergent people are also more likely to be victims of abuse.
ADHD is not caused by "abusive households" because again, you are born with it. Also getting an ADHD diagnosis is probably harder to get than an PTSD diagnosis because most psychologists will expect trauma and is quite normal and expected to talk about trauma in therapy. In fact the whole field of Psychoanalysis that is the second most common therapy method after behavior therapy is based on working through childhood experiences.
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 think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying
Agreed. I think the word "disorder" in DSM terminology is commonly misunderstood/trvialized by lay people. Being forgetful, sad, or tired is just part of life. If it becomes your whole life then you likely need help but an orderly life will contain pain, joy, pride, shame, boredom...
We are always at risk of medicalizing discomfort. Allowing oneself to be miserable for a while can be therapeutic alongside patience, forgiveness, and compassion.
Edit: after a re-read I noticed that she says she feels most of the symptoms daily a year later. That does feel pretty disruptive on its own but the definition is a bit tautological in that case.
Regardless, what she's going through sounds really hard.
I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.
I would posit that you are reading this too literally. I didn't get the impression that the author was trying to rail against the medical establishment but rather to process her own experience in relation to professional guidance on the topic. I took it much more as a personal reflective essay than a professional medical critique.
Sure - it's an expansive essay on the authors' experience around their grief. I never said that this was their thesis, but I do think the way they talk about medicalization is worth critiquing. They put their experience in tension with medicalization in a way that I don't quite see.
Edit: I specifically think it's wrong to say we medicalize grief because we fear it. We medicalize it because some people would like a medical intervention with their grief. It's great and right that the author does not want that - but also they shouldn't write in a way that suggest that medical interventions in grief are wrongheaded.
Ok fair enough. I read her sentence as more of a figurative reflection on social attitudes towards grief, but if it's taken at face value then I see your point.
Further: by defining the criteria under which a condition becomes medically treatable, other parts of the healthcare system, such as insurance (private or government-funded), treatment protocols, and the like, come into play. Individuals should they choose to seek treatment are then able to do so within a much larger system.
By making the criteria reasonably loose and readily met, such a definition also minimises the number of individuals who would benefit from treatment who are excluded from being able to do so. This would include those who are very much unable to function or face larger grief-related risks.
We medicalise grief not because we fear it, but because there are genuinely useful therapies which may be of use to some, and denying them that merely compounds suffering.
And yes, absolutely, grief ultimately is a lifelong experience. You never stop missing that which you've lost, so long as you have the capacities of memory, reason, and feeling. That is not what the clinical definition is about.
I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional".
What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc.
We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors.
I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)
I think what you are talking about is a problem. Having a medical diagnosis gives personal experience an extra weight in the social realm that's quite problematic. We should all get to say how impactful something for us and the medical folks can have their own standards for when they feel comfortable intervening.
That said, if that's what the author was trying to talk about, I think they are doing so in a way that unfairly indicts the medical system for assertions it doesn't make. They say "Apparently, that’s a disease", but as I said I do not think it is. I think they've misunderstood what makes a disease under the diagnostic criteria they list.
> We could just as well have a culture that treats grief as a normal part of the human experience.
That culture does exist. Even in this article there is an experience of grief that's considered normative in the medical community. Including, I would argue, the authors' grief. I would argue that the medical approach to grief is actually better than other western treatments of grief.
I agree that western cultures (and US culture in particular) is horrible about grief. We want people to be robotic and predictable and not make us think about loss and be sad in private and a whole mess of awful, inhuman things. But I don't think that pressure either comes from the medical community or is furthered by how the medical community talks about grief.
In my grief training, it was made pretty clear that typical grieving of a loss takes 3 to 5 years to somehow find to a new normal and start living again, and lasts forever, with phases of varying intensity. It is important to allow all the phases and encourage emotional release so it doesn’t get stuck and somatized. Stuck, unprocessed grief can kill you.
It is common for the first full year to be more in numbness and survival than in strong emotions. The psyche does not want to accept the loss so it pretends it is not real. Anniversaries and such serve as a slow and painful reminder that the person is in fact not there and will never return.
Swinging between emotional denial and waves of anger and intense pain over many years is totally normal, and should be encouraged and supported. Go with your friends into the intensity of their pain. Ask about their loss. Sit with it. Don’t say stuff like “it will pass“. They will love you for it.
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 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.
I'd just like to clear up a misconception that people seem to have about mental healthcare. Getting a diagnosis isn't related to the 'severity' of the thing you're experiencing. But rather how you're dealing with it, and if it requires professional help to work through. Keyword being 'requires'.
Even if you grief a lot, if you're dealing with it yourself you will not get a diagnosis.
If grief makes you isolate yourself, stop working, start abusing alcohol or drugs, stop you from caring for you children, etc. Then there's a very real chance that this behavior could lead to more problems, making it in turn harder to regain positive mental health. In that case the person should get a diagnosis, which would then unlock treatment and therapy for them.
> The American Psychiatric Association describes “disordered grief,” also known as “prolonged grief,” as a loss that occurred at least one measly year ago for adults
Even though that might be true, it's an excellent example of why you can't just take the written word at face value if you're not well versed in the subject. In the mental health profession it's understood that everybody is going to be different from the norm. Only the treating psychologist can put the clients problem in the proper context to determine if a year is enough or not.
I know someone who was concerned about depression, and went to get checked. The diagnosis was normal. They were having an appropriate emotional response to very challenging situations.
Moreover, most diagnostic terms simply describe symptoms. "Pharyngitis" sounds scary, but it just means you have a sore throat. Why does it hurt? It could be many different reasons, but the term just describes what you're feeling, not the specific reason. Having a condition doesn't necessarily even mean anything is wrong with you. "Bradycardia" means having an abnormally low heart rate, which is common in trained athletes. As long as it's not extremely low, it's not a problem.
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.
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 alternate forgetting with disbelief or feeling almost indignant.
"This is so unlike them! They've never just DIED before. They've always gotten through everything." But that is a thing about death. You only do it once.
> 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.
Science has also given us time machine surrogates - photos and videos. I understand this doesn’t work for everyone and can sometimes make things harder, but for me, seeing our common past brings back the smile to my face.
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.
The way the author captures grief (not as a pathology, but as a form of learning, unlearning, and continuing to love) is so raw and honest it almost feels invasive to read. The line "grief is a terrible kind of learning" hit me like a freight train. There's such a deep humanity here, and also a quiet indictment of our culture's need to classify, contain, and "resolve" grief like it's a software bug. We talk a lot about resilience, but rarely about the kind that means simply keeping going while carrying a pain that doesn't lessen, only changes shape.
The depth of grief the author feels drove me to tears. I think I’d feel like this if I lost my spouse. But I worry wouldn’t be able to express my feelings as well as she has here, so people wouldn’t know how much she meant to me. What a silly thing to worry about.
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.
I'm all about hating on the psychiatry profession, but I believe what may be missing here is that these diagnoses are always optional.
If you like your grief, you can keep your grief. But if you need help, the criteria need to be there for you, for insurance companies, employers, and such to systematically do all their accounting and such.
It's a bit similar to a lot of controversies around the autism spectrum. If it's just a personality quirk and you're a functional adult then it doesn't really matter if you meet the this or that criteria. If you like your autism, you can keep your autism.
The worst part of 5 years and 2 months mourning my baby brother was the day that the dream got me. I dreamt about him a lot but I'm a shit screenwriter so the dreams were always cliched garbage with obvious meaning. Stuff like "We're standing on a bridge that I can't cross, and he says he needs to cross it but I'm trying to convince him not to". The kind of stuff you write for a high school creative writing class that you don't need to pass in order to graduate. But one got me goooooooooood. It was one of those hyper-realistic dudes, I was driving with my wife to a restaurant that I used to go to as a kid, we were picking up takeout to bring back home. As I was loading it into the car I heard his voice behind me say "Aren't you forgetting something?" I turned around and it was him, and everything else about the situation felt so normal and boring that of course he would be there because he was always there every time we did this. But my brain knew that we had been spending the last few years more or less constantly thinking about the fact that he was gone. It almost always results in me realizing that I'm dreaming, but just this one time it went the other way and my brain said "Oh joy, there must have been some sort of years-long misunderstanding and he's actually been here and fine the entire time!" Then I woke up. Cruelest thing I've ever done to myself, but it's a bit comforting to realize that it's in the realm of normality.
The quote "Grief is love with no where to go" has always been fully embodied in my dreams. Since my Dad died I have dreams where he would appear and I would jubilantly (and sometimes angrily) greet him with "Where have you been?! I've been looking everywhere for you!". And it is true, I look for him everywhere.
Waking up from those is so painful but I am grateful I still get to see and hug him once in a while.
I wish someone mentioned DMT here (N,N-DMT). It's really that powerful that you can't ignore that.
Look up DiMiTri ladder protocol, or even without a protocol. The thing is that DMT enthusiasts have advanced quite a bit. Now you don't need to smoke DMT to get a "breakthrough". The entire "breakthrough" moment is somewhat overhyped.
But you can extract the molecule by yourself, and create your own vape, and experience the safest way known so far to overcome years of grief in weeks, sometimes days.
The idea is inhaling every minute relatively small dose to keep yourself here in this world without any breakthroughs, and maintaining this control for the next 60 minutes, while healing the trauma. So in total 60 relatively easy inhales. And it works.
It's definitely underestimated in HN community.
PS and "breakthrough" moments might allow you to see the person and talk to them
It seems that people forget that while medical terms do enter the vernacular, medicine also appropriates common terms and gives them specific, narrower definitions.
In the former, those terms do lose some of their specificity and should be considered shorthands for "what feels like [ADHD, autism, depression...]".
In other words, language is a flexible, living thing, and interpretation can obly be done in context.
This is why some of these statements sound so much worse when typed out on the internet, as they are missing any and all emotional cues coming from visual and audio communication.
It happens in other areas as well ("cloud" in IT or "space" in math).
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?
> Sometimes, I close my eyes while I breastfeed my daughter and the cocktail of oxytocin and prolactin saturates my brain in a way that resurrects Jake with hallucinatory vividness. Suddenly, we’re 27 and running out of the cold Seattle rain into Belle’s Buns for coffee, and then Athena unlatches from my nipple and I’ve lost him again.
I don't really have anything to add but that this is chilling. It really makes me want to take care of myself better even though this man's death had nothing to do with that.
In Taiwan there's usually a little shrine dedicated to someone deceased, and if you miss them you talk to them there, or maybe place some flowers or offerings.
I feel like this kind of ancestor worship is a pretty natural and normal way to deal with things. I'm not an expert but I believe many European religions had practices like this before we adopted Middle Eastern practices.
