The ‘medicalisation’ of distress, is it right?

We can’t escape the headlines:

We are at crisis point in children’s mental health.

Antidepressant prescriptions have increased dramatically and one of the biggest increases has been in those aged 12 and under.

Rates of childhood anxiety, depression, self-harm, self-esteem, identity, body dysmorphia, social isolation, and eating issues are rising year on year.

The response of our risk averse, anxious, more selfish society has been to seek scientific and logical explanations for what it views as ‘non-standard’ behaviours naming different kinds of human distress as ‘illnesses’- as deviations from what is considered normal.The fifth edition of the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5)lists disorders, describing symptoms.Illnesses of course, require treatment, need fixing or a cure.Drugs or Cognitive Behavioural therapies are often suggested as a solution, but for me, there is a downside: they may carry side effects