I’m not sure I see a problem with that definition for disordered grief. To truly experience three of those every day one year on would be debilitating. Having the person pop into your thoughts regularly, forgetting they’re gone etc sounds like normal grief (which is also horrible but not debilitating). I guess I would look at it in the way that people feel depressed and then there are people that can’t get out of bed, keep themselves clean, or go to work. Both suck. One’s a serious clinical issue if it’s not improving.
These are very typical and normal thoughts when dealing with grief. The thing is, it's a misconception that it "goes away" or becomes lessened. It doesn't, and that's the honest truth, it will always be there. Over time though it becomes less unbearable, and for me anyway, 10+ years removed from it, has become such a core part of my personality I'm unsure of how or who I'd be without it. Not that I prefer it, it's just become ingrained.
"Time heals all wounds" is the biggest trap I think these thoughts are driven from. The simple and difficult truth at this stage of grief is accepting that yes, things are probably always going to feel like this. Yes, when other people have moved on you won't have. Yes, it makes people uncomfortable and you're going to have to learn to navigate those situations gracefully. The hopeful message though is that you adapt to it and it becomes less distressful over time. If it doesn't, and significantly impacts your life years later, is where I think diagnoses come into play.
I sometimes get jealous of bad people.
Bad people tend to surround themselves with other bad people.
So when their 'close ones' die, they probably don't feel much grief... And they probably inherit more money because bad people have more money.
It's like how some criminals describe feeling a sense of relief once they got caught. Some part of them is glad that they get punished.
Being a bad person is a win-win in this world; you win by cheating and then if you get caught, you can at least rejoice in knowing that there is justice in the world.
Being a good person is hard because everyone close to you is also good, so their death is unbearable and unjust.
The only thing which sucks about being a bad person is love... Because if you're good and you fall in love with someone and they don't love you back, it's much easier to fall out of love. "Maybe they're a psychopath" or "They're too superficial" you subconsciously tell yourself...
But if you're a bad person and you fall in love with someone and they don't love you back, you think to yourself "They must be a good person; they can see straight through me into my dark heart" and this sign of virtue makes you even more attracted to them. Hating you is proof that the person is sane, wholesome and perceptive... Which is very attractive to someone who is none of these things!
It's is immensely epistemically arrogant to so confidently opine on this topic when every single day you experience consciousness, which is impossible to explain at all using Physics and likely simply impossible to ever explain within that framework (Edward Witten, the greatest living Physicist, shares this belief).
It's also extraordinarily arrogant - and rude - to state that atheists cannot deal with death. Certainly they face it with far more bravery than, say, someone who believes people don't actually die but instead go to a magical place in the sky.
1. You've made the mistake of assuming I'm religious. I am not. This is my lived experience.
2. I think that, largely, materialism is a system that isn't merely arrogant (which it clearly is, as outlined above), but also unfulfilling. You can simply ignore the concept of death but if you choose to really wrestle/engage with it in a materialist framework you will see yourself staring into an abyssal, terrifying maw. I think most atheists don't engage with this concept because it's difficult to do so, just as many religious people believe in religion because it's convenient to do so. It's a fairly even cut.
I've already stated I'm not religious, which I'm not. I share the scientific view that human behavior is explicable so far as we can tell via mechanical/biological mechanisms, behaviors such as altruism not being explained because they are objectively good, but only being explained as preferences we've evolved because they were conducive to our genetic survival.
But, let me propose something from a scientific/rational point of view to you, a brief experiment sort of in this vein. Paraphrasing, Jesus said something like "if you do not believe me, believe the works".
I know this may seem a massive imposition, or horrific undertaking, or you may not be able to engage with it meaningfully, but, if you are able to humor me, I'd propose this:
Take all of the core precepts of what most religions might propose as being 'good' - there is variance but that's alright, humans disagree in every domain on everything - and apply them to your life.
Nip lies in the bud. Road-rage, rage at people on the internet? Let it go. Forgive those people and treat them well. Give people the benefit of the doubt, even people you hate.
You won't be perfect, but don't let that discourage you.
I'm encouraging this experiment because I believe you will "believe the works" and see that there is an element of the human experience that is genuinely transcendant and you can do these things not merely because they are nice or convenient and may be easy to do in the moment, but because they are hard to do, require constant correction and should be done as you are compelled to treat the gift of your own existence with care.
I suspect we are compelled to behave transcendently for our own good though my only proof is lived experience that merely behaving as if this is true is immensely fulfilling. Quite the coincidence.
>Take all of the core precepts of what most religions might propose as being 'good' - there is variance but that's alright, humans disagree in every domain on everything - and apply them to your life.
A sum of a thousand imaginary friends is still imaginary.
I'm unsure why you think I don't already try to live a "good" life.
To me, and most atheists I've discussed this with, death is not an "abyssal, terrifying maw" - it is simply the natural conclusion to life of any kind. It does not 'scare' me; it inspires me to live a good life, to help others, to die with the knowledge that I hopefully made the world a slightly better place.
You're saying the words but I suspect you haven't interrogated them. Again, I'm not sharing my speculation, I'm sharing my actual experience and conclusions as an atheist. Anyways, it doesn't seem like we're getting anywhere with our dialogue, cheers.
Also I want to point out that it's clear that you don't practice what I outlined or you wouldn't have mocked the belief of religious people as "a magical place in the sky", hence cargo cult morality. It looks like morality to you, it may even feel like morality, but it demonstrably isn't. You haven't inconvenienced yourself at all, you merely did what felt good.
> Again, I'm not sharing my speculation, I'm sharing my actual experience and conclusions as an atheist.
As am I, which you seem to refuse to believe for some reason.
> Also I want to point out that it's clear that you don't practice what I outlined or you wouldn't have mocked the belief of religious people as "a magical place in the sky", hence cargo cult morality. It looks like morality to you, it may even feel like morality, but it demonstrably isn't. You haven't inconvenienced yourself at all, you merely did what felt good.
Just because one does not live a perfectly moral life 100% of the time does not mean they are not moral. As you said, "You won't be perfect, but don't let that discourage you."
>It's is immensely epistemically arrogant to so confidently opine on this topic when every single day you experience consciousness, which is impossible to explain at all using Physics and likely simply impossible to ever explain within that framework (Edward Witten, the greatest living Physicist, shares this belief).
Look, you asked for it by setting up secularism as the problem. The opposite of secularism is commonly understood to be religion, and religion is self-delusion. The fact that you can't explain consciousness via a materialistic framework, doesn't mean you have to invent an imaginary friend to explain it. It's like saying that since you can't fly an airplane to the Moon, you should take a train (with no wheels).
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:
I came across this when I was going through the death of a parent. It helped me process and manage grief, I hope it helps others, and feel it is relevant to share in this thread.
"Alright, here goes. I'm old. What that means is that I've survived (so far) and a lot of people I've known and loved did not. I've lost friends, best friends, acquaintances, co-workers, grandparents, mom, relatives, teachers, mentors, students, neighbors, and a host of other folks. I have no children, and I can't imagine the pain it must be to lose a child. But here's my two cents.
I wish I could say you get used to people dying. I never did. I don't want to. It tears a hole through me whenever somebody I love dies, no matter the circumstances. But I don't want it to "not matter". I don't want it to be something that just passes. My scars are a testament to the love and the relationship that I had for and with that person. And if the scar is deep, so was the love. So be it. Scars are a testament to life. Scars are a testament that I can love deeply and live deeply and be cut, or even gouged, and that I can heal and continue to live and continue to love. And the scar tissue is stronger than the original flesh ever was. Scars are a testament to life. Scars are only ugly to people who can't see.
As for grief, you'll find it comes in waves. When the ship is first wrecked, you're drowning, with wreckage all around you. Everything floating around you reminds you of the beauty and the magnificence of the ship that was, and is no more. And all you can do is float. You find some piece of the wreckage and you hang on for a while. Maybe it's some physical thing. Maybe it's a happy memory or a photograph. Maybe it's a person who is also floating. For a while, all you can do is float. Stay alive.
In the beginning, the waves are 100 feet tall and crash over you without mercy. They come 10 seconds apart and don't even give you time to catch your breath. All you can do is hang on and float. After a while, maybe weeks, maybe months, you'll find the waves are still 100 feet tall, but they come further apart. When they come, they still crash all over you and wipe you out. But in between, you can breathe, you can function. You never know what's going to trigger the grief. It might be a song, a picture, a street intersection, the smell of a cup of coffee. It can be just about anything...and the wave comes crashing. But in between waves, there is life.
Somewhere down the line, and it's different for everybody, you find that the waves are only 80 feet tall. Or 50 feet tall. And while they still come, they come further apart. You can see them coming. An anniversary, a birthday, or Christmas, or landing at O'Hare. You can see it coming, for the most part, and prepare yourself. And when it washes over you, you know that somehow you will, again, come out the other side. Soaking wet, sputtering, still hanging on to some tiny piece of the wreckage, but you'll come out.
Take it from an old guy. The waves never stop coming, and somehow you don't really want them to. But you learn that you'll survive them. And other waves will come. And you'll survive them too. If you're lucky, you'll have lots of scars from lots of loves. And lots of shipwrecks."
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.
The fake death thought is very common. My brother drowned at the beach when he was only 17. We all stood there helpless, unable to find him. His body took some time to return to the shore, and a friend of a friend of the family was the one who identified him.
I was very young, only 7, but my cousin, who was 15 at the time, spent years searching for him, convinced the body had been misidentified. Later, when I grew older, I also went through the phase of thinking, "He was too smart and strong for that. Maybe he ran away somehow."
My best friend of 25 years died 4 years ago and I still think of him at least once a week, wishing I could talk to him. It was almost a year before I could even talk about him without completely breaking down. I never once thought: "oh, this is a medical issue". It was just me having the same problems processing my grief that American men have because we're not raised to talk stuff out. Once I did start talking about it, it got easier and easier to deal with.
I still miss that guy, though.
I still randomly gmail my dear beloved best friend who died of melanoma 18 years ago. It goes into the ether. I hope gmail doesn't reassign his account to someone else for inactivity, they will get my "thinking of you, miss you, this thing happened that you would have found hilarious" emails.
That actually happened with texts to a grandmothers phone number that was (eventually) reassigned.
https://www.the-independent.com/news/uk/home-news/family-sho...
I heard about people that would keep the voice mail of a departed loved one on their phone undeleted. They would replay it from time to time to get the feeling that they are still there. Also they would wear their clothes to feel their presence.
https://www.youtube.com/watch?v=s_i59j74g3s
FWIW, there's no way gmail recycles inactive email addresses. That would wreck security worldwide.
Sound right, as it would be an easy way to take over other accounts connected to that inbox.
What happens to those accounts they've been deleting for inactivity lately then?
They just sit there, dead.
Yep. I've been trying to get one for my username.
It's one of only two conflicts I've ever encountered online, and it's been inactive for over a decade, but I can't claim it.
Yahoo does recycle emails though if i recall
Grief is a very difficult emotion and I like the analogy of it being a deep ocean. When you experience profound grief you are dropped almost immediately into that ocean. If it is your rodeo with grief you don’t know how to swim. You don’t know where you are. You are in an endless night of depth. You may not even know you are in the ocean at first. Your brain is simply drowning. Some constant in the mind’s universe has changed. Abruptly.
I don’t believe, completely in the narrative of American men not taking stuff out, but it is a factor. The underlying issue for not talking stuff out is ensuring you feel understood. That you are not alone in this experience. That grief is okay, normal. That you have been taught a life philosophy that encompasses grief. That it can exist without consuming all. It helps anchor these powerful emotions. There are other ways to achieve this, everyone will have their own strategies. I do think you have to have a philosophy and process to handle grief however you do it.
I believe in acknowledging grief and practicing Stoic style thinking to stay present. It really helps me to acknowledge the moment is precious. Wrenching on a car with a buddy. Sitting at the dinner table with your family. Acknowledge how special that is. That it won’t last forever. Cannot. Tell them and yourself how special it is. Visualize life without that moment anymore. Bring a little grief to the every day and present as a part of our human condition. It is okay! It is not spoiling the moment if you are using that emotion to fully experience the present.
Grief as many people experience and process it is almost always the past. Even simply acknowledging it as the powerful force in our mind can help tame it. Observe the grief so to speak, see it as an observer. I am glad you found your way. Everyone should think about grief and talk about it. Just part of us.
It’s love with nowhere to go
I love to miss people. I think missing is a complete and beautiful expression of love, just as much as having.
I think you don't truly know if you love someone until you miss them for some time.
That's nice, but I'm curious if this feeling that you love is from the loss of a spouse or (even more so) a child? The "unthinkable" losses.
When I first encountered this description of grief it really resonated, but it's felt less poignant as I've gotten older, partly because I find myself grieving people who still live, and are simply too different from how I remember them or how I thought I knew them to support the relationships I want to have with them.
I suppose the principle still holds: the "love" I have for those versions of those people cannot go anywhere, but that feels dissonant with not wanting to know these people as they are, or knowing the relationship I'm wishing for is otherwise ill-fated. In either case, the relationship cannot continue, and that drive the sense of grief anyway, so maybe I'm just splitting hairs.
Such is the complex nature of grief and of human relationships, I suppose.
Love is best shared. Grief can be a powerful tool to help build up healthy new relationships.
"what is grief if not love persevering"
I lost four close family members, including my parents in the last five years and so I know exactly what that urge feels like.
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.
I found your comment very moving. Thank you for sharing that remarkable portrait of your father
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.
I find that surprising in turn! What were the beliefs you had around death?
I can sort of see why you found it less significant, but in monotheistic religions it is still pretty final. It is still the end of the one life you get, even if it is also the entry into something completely different and better.
I typed out the response below but I'm not sure I have a coherent response as to why the secular zeitgeist of death is less intimidating to me than the religious context of it. (Though, I'm not who you're replying to.)
I think it comes down to the sheer amount of pressure I felt within religion to be a certain way while also being told I could never be that way enough to achieve satisfaction in the eyes of god, and outside of religion I'm just another person in a flawed world trying to do my best.
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At the risk of being redundant, death within religion isn't an end, but yet another beginning. Eternal life is the reward for being a diligent disciple, where that means internalizing one's inherent flawed nature and inability to be redeemed but through death in devotion to god... which is a hell of a weight to carry throughout ones' life!
The Christian ethos is woven through with constantly being judged. And forgiven, yes, in theory, but still there is a constant undertone of "you cannot avoid making mistakes, and the mistakes you make are so offensive to god he wouldn't want you anywhere near him, but for magic religion reasons you've been redeemed by god doing something so terribly debased that it outweighs all the awful mistakes you've made."
Death (and "everlasting life") is no reprieve from this, but a form of stick that weighs heavy over you all through your days. You must work to save those around you, or they'll be eternally lost. You must cleave to the teachings of god, or at the very least belief in him, or you'll be eternally lost.
Since I left the church so many things of import that I felt I didn't understand now make much more sense; I struggled to comprehend how god could allow suffering, but now I see that the universe is just absurd and uncaring. While that may seem less comforting, I find the notions of bad things happening randomly less upsetting than there being an all-powerful being who cares about me but chooses to let me suffer for reasons that were never convincing, and as I've grown older sound more and more like an abusive relationship.
Through that lens, death is just a natural consequence of the world. Scary, yes, in the sense that I may not live up to all I want to be before my time is up, but I'm not pre-marked as eternally flawed and only redeemable through processes that do not make sense to me. Instead I know that I can only do my best, and that has to be enough, because I can't possibly do more.
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.
It looks like you were downvoted but for what it's worth you parsed and explained my intention accurately, and I appreciate that.
You're welcome. I'm glad I was able to clarify it.
It's not the first time I've made such a clarification - it's a very human impulse to defend your belief system from unjust attacks that aren't actually there.
Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking. We're used to thinking we control things, and can get anything we want. One thing useful from the religions was having a healthy sense of your own limitations, or you could say a sense of wonder or mystery or perspective. A reminder that you're not the most powerful thing in the universe. Which is true, and healthy to be aware of, whether any god exists or not.
Edit to add: There are few places where that hubris and certainty tend to be more pronounced than among doctors. Part of what this woman is grieving is probably the loss of certainty, of control or the illusion thereof.
> Which is probably why religion was developed in the first place, for its comforting effects, as a balm, a bravery-enhancer, a coping strategy for dealing with inevitable death.
It maybe a factor, but I do not think it was the main one. Death is still very hard to cope with, regardless of religious belief. There are other things behind religious belief, mostly experiences.
> I think the way we deal with death nowadays has more to do with arrogance or hubris, coupled with wishful thinking
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.
Thanks, this is clearer.
Do you really believe atheists are incapable of recognizing the significance of children or of caring about them?
No, I don't believe that. I valued children just as much when I was an atheist as when I became religion.
What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not. I work in FAANG and previously in finance, so my peers are people who can certainly afford kids and are positioned to take care of them - and yet literally most are choosing to do something else.
I am not commenting on a universal attitude, I am commenting on a significant trend that I think is obvious.
>What's significant though is the PREVALENT opinion. 100% of my religious friends want and have kids, while the majority of my secular friends do not.
Do all of your religious friends subscribe to the same religion?
If so, does this religion proscribe having children and raising families as a necessary, or desired, component of the faith or community?
Because you could be confusing religion and culture here. Secular values often abrogate traditional gender and sexual norms, so secular people may not feel compelled to "be fruitful and multiply." I wouldn't ascribe that to lack of religion per se so much as not being affected by the same cultural pressures. After all, plenty of theists are essentially forced into marriage and children because it's what's expected, not because it's what they want.
I am not sure "culture" and "religion" are separable in the long run but I don't think that aligns with the point you're making.
Religious people see "be fruitful and multiply" as a literal command from G-d and one of the fundamental points of religion. So while religious culture can evolve, the evolution of this attitude isn't a flexible point.
On the flip side, secular culture has no intrinsic reason for "family values" - which is why, I think, atheist culture over time devolves to childlessness - because reasons "why not" are more immediate and in your face, vs "why yes."
So yes it's "culture" but what the culture is is obviously determined by your underlying beliefs and that which you consider eternal and that which you consider negotiable.
>which is why, I think, atheist culture over time devolves to childlessness
I don't think the data supports this, yet. Religiously affiliated completed TFR is 2.2 while unaffiliated is 1.8. However, completed TFR means this is looking at those older than 60, so expect those numbers to drop in the future.
https://www.pewresearch.org/religion/2025/02/26/religion-fer...
From my observations, TFR is not much different between most people who describe themselves as religious and most people who describe themselves as non religious. However, the TFR is different for those who I would describe as the most religious, compared to the "casually" religious/non religious.
For example:
https://danielgordis.substack.com/p/israel-has-high-birth-ra...
Totally agree, even without reading your links. What matters is the actual faith in Gd. I see this myself. We're members of two temples - one more orthodox and one more what you'd call casual.
The people that show up to the casual one once a year or even a few times a year aren't really "different" than someone who doesn't bother to show up. It's good they are there but the religion isn't influencing how they think and act - which is why the TFR is similar between casually religious and casually non-religious.
Where things differentiate is on the extremes. Someone explicitly atheistic (vs just non-religious) has a TFR around 1 from what I remember, while orthodox and ultra-orthodox have 3.3 and 6.6 respectively. What makes the difference is the degree to which they allow the religion to permeate their mundane existence, which is a factor of faith.
This doesn't seem to track with broader sociological trends. For example, let's compare the USA, one of the most religious Western countries, with the USSR, where 60%+ of the population was atheistic, and where the state promoted atheism. Between 1960 and 1980, the US population grew from 179M to 226M (a 26% increase). The USSR population grew from 208M to 262M (a 25% increase). So, despite massive differences in religiosity, the population rate was pretty similar. China, another largely atheistic state, grew from 582M to 1B in roughly the same period - a 73% increase.
So while it may be true that certain small deeply religious populations are more incentivized to have children, this doesn't seem like a significant effect at population levels overall. You'll also find small non-religious groups with similar behaviors.
Borderline militant atheist, my children are the great joy in my life and the best thing I’ve ever done.
Putting aside the question of whether your own experiences hold for the general population, you must consider why these opinions are so prevalent, either way. One might argue that religion doesn't teach 'values' so much as 'roles', and so people feel they must do these things, not for any significance or with little thought to possible negative repercussions, but simply because... well, that's just what you do, right? Find a partner, have kids, go to church. That's the lifestyle religion teaches. One might also argue that secular people aren't as intent on having kids because they're more willing to accept different lifestyles.
For what it's worth, krapp's comment is better written but is what I'm talking about here.
I probably agree with most of what you wrote, but at the end of the day, the difference between 'values' and 'roles' seems insignificant to quibble about in the face of the result we're talking about here.
[flagged]
This is not even slightly true and seems to be based on a profound misunderstanding of atheism. From my perspective as atheist since the age of 11, it's the reverse of the case.
> 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 single forum 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're on to something here; there's an inherent conflict between ruthless individualism that tells people they can do anything they put their mind to, and the stark, limiting reality of mortality. That's a bummer, so don't think or talk about it, or it'll mess with your grindset.
Collectivist cultures already embraces the idea that one's life is more than just about the individual, so grief and talking about death are far less radioactive. Religions that embrace ancestral spirits being presence offer comfort in continuity; her husband isn't really gone, and he may even watch ober their daughter, and even help her in math exams. In that light, dying is less of a big deal - more of a transition really - compared to oblivion, which is super heavy. I'm not saying these are better
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
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 my understanding ADHD is one of the few conditions that is extremely well studied and consistently appears to be a certain % of the population regardless of nationality with very strongly correlated negative outcomes with their suite of symptoms. I'm talking addition, obesity, and a shortened lifespan directly related to their ADHD. This seems like a disorder to me. If someone has attention difficulties and can function fine they obviously don't have a disorder vs someone who has attention difficulties and as a result becomes addicted to cocaine.
Function in what context? I have been diagnosed with ADHD at age seven. I have had many checkups and am currently medicated. I can tell you that I wouldn't need to if I didn't have to work a menial wageslave job. Interestingly I can focus perfectly fine when doing interesting stuff without medication and it has always been this way. What you are saying is that there is some proper definition of disorder, which would sensibly be defined relative to some "normal" human baseline. Tell me you know one "normal" human, why you see this person as "normal" and how it would be useful to use this as a reference for the big spectrum of human personality and mental fitness. I can tell you from experience that I didn't need medication when I wasn't forced to attend 12 useless meetings a week, use inefficient and stupid software and one would just let me get my shit done. I have quite a few friends who have had very similar experiences, and the idea of ADHD is just used to pathologize and medicate someone so he can work and be a "positive contributor" to whoever above them. Add here the necessary disclaimer that my experience is not universal and there may be people gravely suffering from it, etc. I do too, even with medication, but at least I can generate some bucks for management.
And what I know with ADHD is that the incapacity to handle dumb meetings is just one definition of functioning. Maybe you don't need medication to clean yourself enough to prevent skin issues, prevent addiction to substances, compulsive criminal behavior, avoid hoarding behaviors, have a safe living space, have the capacity to maintain friendships/avoid loneliness, engage with social interactions in a mutually respectful manner etc. But most people I know with ADHD severely struggle with at least one of the above and I consider that functioning, not just holding down a job. My understanding is not on the level of "can you do bullshit work" but it is "can you clean your dishes before they stink" and "can you respond to being turned down by a girl without blowing up your life".
Tell them to use disposable plates or foil over their planes. Works wonders
I'd be willing to bet that there's some percentage of people who don't have ADHD, but they're also not capable of adapting to and meeting the unnatural demands school and work place on everyone and so they struggle in those environments where most people don't. ADHD medication still helps them overcome that difficultly and those medications can make a huge positive impact on their lives as a result. I'm okay with that.
Maybe we should have a different diagnosis for those kinds of people entirely and leave ADHD to the folks who couldn't accomplish what they wanted to do even if they never had to work, go to school, or follow a schedule set by another person. In the end though, what you call it doesn't matter. Both situations are thankfully improved through the use of the same types of medications. Medications which are pretty safe and can mean the difference between being able to support yourself or failing to.
I'm okay with a wider spectrum of people falling under the ADHD umbrella even if some of them don't like being lumped in with people who really do have an executive function disorder. Odds are good those people wouldn't like whatever new label doctors came up with to describe them either. It'll pretty much always carry negative connotations because ultimately, it means that you don't have it in you to do what most people are able to do just fine.
> In those cases, why is it a "disorder"? Why can't it just be "how some people are"?
It often is:
> It can be helpful to think of ADHD not just as a deficit or disorder but as a ‘difference’.
Especially as it seems to come with positive traits! It goes on to list focus, responding well in a crisis and creativity as common ADHD traits.
https://www.rcpsych.ac.uk/mental-health/mental-illnesses-and...
I'm autistic which is also a disorder. Like ADHD it's a neurodevelopmental disorder because from a scientific and medical POV the brain developed abnormally compared to a neurotypical person's brain.
I guess your point is why does it require a label at all but science abhors a taxonomic vacuum, everything must be classified and if so I'd rather it be a disorder than a disease or illness.
Of course this opinion is just mine, I have no idea how other autistic or adhd people see this as I don't keep up with the neurodiverse community and what words are considered good or bad.
The DSM-5 defines ADHD as "A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development". If you're functioning fine, then by definition you don't have ADHD.
>> For some people this is problematic, but others can function fine and happily with this.
In that case I would say it’s not ADHD, which as its name suggests is disordered. If the ADH part isn’t negatively impacting your life why would it require a diagnosis?
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.
>a young pregnant woman losing her husband, and say, something like a middle aged person losing an elderly parent
This isn’t really your point, but this person lost their husband at 40. By some definitions, that is middle aged. In the general view of things, not young. That doesn’t really change much, but I was thinking of a mid-twenties before I realized who it was.
Don't take this the wrong way, but what point are you trying to make? What was your goal here?
What a great article!
> Absolutely right. There is a certain cowardice in how we deal with death in the contemporary west.
This is one of my favourite topics.
I had forgotten to bring "cowardice" to the table when thinking about death (etc) I've mostly thought of it as some kind if vague unspecified fear, thank you for injecting this word and concept into my jumble of thoughts.
I've been using "dignity" to try and make my thoughts more clear, but cowardice clearly has a place at the table too.
When thinking about suicide I have thought of that way to die as potentially needing bravery (as in being able to do something you fear).
The topic of death is dear to me me not only for personal reasons but I also think this relates to quite a few aspects of our societies and not only the obvious ones like how (if we can afford it) seem to overtreat people medically rather than give them proper palliative care and their close ones time and space to be there at this grand moment in life, that death ultimately is :)
It feels weird to use words like: bravery, cowardice, dignity and fear, they feel like from another era, possibly only a fictional era of knights, damsels and dragons.
And somehow I sense that that feeling of weirdness somehow is connected to the medicalisation of "everything" and also our longer work hours and expected increased efficiency. As if we hide and disallow the big important things in life only then will we agree to work the way we do.
But then in the other hand we can cure a lot of disease and I can type this on a tiny screen keyboard and post this to the internet, so...
I don't know, I only know that there is something wrong with death.
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 think for people over 50, I guess "Gen X" and older, this is still often true. I've never considered therapy or medical help for any way that I was "feeling" and certainly have had times of grief and loss and sadness in my life. In some of those moments, when peers or friends noticed it, the gist of their advice was to “suck it up” or “get over it”.
I am also introverted, procrastinate, am not very organized, and am not very good at housekeeping. My view on how I would change those things would be to just suck it up and do better, if I had to. And when it matters, that's what I do.
I don't mean to say that this is the only correct way to approach life but it is how I look at things.
I tol am unfortunately also introverted, prone to procrastination and seem quite unable to keep my house as spotless as I would like
Do you have any advice for overcoming my problem with atleast procrastination (i suspect that it is probably causing the other two issues).
Suck it up and just do it.
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 or even passive-hypochondria.
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 agree it’s not a simple divide. I was trying to paint that there are many reasons why we handle death poorly in the west and I honestly only know a raindrop about the east. I can only fathom the handling of death and the reasons why gradients across the globe in every direction.
> 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 friend 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.
That's moving the goalposts. Implying that people do not go through that remembrance vs implying that they do not do so on a set routine are not the same thing.
Not to mention that such a routine might very well be part of the medical therapy that we are talking about here.
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
> 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?
> There is a certain cowardice in how we deal with death in the contemporary west.
It's because we have a dearth of true elders right now.
Not in age, but in temperament and learning.
I got interested in story telling during COVID and managed to find a great author (K.M. Weiland) that went in deep on the archetypes of story.
Her hook was essentially: "What happens after the Hero's Journey/happily ever after?" And then she got real deep on her idea of the 6 phases of life. Her work is properly about how to write a plot, but man does it apply more broadly.
The pertinent one here is the 'Crone' stage of life [0]. You're no longer the 'King' of your little fief, you had to give up the power and make way for the next generation. But now what?
The journey of the Crone is essentially learning that Death is a part of Life, that Death is not Evil, Death is a Friend.
K.M. Weiland admits that less and less people ever make it through the stages as you go along.
But, I think right now in the West, we have a lot of boomers that never really progressed past the Hero stage, let alone the Queen or King stages. There should be more Crone and Mage people around, but the boomers were retarded in their development. Just look at RBG, Feinstein and Pelosi (to name but a few), grappling on to power like the Tyrants or Sorceresses (strong shadow archetypes of the Queen and King) and never letting go, to the classical harm of the kingdom/hearth that such stories tell.
Facing Death is hard, very hard. But is something that we all must do. Realizing that Death is not Evil, but a part of life, and one to be welcomed at times, that is something that very few of us can do.
[0] https://www.helpingwritersbecomeauthors.com/archetypal-chara...
I've always been averse to this sort of Jungian schema (it's a Freudian baggage I have -- Mourning and Melancholia has much value on the present topic!), but more and more I'm seeing how much wisdom was lost in the historic disavowal of myth and archetypal thought. Since having a child, my wife and I have been repeatedly stunned at how incapable our own parents are. I don't mean a mere absence of help with babysitting (although they suck at this, too), I mean they just have no idea how to deal with us or our kid as living beings. They shrink at the first sign of difficulty. They want absolutely no relationship with death. We've had to find new elders elsewhere; they really aren't easy to find but they do exists.
Parenthood is simultaneously saying about your own parents:
-How the hell did they do it?
And
- What the hell were they thinking?
I'll echo the frustrations you're having. I have the exact same ones with my own folks
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.)
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.
> She is doing as well as one can be for how much she loved Jake and how much she misses him.
Again, my point is that that statement is absolutely true and also does not preclude the notion that additional professional help may be warranted.
I went on Prozac earlier this year after a conversation with my doctor that went, roughly: “I think you’ve got anxiety” “well yeah, look at the fucking world!” “…right.” Just because there’s a good reason for what you’re going through doesn’t mean you’re not going through it.
Put another way, if the author had been shot a year ago and was saying things like “most days I’m fine, but some days I literally cannot walk or feel my left arm,” the notion that they should be talking to professionals would not be controversial, even though their symptoms are absolutely utterly explicable given what they’ve been through.
Consider that the author may elect to this suffering as a testament to her love for her partner and as a way to memorialize what he meant to her.
If your partner died and the very next day a doctor said, "Here's a pill that will make you forget you were ever together and erase 100% of the pain. You'll feel amazing." Would you take it?
I would very much like for the author to be able to memorialize her partner in a way that she feels offers a testimonial to someone who was such a big part of her life. If she's able to do that right now, that's fantastic (and this post is certainly a well-rendered testimonial). The point of getting additional help (and, again, as stated above, I mean therapy, not necessarily drugs) is to ensure she can do that - to provide the support, structures, framework, and understanding that she can make those choices consciously and in a way that allows her to feel as though she's honoring his memory in the best way she can.
Usually I would agree with your points, especially that wounds on the soul should be treated like wounds on the body - objectively, and with the best practice medical support for proper healing to minimize adverse effects.
But as she so eloquently puts it, the grief is not just a wound, its a lifestyle change. Its the repetition of existing expectations and systems that have to be retrained and rewired.
Professional help can help numb feelings but when it comes to retraining your entire life, as she also implies, professional help is only medically necessary if you are completely debilitated and unable to do the retraining yourself.
Professional help is only as helpful as it can do it better than she can. And I think because it involves lots of instances of processing her own feelings, that kind of help is difficult to provide medically.
Support groups I can understand helping her situation though.
To be clear, I'm not advocating for chemical intervention - I think a competent therapist/grief counselor can help process and metabolize the change. I also am not suggesting that the ideal goal is that the author feels no grief, rather that she is able to move in a productive and healing direction, as opposed to feeling like she's being battered beyond her control.
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.
the reason to NOT have a DSM-recognized diagnosis on your medical record is it can be used to disqualify you for things later in life.
And we cannot predict all of these future changes, either in our interests and/or the law.
"We don't want pilots with depression or anxiety, because duh obvious reasons" and there goes a career option for you. (something very like this happened to my cousin)
That's an interesting example. On the one hand, we really don't want actively suicidal pilots. On the other, are the current guidelines too stringent? I can't imagine you're saying that actively suicidal pilots should be allowed to fly hundreds of people, so the argument seems to be more that private corporations have too much information and too much power and are willing to blacklist qualified candidates just to reduce examination costs.
That seems more like an argument against corporate overreach than anything else.
The problem is that the policy incentivizes pilots who develop problems to hide them. So pilots who should take time off to work through problems are instead flying planes, because the alternative is losing their career.
> we really don't want actively suicidal pilots
We do not, and so providing pilots with the ability to seek help and support seems like what we'd want to do.
The degree to which mental health has been pathologized is unhealthy for those in need and for society at large.
The pilot restrictions definitely need a revamp. Any diagnosis or medication can greatly restrict you for a long time after, incentivizing avoiding treatment completely.
> 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.
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.
Assuming the days you took off from work because of depression were unexpected and not planned in advance, why did you feel you had to explain anything?
Why couldn't you say: "I'm sick and won't be at work today."
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 mean, I have no data for this, but I think it's a combination of two factors:
- Access to mental healthcare here is HEAVILY gate-kept by a combination of it often costing quite a lot of money, generally having longer waits than most healthcare services, heavy variability in availability by location, and insurance coverage runs the gamut between great or utterly absent, sometimes even in the same policy depending on what you need. Self-diagnosis is for many people the only diagnosis they have access to, and even if it's wrong, you can often use whatever diagnosis it is to find coping mechanisms that help you, or substances that will help you self medicate.
- Naming something medically is the only way to get institutions to pay attention to it, which can mean a number of things by itself, from getting appropriate accommodations at work or school, to getting certain kinds of coworkers or authority figures to treat you in a way that's more amenable to your mental state.
And I don't think its wrong to make it part of your identity either. Some definitely take it to a weird, unhealthy place, and also most of those people are teenagers. Teenagers do tons of stupid shit, I did tons of stupid shit. It's just part of growing up. But ultimately... it is part of you that you're going to be dealing with probably forever, so, some amount of identifying with it is probably healthy.
Edit: Also not sure how to read you calling this "oversharing?" Like I guess it could be depending what it is, but I dunno, my wife has BPD and a touch of Autism, she doesn't announce it when we meet someone but it isn't a secret either.
Everybody wants to be the one who overcame the odds or struggled bravely on. Everybody wants their story to be special because of how hard it was for them compared to everyone else.
I think some of it comes from the value the culture places on underdog stories and some of it comes from the oversaturation of everything in modern life.
I think some of it also is an overcorrection from how taboo it used to be to discuss mental health previously... so now oversharing is encouraged vs suffering in silence.
Americans, and I am speaking in stereotypes and not about a particular person, don't respect personal boundaries on topics that other cultures would not discuss openly with someone they don't know well. Like for example, you tell me, a stranger on the internet, that your wife has borderline personality disorder. That would be oversharing if we had just met in a social setting and were discussing this topic together.
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".
Unc “I'm literally shaking rn” is only ever used ironically. In a culture of ever increasing extremes language follows, that’s all that is to this
I think it will continue as it's been turned into socially acceptable and even expected behavior now.
There’s also that linguistic phenomenon where you have to use stronger and stronger language to signify the same thing. Maybe we just think it’s ridiculous because we’re the older generation. Or at least that could be part of it.
> 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.
The thing is, many people have valid reasons not to trust the medical system. Not so long ago:
1. Homosexuality was considered a mental disease
2. Forced sterilization of minorities was good medical practice
3. FDA ignored warnings about pesticides being potentially harmful because that would be bad for business
4. FDA ignored warnings about pesticides being potentially harmful because that would be bad for international politics
5. Entire field of psychiatry was just basically random shit, it's not until very recently that we have any actual scientific knowledge
6. Pregnant women were presribed medicine that fucked up their fetuses
Not to mention that most likely when you go to a doctor you're not getting state-of-the-art diasgnosis, most likely the doctor is just a random guy doing his job, sometimes better sometimes worse. Personally I don't trust medical system with my mental health because medical system is a product of a society that made me have mental problems in the first place.
I mean I live in Germany where Hans Asperger oversaw the mass killing of autistic children. He decided which one were to be murdered or which had the "right kind of autism" i.e. Asperger syndrome and could serve the fatherland. (Just to be clear, the differentiation between autism and Asperger has not and had never any scientific leg to stand on.)
The term Asperger syndrome was only removed from the DSM in 2013.
For autistic children something called Applied Behavior Therapy is still the most common treatment. It is the same thing they use in gay conversation camps. Yes, literally. It can be super traumatizing to autistic children.
The way we treat neurodivergent people is absolutely abhorrent.
That said, the main issue people don't get a diagnosis is not lack of trust but lack of access. Most people can't afford it or are not able to jump over the bureaucratic hurdles to get it.
Germany is notorious for being shitty to people with mental illness. Even people with something as common as ADHD struggle to get the care they need there!
On the subject of Asperger syndrome, after learning about the history I was surprised that there are people previously diagnosed with Asperger's syndrome who were (and still are) very angry about the term being removed resulting in them being lumped in with everyone else diagnosed as autistic.
Being labeled as "autistic" could mean anything from seeming a bit strange but being highly intelligent and perfectly capable, to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care. Some "Aspies" saw Asperger's as a very convenient way to differentiate their particular flavor of autism. Convenient enough that the usefulness of that distinction far outweighed the shadow of the terrible origin of the name itself and also the fact that it hilariously sounds like "ass burgers".
Personally, I'm glad that Asperger's was removed but I have to agree with the Aspie crowd that they got screwed over when no new term was given to replace what they had. The still grossly overbroad "3 level" system is trash. The spectrum of autism is so wide that the term is nearly useless.
> could mean anything from seeming a bit strange but being highly intelligent and perfectly capable
No, everyone that is diagnosed under ASD has some sort of care needs. If you are just a bit strange and it is not disabling in any form, then you are just strange.
People see autistic people on the internet and seem to miss that video editing exists and that the they are seeing just a very specific and carefully chosen part of this person. They are seeing the highlight reel not daily life that can look very differently.
One of the fears with removing Aspergers was indeed that some people diagnosed under Asperger might not be diagnose under ASD as it is arguably stricter.
> to being totally non-communicative, being drastically intellectually and emotionally underdeveloped and being unable to function requiring 24 hour care.
The problem is that many people see things as single line from low care needs to high care when in reality it is multi dimensional. Just being non-verbal does not mean that one is not intelligent, that is a huge stigma that non-verbal autistic people suffer. Many autistic people struggle with sensory issues but some don't. You might struggle heavily in one area but not so much in another.
If you know one autistic person, you know one autistic person.
> The still grossly overbroad "3 level" system is trash.
It is a step in the right direction because it realizes that care needs can change over the course of a persons life. You are born autistic but how disabling it is for you can change depending on how much help you get. It can get better or worse depending on your life situation.
Otherwise you have a current situation where people assume it isn't worth giving a non-verbal autistic child a proper education because they they think that they will never be able to life on their own anyway, acting like their outcomes are already predetermined. Or when someone with Asperger is assumed to never have serious care needs.
That said, people that have been diagnosed as Asperger, I don't correct them if they cling to their diagnosis. It is the diagnosis they have identified with for years or decades and if it what works for them then that is fine.
Still the new system is a good step in the right direction. Not perfect but better.
The dilution by people with no formal diagnosis become more common is scary because of how it normalizes not seeking help, which is the hardest part of actually having these issues. It creates this illusion that one should be able to treat themselves and that things like sitting at your desk all day thinking it wouldn't be that bad if you died in a car accident, or having your heartrate spike and sweating profusely while you thoughts are paralyzed are normal things that happens regularly to everyone so your inability to deal with them is a personal failing. They are not and if you do feel this way try and seek assistance from a experienced professional.
Standard among previous generation was to not seek help, stigmatize those who do, mock the issues and generally not even have vocabulary to talk about them.
This is very true, we are in a better place than the previous generation but there is still room for improve and a over abundance of something can be a problem just as easily as the absence of something.
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.
>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.
I was with you up until this point. My wife has C-PTSD, Bipolar type 2 and ADHD, along with what her psychologist describes as "Social OCD". I can't tell you how many times I've had to explain to other people that her mental illnesses are real and some days she and I just can't hang out because she smelled a smell that gave her flashbacks. Because people have normalized the language, they think "triggered" just means upset. For someone with real PTSD, it doesn't mean upset, it means their mind has come unstuck in time and they don't know who to trust or sometimes even what is real. Sometimes this lasts 5 minutes, sometimes it lasts almost all day. She just loses that time, and all I can do is try to calm her down and try to get her to take medication to re-stabilize her.
My wife has been in therapy with a PhD psychologist for 11 years, and only just this year has gotten to the point where it seems like she could probably hold down a job and keep her trauma compartmentalized like most people do all the time. People normalize the language for these debilitating full-blown disabilities and then don't understand the gravity of the situation when somebody with a legitimate mental illness of that sort of degree comes along.
Co-opting medical language for sub-disorder level dysfunctions is bullshit. And that's fine, when you're just bullshitting with your friends or whatever, but how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
I would posit your issue is not in co-option of terminology but in that ableism is still rampant and these are people who wouldn't take your wife seriously even if you described her symptoms. I have conditions that people do not uwu cutesy about on tiktok and people still illegitimate me when it inconveniences them slightly like canceling plans. People playing down disabilities the disabilities of others is extremely common. Being able to be flexible and accommodating to any degree I can to someone's disability has nothing to do with whether or not I think it is legitimate, and gating my flexibility to whether or not I personally judge someone's disability as legitimate is ableism plain and simple.
I upvoted your comment because this is also a huge issue. I just find that the co-opted terminology does worsen the quality of dialogues about the co-opted terms. People need to have the symptoms fully described for them in detail and sometimes don't believe me or think I'm exaggerating because it doesn't match their preconceived notions of what those words mean.
I'm not saying that the problem isn't ableism, it absolutely is, just that the co-opting of the terms is still harmful in that it uses up spoons and makes it harder to communicate clearly, especially with those who are stuck on the pop-culture meanings instead of actual medical meanings.
I flagrantly disagree that disbelieving someone's disability or believe someone is exaggerating because it doesn't mean their preconceived notions is something that can be helped if the culturally known depictions were specific to your wife's depictions. This is the mental health equivalent of yelling at someone in a wheelchair who can stand for short periods of time. Disbelieving someone about a disability assumes I am even capable of telling who is "really" disabled, which is an ableist belief that will not go away even if all the TikToks that say they were triggered by a minor toe stub disappeared.
In fairness, I believe that people who make jokes and light of disability suck in that I also believe this is an ableist activity. And I fully believe you that this kind of uwu-ification of disability is used as justification for ableist people to behave shittility towards your loved one.
It's not really a matter of it entirely solving the issue. As the other commenter is trying to stress, these are 2 separate issues, even if 1 underpins the other. We can and should try to solve for both. The thing is, 1 is a heck of a lot easier to solve. So why wouldn't we?
I don't think the position of "Having more accurate pop culture depictions of mental health issues and disabilities would enable better understanding from non-disabled people" is an entirely crazy one, and you haven't really made any arguments as to why we shouldn't do that.
I am so sorry to hear about what you and your wife have gone through. It sounds extremely frustrating and aggravating. I also suspect that when it comes up the people who downplay your wifes' conditions often act as if they are the insulted party.
We have an epidemic of not taking psychological conditions seriously. As my depression has worsened I've understood better the depth to which someone can fall and re-thought when it makes sense to say that I'm having a "depressive episode." I think there's a real issue of people mis-understanding diagnoses (in the way the comment I was replying to spoke about) and describing themselves as having them when their symptoms would not rise to the level of a diagnosis. Un-restrained by medicine and popularized by social media, watered-down understandings of disorders proliferate.
> Co-opting medical language for sub-disorder level dysfunctions is bullshit.
However, this I disagree with. Someone invoking PTSD or Bipolar to characterize their experience is not the same as claiming that label for themselves. I am not bipolar, but I mention the condition to talk about cyclic moods that I do experience (that are neither major depressive or manic but impact me). I think it's common to talk about a disease condition with the understanding that the condition has a range of severity.
I have a friend who was institutionalized for depression for a time. I don't think I am co-opting them to talk about my much less serious case - even though there's a similar "flattening" effect. If people hear my mental health journey first they might assume my friend is putting on airs about their situation. My friend has constantly had people imply or accuse them of overplaying their condition to get special treatment, which is gross.
> how is someone like my wife supposed to be seen or understood, let alone properly accommodated for when everybody thinks they know what a panic attack is but has never in their adult life been so panicked they became nonverbal?
My hope - and it is just a hope - is that on balance the social spread of broad and vague understandings of mental disorders is a net positive overall. The alternative feels like locking these terms away in the medical field - where when your wife (or anyone) says they're having a panic attack and the person who's there to help her has never heard of it. People are often shitty when you are going through a serious illness through ignorance and selfishness and I think medical conditions are the same as physical[1] in this case. I do not think that talking or identifying less with disorders is a net-positive.
All of these conditions have a spectrum of severity and, I believe, many people have sub-diagnostic versions of medical conditions. Those people will often improve their lives by recognizing patterns in their lives and using coping mechanisms developed for people with more severe cases. On balance I think that practice increases empathy for more severe conditions - because once people recognize a trend outside normative experience I think they often can extend it. I've also known far too many people who had life-changing adult diagnoses of conditions ("you mean this isn't what everyone is dealing with") to be set against the popularization of considering if you have a diagnosis.
[1] Mental conditions are, of course, also physical conditions but the dichotomy is widespread.
Someone can see their cyclic moods resemble bipolar disorder, use coping mechanisms developed for bipolar disorder, and gain empathy for people with bipolar disorder. Or someone can see their normal post traumatic stress resembles PTSD, use coping mechanisms developed for normal post traumatic stress, and lose empathy for people with PTSD.
Exactly this. Thank you
I'm not sure if this is "human nature" or if it's a specific cultural problem in the modern west. It's certainly true here in Canada too -- everyone uses terms that are really quite heavy duty to describe quite minor things.
I'm deaf. When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too." Now not to go policing people on their identities but -- no you're not.
Like what do I need to say? Clinically deaf. Severe-profoundly deaf. Cannot hear a fire alarm without hearing aids?
It's one thing when it's an elderly person. Yes maybe they are in fact a bit deaf too. But for all the people in their 30s or 40s who have said it to me -- the odds they all have moderate or worse hearing loss is nil! Most of the people who are saying it presumably have normal hearing. I understand that they're trying to identify with and not alienate me. But it's such a strange dynamic.
>When I tell people this, one of the most common response is "Oh, don't worry. I'm a little bit deaf too."
I think that is just people being people, and that's the first "acceptable" thing that pops into their mind when they hear that. They are just trying to relate to you. They are socially conditioned to not say things like, "that's too bad", or "I'm sorry", etc.. They were probably prepping to say something about the latest weather trends or something equally banal, and now you've hit them with something out of left field that they've never encountered before. How would you like people to respond? I am a migraine sufferer, and get the same types of responses, like "oh, I get headaches too", and "my sister in-law cured her migraines with mint oil!". I mean, most of the things that most people say are rather dopey.
Just start speaking ASL (or whichever) when they tell you they are deaf! Let them handle that gracefully.
Conversations are rarely about saying truthful things, and mostly about societal theatre that is supposed to leave both parties feeling better. Nobody cares that you're deaf, what you're expected to do is to react in a way that makes the other person feel good. I don't like this either, but that's how, for the lack of better word, "normies" function.
This is an excellent summary of the issues I have faced, where if you inform someone in the middle of a conversation of an experience you had in the past where someone else has done something bad, they tell me I am being negative... But it wasn't me who did the bad deed. It is completely baffling to me, and you summarised very well how people just want to effectively be tickled instead of dealing with facts. It is very isolating.
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> I’ve been offered helpful links to TikTok ADHD influencers to help me understand them
To be fair, giving you an example of someone else who performatively pretends to have a mental illness is a great way to understand them.
> When they’re procrastinating a task that is fun “my ADHD is flaring up today”.
I mean, our industry is filled with people of all ages with ADHD (arguably because it’s one of the few industries where you can succeed while having severe ADHD), GenZ folks are just more likely to admit it in public where older millennials are more likely to either be quiet about it or ignore the fact that they are subject to it.
You’re right and it’s actually wild how many people lack the ability to just deal with it. I think they do it because having a medicalized identity gives you a kind of framework or structure to lean on in social situations. You don’t need to learn the complex social rules to get grace from other people, instead you can do this easy thing and demand it. I think it is downstream of social media displacing face-to-face social interactions.
another therapy-speak term that has spilled over is "masking".
apparently, any time that you need to politely smile when you dont feel like it is "masking"
I know people like to blame social media and just "the kids these days" in general - but I think there's another reasonable, far more charitable explanation: it's a sort of overcorrection after those illnesses being very heavily stigmatized for practically ever. It's perhaps not ideal, but if a symptom of more people who truly have those illnesses being able to get help is a small portion of people using it as a fashion statement, that's a price I think we can pay. And I'm confident it will correct itself over time.
> 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”.
Somewhat unrelated, but I complain about the same thing in software parlance. Our work gets divided up into "sprints". A SPRINT is traditionally something you do a handful of times in your life, like when you're fleeing for your life, pursued by a bear. And then when you're a safe distance away and the adrenaline wears off, you collapse from exhaustion and rest. The idea that your employer would use that term to describe how they envision their employees structuring every day of the rest of their lives is either painfully tone-deaf, or even worse, is a brutally honest view of how they regard employee burnout.
Some of us do sprint workouts every week or two as part of sports training. Those are exhausting and require some recovery but you won't get faster unless you put in work.
But your point about misleading terminology is correct. That's why modern methodologies such as Scaled Agile Framework (SAFe) have adopted the more neutral term "iterations" which doesn't imply anything about velocity.
https://framework.scaledagile.com/iterations/
Those folks are the ones who refuse to acknowledge and accept the fact that they were abused by family members while growing up, where those personality 'symptoms' are common. It is very well known that ADD and ADHD comes from abusive households. Nobody except psychologists and anyone in the mental health field would ever admit such failures in life. They will not accept the fact, and exaggeration and deflection of character faults into false medical diagnosis is what happens. Not very many doctors want to get screamed at by their patients (which would prove the doctor right) for telling them the truth of their own past, and besides, they're not even paid to tell them.
"Truth hurts, don't it" is a very true phrase. It's a very sick trend affecting Millennials and Gen Z alike, and contributes to other worse mental health and criminal outcomes.
It's not even new.
No. Please stop spreading misinformation.
ADHD is something you are born with it. If one biological parent has ADHD there is a 40% chance the child will have it as well. We already know there is a strong genetic link. It is NOT caused by trauma.
There is a huge overlap in symptoms between ADHD and complex PTSD. Yes, one needs to be careful to not confuse the two. That is why when I was diagnosed with ADHD, I was also checked for trauma or any other conditions that could explain my symptoms better. This is the recommended and required procedure for diagnosis.
Furthermore many ADHD people also often have (C)PTSD because living with ADHD can in itself be very traumatic, especially when undiagnosed. And neurodivergent people are also more likely to be victims of abuse.
ADHD is not caused by "abusive households" because again, you are born with it. Also getting an ADHD diagnosis is probably harder to get than an PTSD diagnosis because most psychologists will expect trauma and is quite normal and expected to talk about trauma in therapy. In fact the whole field of Psychoanalysis that is the second most common therapy method after behavior therapy is based on working through childhood experiences.
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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 think when the author says "we medicalize grief because we fear it," she's not arguing that clinicians are eager to diagnose grief, but that society at large wants a clean, manageable container for something inherently messy and terrifying
Agreed. I think the word "disorder" in DSM terminology is commonly misunderstood/trvialized by lay people. Being forgetful, sad, or tired is just part of life. If it becomes your whole life then you likely need help but an orderly life will contain pain, joy, pride, shame, boredom...
We are always at risk of medicalizing discomfort. Allowing oneself to be miserable for a while can be therapeutic alongside patience, forgiveness, and compassion.
Edit: after a re-read I noticed that she says she feels most of the symptoms daily a year later. That does feel pretty disruptive on its own but the definition is a bit tautological in that case.
Regardless, what she's going through sounds really hard.
I have a friend who was hospitalized recently. He tried to take his own life multiple times. Before reaching this point, he was struggling for months, but he thought it was ok bc he was working. So it's hard to draw the line for some people. Obviously, everything in life is a tradeoff and can be risky. But seeking medical advice is probably the best thing you can do bc you can reach a point of no return, and you will not accept treatment. How to draw the line? Like you said, disruptive changes and also disruptive behaviors. It's a complex problem.
I would posit that you are reading this too literally. I didn't get the impression that the author was trying to rail against the medical establishment but rather to process her own experience in relation to professional guidance on the topic. I took it much more as a personal reflective essay than a professional medical critique.
Sure - it's an expansive essay on the authors' experience around their grief. I never said that this was their thesis, but I do think the way they talk about medicalization is worth critiquing. They put their experience in tension with medicalization in a way that I don't quite see.
Edit: I specifically think it's wrong to say we medicalize grief because we fear it. We medicalize it because some people would like a medical intervention with their grief. It's great and right that the author does not want that - but also they shouldn't write in a way that suggest that medical interventions in grief are wrongheaded.
Ok fair enough. I read her sentence as more of a figurative reflection on social attitudes towards grief, but if it's taken at face value then I see your point.
Further: by defining the criteria under which a condition becomes medically treatable, other parts of the healthcare system, such as insurance (private or government-funded), treatment protocols, and the like, come into play. Individuals should they choose to seek treatment are then able to do so within a much larger system.
By making the criteria reasonably loose and readily met, such a definition also minimises the number of individuals who would benefit from treatment who are excluded from being able to do so. This would include those who are very much unable to function or face larger grief-related risks.
We medicalise grief not because we fear it, but because there are genuinely useful therapies which may be of use to some, and denying them that merely compounds suffering.
And yes, absolutely, grief ultimately is a lifelong experience. You never stop missing that which you've lost, so long as you have the capacities of memory, reason, and feeling. That is not what the clinical definition is about.
I think you are misinterpreting what the author means with "medicalize". They aren't saying "require to be treated by a medical professional".
What they're saying is that as a culture, we reason about grief using the tools and concepts of the medical industry. Because it's part of our culture, this is so automatic that it's almost hard to conceive of any other way. But it is indeed a choice to describe grief as a sort of labeled pain which can be explored using falsifiable scientific experiments, is amenable to treatment by medical professionals, is a problem representing a delta between a "normal healthy human" and their current state, etc.
We could just as well have a culture that treats grief as a normal part of the human experience. We could consider a person currently grieving as exactly as healthy and normal as someone playing the saxophone. We could (and some do) consider that the most appropriate people to offer help for grief be spiritual counsellors.
I'm not saying we should handle grief differently. I'm just trying to point out that what the author's saying is that it's a cultural choice the way we present and work through it socially. (But, for what it's worth, I do think we should handle it in a less medical way.)
I think what you are talking about is a problem. Having a medical diagnosis gives personal experience an extra weight in the social realm that's quite problematic. We should all get to say how impactful something for us and the medical folks can have their own standards for when they feel comfortable intervening.
That said, if that's what the author was trying to talk about, I think they are doing so in a way that unfairly indicts the medical system for assertions it doesn't make. They say "Apparently, that’s a disease", but as I said I do not think it is. I think they've misunderstood what makes a disease under the diagnostic criteria they list.
> We could just as well have a culture that treats grief as a normal part of the human experience.
That culture does exist. Even in this article there is an experience of grief that's considered normative in the medical community. Including, I would argue, the authors' grief. I would argue that the medical approach to grief is actually better than other western treatments of grief.
I agree that western cultures (and US culture in particular) is horrible about grief. We want people to be robotic and predictable and not make us think about loss and be sad in private and a whole mess of awful, inhuman things. But I don't think that pressure either comes from the medical community or is furthered by how the medical community talks about grief.
Grief is feared and timed because it impacts the velocity in scrum.
Closing your Jira tickets on time is the order. Therefore grief by preventing the closure creates disorder.
Stop reading HN and work on your next Jira.
In my grief training, it was made pretty clear that typical grieving of a loss takes 3 to 5 years to somehow find to a new normal and start living again, and lasts forever, with phases of varying intensity. It is important to allow all the phases and encourage emotional release so it doesn’t get stuck and somatized. Stuck, unprocessed grief can kill you.
It is common for the first full year to be more in numbness and survival than in strong emotions. The psyche does not want to accept the loss so it pretends it is not real. Anniversaries and such serve as a slow and painful reminder that the person is in fact not there and will never return.
Swinging between emotional denial and waves of anger and intense pain over many years is totally normal, and should be encouraged and supported. Go with your friends into the intensity of their pain. Ask about their loss. Sit with it. Don’t say stuff like “it will pass“. They will love you for it.
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
Reminded of https://news.ycombinator.com/item?id=41157974 1209 who was her husband
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.
I'd just like to clear up a misconception that people seem to have about mental healthcare. Getting a diagnosis isn't related to the 'severity' of the thing you're experiencing. But rather how you're dealing with it, and if it requires professional help to work through. Keyword being 'requires'.
Even if you grief a lot, if you're dealing with it yourself you will not get a diagnosis.
If grief makes you isolate yourself, stop working, start abusing alcohol or drugs, stop you from caring for you children, etc. Then there's a very real chance that this behavior could lead to more problems, making it in turn harder to regain positive mental health. In that case the person should get a diagnosis, which would then unlock treatment and therapy for them.
> The American Psychiatric Association describes “disordered grief,” also known as “prolonged grief,” as a loss that occurred at least one measly year ago for adults
Even though that might be true, it's an excellent example of why you can't just take the written word at face value if you're not well versed in the subject. In the mental health profession it's understood that everybody is going to be different from the norm. Only the treating psychologist can put the clients problem in the proper context to determine if a year is enough or not.
I know someone who was concerned about depression, and went to get checked. The diagnosis was normal. They were having an appropriate emotional response to very challenging situations.
Moreover, most diagnostic terms simply describe symptoms. "Pharyngitis" sounds scary, but it just means you have a sore throat. Why does it hurt? It could be many different reasons, but the term just describes what you're feeling, not the specific reason. Having a condition doesn't necessarily even mean anything is wrong with you. "Bradycardia" means having an abnormally low heart rate, which is common in trained athletes. As long as it's not extremely low, it's not a problem.
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.
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 alternate forgetting with disbelief or feeling almost indignant.
"This is so unlike them! They've never just DIED before. They've always gotten through everything." But that is a thing about death. You only do it once.
> 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.
> science has nothing more to say about it
Science has also given us time machine surrogates - photos and videos. I understand this doesn’t work for everyone and can sometimes make things harder, but for me, seeing our common past brings back the smile to my face.
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.
The way the author captures grief (not as a pathology, but as a form of learning, unlearning, and continuing to love) is so raw and honest it almost feels invasive to read. The line "grief is a terrible kind of learning" hit me like a freight train. There's such a deep humanity here, and also a quiet indictment of our culture's need to classify, contain, and "resolve" grief like it's a software bug. We talk a lot about resilience, but rarely about the kind that means simply keeping going while carrying a pain that doesn't lessen, only changes shape.
Both Bess and Jake's writing is all very much like this. "Almost feels invasive" is certainly how it felt reading their posts during Jake's illness.
The depth of grief the author feels drove me to tears. I think I’d feel like this if I lost my spouse. But I worry wouldn’t be able to express my feelings as well as she has here, so people wouldn’t know how much she meant to me. What a silly thing to worry about.
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.
I'm all about hating on the psychiatry profession, but I believe what may be missing here is that these diagnoses are always optional.
If you like your grief, you can keep your grief. But if you need help, the criteria need to be there for you, for insurance companies, employers, and such to systematically do all their accounting and such.
It's a bit similar to a lot of controversies around the autism spectrum. If it's just a personality quirk and you're a functional adult then it doesn't really matter if you meet the this or that criteria. If you like your autism, you can keep your autism.
> 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.
The worst part of 5 years and 2 months mourning my baby brother was the day that the dream got me. I dreamt about him a lot but I'm a shit screenwriter so the dreams were always cliched garbage with obvious meaning. Stuff like "We're standing on a bridge that I can't cross, and he says he needs to cross it but I'm trying to convince him not to". The kind of stuff you write for a high school creative writing class that you don't need to pass in order to graduate. But one got me goooooooooood. It was one of those hyper-realistic dudes, I was driving with my wife to a restaurant that I used to go to as a kid, we were picking up takeout to bring back home. As I was loading it into the car I heard his voice behind me say "Aren't you forgetting something?" I turned around and it was him, and everything else about the situation felt so normal and boring that of course he would be there because he was always there every time we did this. But my brain knew that we had been spending the last few years more or less constantly thinking about the fact that he was gone. It almost always results in me realizing that I'm dreaming, but just this one time it went the other way and my brain said "Oh joy, there must have been some sort of years-long misunderstanding and he's actually been here and fine the entire time!" Then I woke up. Cruelest thing I've ever done to myself, but it's a bit comforting to realize that it's in the realm of normality.
The quote "Grief is love with no where to go" has always been fully embodied in my dreams. Since my Dad died I have dreams where he would appear and I would jubilantly (and sometimes angrily) greet him with "Where have you been?! I've been looking everywhere for you!". And it is true, I look for him everywhere.
Waking up from those is so painful but I am grateful I still get to see and hug him once in a while.
I felt that one, too.
It took a couple of years after a good friend of mine died before I stopped texting him on occasion.
I wish someone mentioned DMT here (N,N-DMT). It's really that powerful that you can't ignore that.
Look up DiMiTri ladder protocol, or even without a protocol. The thing is that DMT enthusiasts have advanced quite a bit. Now you don't need to smoke DMT to get a "breakthrough". The entire "breakthrough" moment is somewhat overhyped.
But you can extract the molecule by yourself, and create your own vape, and experience the safest way known so far to overcome years of grief in weeks, sometimes days.
The idea is inhaling every minute relatively small dose to keep yourself here in this world without any breakthroughs, and maintaining this control for the next 60 minutes, while healing the trauma. So in total 60 relatively easy inhales. And it works.
It's definitely underestimated in HN community.
PS and "breakthrough" moments might allow you to see the person and talk to them
I would argue that you’re advocating for hallucinogenic drugs in a relatively novel treatment and this seems fairly drastic even here.
It seems that people forget that while medical terms do enter the vernacular, medicine also appropriates common terms and gives them specific, narrower definitions.
In the former, those terms do lose some of their specificity and should be considered shorthands for "what feels like [ADHD, autism, depression...]".
In other words, language is a flexible, living thing, and interpretation can obly be done in context.
This is why some of these statements sound so much worse when typed out on the internet, as they are missing any and all emotional cues coming from visual and audio communication.
It happens in other areas as well ("cloud" in IT or "space" in math).
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?
> Sometimes, I close my eyes while I breastfeed my daughter and the cocktail of oxytocin and prolactin saturates my brain in a way that resurrects Jake with hallucinatory vividness. Suddenly, we’re 27 and running out of the cold Seattle rain into Belle’s Buns for coffee, and then Athena unlatches from my nipple and I’ve lost him again.
I don't really have anything to add but that this is chilling. It really makes me want to take care of myself better even though this man's death had nothing to do with that.
In Taiwan there's usually a little shrine dedicated to someone deceased, and if you miss them you talk to them there, or maybe place some flowers or offerings.
I feel like this kind of ancestor worship is a pretty natural and normal way to deal with things. I'm not an expert but I believe many European religions had practices like this before we adopted Middle Eastern practices.
I’m not sure I see a problem with that definition for disordered grief. To truly experience three of those every day one year on would be debilitating. Having the person pop into your thoughts regularly, forgetting they’re gone etc sounds like normal grief (which is also horrible but not debilitating). I guess I would look at it in the way that people feel depressed and then there are people that can’t get out of bed, keep themselves clean, or go to work. Both suck. One’s a serious clinical issue if it’s not improving.
These are very typical and normal thoughts when dealing with grief. The thing is, it's a misconception that it "goes away" or becomes lessened. It doesn't, and that's the honest truth, it will always be there. Over time though it becomes less unbearable, and for me anyway, 10+ years removed from it, has become such a core part of my personality I'm unsure of how or who I'd be without it. Not that I prefer it, it's just become ingrained.
"Time heals all wounds" is the biggest trap I think these thoughts are driven from. The simple and difficult truth at this stage of grief is accepting that yes, things are probably always going to feel like this. Yes, when other people have moved on you won't have. Yes, it makes people uncomfortable and you're going to have to learn to navigate those situations gracefully. The hopeful message though is that you adapt to it and it becomes less distressful over time. If it doesn't, and significantly impacts your life years later, is where I think diagnoses come into play.
Damn this is so sad
I sometimes get jealous of bad people. Bad people tend to surround themselves with other bad people. So when their 'close ones' die, they probably don't feel much grief... And they probably inherit more money because bad people have more money.
It's like how some criminals describe feeling a sense of relief once they got caught. Some part of them is glad that they get punished.
Being a bad person is a win-win in this world; you win by cheating and then if you get caught, you can at least rejoice in knowing that there is justice in the world.
Being a good person is hard because everyone close to you is also good, so their death is unbearable and unjust.
The only thing which sucks about being a bad person is love... Because if you're good and you fall in love with someone and they don't love you back, it's much easier to fall out of love. "Maybe they're a psychopath" or "They're too superficial" you subconsciously tell yourself...
But if you're a bad person and you fall in love with someone and they don't love you back, you think to yourself "They must be a good person; they can see straight through me into my dark heart" and this sign of virtue makes you even more attracted to them. Hating you is proof that the person is sane, wholesome and perceptive... Which is very attractive to someone who is none of these things!
> if you get caught, you can at least rejoice in knowing that there is justice in the world.
No, it doesn't work like this.
>There’s no modern cultural framework for dealing with death
Correct, secularism can't deal with death, it doesn't work.
Sure, only an imaginary friend can deal with death.
/s
It's is immensely epistemically arrogant to so confidently opine on this topic when every single day you experience consciousness, which is impossible to explain at all using Physics and likely simply impossible to ever explain within that framework (Edward Witten, the greatest living Physicist, shares this belief).
It's also extraordinarily arrogant - and rude - to state that atheists cannot deal with death. Certainly they face it with far more bravery than, say, someone who believes people don't actually die but instead go to a magical place in the sky.
1. You've made the mistake of assuming I'm religious. I am not. This is my lived experience.
2. I think that, largely, materialism is a system that isn't merely arrogant (which it clearly is, as outlined above), but also unfulfilling. You can simply ignore the concept of death but if you choose to really wrestle/engage with it in a materialist framework you will see yourself staring into an abyssal, terrifying maw. I think most atheists don't engage with this concept because it's difficult to do so, just as many religious people believe in religion because it's convenient to do so. It's a fairly even cut.
I've already stated I'm not religious, which I'm not. I share the scientific view that human behavior is explicable so far as we can tell via mechanical/biological mechanisms, behaviors such as altruism not being explained because they are objectively good, but only being explained as preferences we've evolved because they were conducive to our genetic survival.
But, let me propose something from a scientific/rational point of view to you, a brief experiment sort of in this vein. Paraphrasing, Jesus said something like "if you do not believe me, believe the works".
I know this may seem a massive imposition, or horrific undertaking, or you may not be able to engage with it meaningfully, but, if you are able to humor me, I'd propose this:
Take all of the core precepts of what most religions might propose as being 'good' - there is variance but that's alright, humans disagree in every domain on everything - and apply them to your life.
Nip lies in the bud. Road-rage, rage at people on the internet? Let it go. Forgive those people and treat them well. Give people the benefit of the doubt, even people you hate.
You won't be perfect, but don't let that discourage you.
I'm encouraging this experiment because I believe you will "believe the works" and see that there is an element of the human experience that is genuinely transcendant and you can do these things not merely because they are nice or convenient and may be easy to do in the moment, but because they are hard to do, require constant correction and should be done as you are compelled to treat the gift of your own existence with care.
I suspect we are compelled to behave transcendently for our own good though my only proof is lived experience that merely behaving as if this is true is immensely fulfilling. Quite the coincidence.
>Take all of the core precepts of what most religions might propose as being 'good' - there is variance but that's alright, humans disagree in every domain on everything - and apply them to your life.
A sum of a thousand imaginary friends is still imaginary.
I'm unsure why you think I don't already try to live a "good" life.
To me, and most atheists I've discussed this with, death is not an "abyssal, terrifying maw" - it is simply the natural conclusion to life of any kind. It does not 'scare' me; it inspires me to live a good life, to help others, to die with the knowledge that I hopefully made the world a slightly better place.
You're saying the words but I suspect you haven't interrogated them. Again, I'm not sharing my speculation, I'm sharing my actual experience and conclusions as an atheist. Anyways, it doesn't seem like we're getting anywhere with our dialogue, cheers.
Also I want to point out that it's clear that you don't practice what I outlined or you wouldn't have mocked the belief of religious people as "a magical place in the sky", hence cargo cult morality. It looks like morality to you, it may even feel like morality, but it demonstrably isn't. You haven't inconvenienced yourself at all, you merely did what felt good.
> Again, I'm not sharing my speculation, I'm sharing my actual experience and conclusions as an atheist.
As am I, which you seem to refuse to believe for some reason.
> Also I want to point out that it's clear that you don't practice what I outlined or you wouldn't have mocked the belief of religious people as "a magical place in the sky", hence cargo cult morality. It looks like morality to you, it may even feel like morality, but it demonstrably isn't. You haven't inconvenienced yourself at all, you merely did what felt good.
Just because one does not live a perfectly moral life 100% of the time does not mean they are not moral. As you said, "You won't be perfect, but don't let that discourage you."
>It's is immensely epistemically arrogant to so confidently opine on this topic when every single day you experience consciousness, which is impossible to explain at all using Physics and likely simply impossible to ever explain within that framework (Edward Witten, the greatest living Physicist, shares this belief).
Look, you asked for it by setting up secularism as the problem. The opposite of secularism is commonly understood to be religion, and religion is self-delusion. The fact that you can't explain consciousness via a materialistic framework, doesn't mean you have to invent an imaginary friend to explain it. It's like saying that since you can't fly an airplane to the Moon, you should take a train (with no wheels).
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.
I find some comfort in Seneca's letter myself, simple words that takes days to digest: https://en.wikisource.org/wiki/Moral_letters_to_Lucilius/Let...
Thank you for sharing.
Off the front page within minutes, how odd.
Happens all the time.
FWIW, it's back on front for now.
“Some days I wake up at 4am, seized by the need to hold Jake’s hand, and feel anger that all I have is a plaster model of it.“
At least kids depend on her.
Previous title “Oh fuck, you’re still sad”.
I came across this when I was going through the death of a parent. It helped me process and manage grief, I hope it helps others, and feel it is relevant to share in this thread.
"Alright, here goes. I'm old. What that means is that I've survived (so far) and a lot of people I've known and loved did not. I've lost friends, best friends, acquaintances, co-workers, grandparents, mom, relatives, teachers, mentors, students, neighbors, and a host of other folks. I have no children, and I can't imagine the pain it must be to lose a child. But here's my two cents.
I wish I could say you get used to people dying. I never did. I don't want to. It tears a hole through me whenever somebody I love dies, no matter the circumstances. But I don't want it to "not matter". I don't want it to be something that just passes. My scars are a testament to the love and the relationship that I had for and with that person. And if the scar is deep, so was the love. So be it. Scars are a testament to life. Scars are a testament that I can love deeply and live deeply and be cut, or even gouged, and that I can heal and continue to live and continue to love. And the scar tissue is stronger than the original flesh ever was. Scars are a testament to life. Scars are only ugly to people who can't see.
As for grief, you'll find it comes in waves. When the ship is first wrecked, you're drowning, with wreckage all around you. Everything floating around you reminds you of the beauty and the magnificence of the ship that was, and is no more. And all you can do is float. You find some piece of the wreckage and you hang on for a while. Maybe it's some physical thing. Maybe it's a happy memory or a photograph. Maybe it's a person who is also floating. For a while, all you can do is float. Stay alive.
In the beginning, the waves are 100 feet tall and crash over you without mercy. They come 10 seconds apart and don't even give you time to catch your breath. All you can do is hang on and float. After a while, maybe weeks, maybe months, you'll find the waves are still 100 feet tall, but they come further apart. When they come, they still crash all over you and wipe you out. But in between, you can breathe, you can function. You never know what's going to trigger the grief. It might be a song, a picture, a street intersection, the smell of a cup of coffee. It can be just about anything...and the wave comes crashing. But in between waves, there is life.
Somewhere down the line, and it's different for everybody, you find that the waves are only 80 feet tall. Or 50 feet tall. And while they still come, they come further apart. You can see them coming. An anniversary, a birthday, or Christmas, or landing at O'Hare. You can see it coming, for the most part, and prepare yourself. And when it washes over you, you know that somehow you will, again, come out the other side. Soaking wet, sputtering, still hanging on to some tiny piece of the wreckage, but you'll come out.
Take it from an old guy. The waves never stop coming, and somehow you don't really want them to. But you learn that you'll survive them. And other waves will come. And you'll survive them too. If you're lucky, you'll have lots of scars from lots of loves. And lots of shipwrecks."
Source: https://web.archive.org/web/*/https://np.reddit.com/r/Assist... | https://archive.today/CkLxT
Hey, I was going to post this!
But yeah, I read this when it was initially posted and it has stuck with me ever since. It's a really great expression of the struggle with grief.
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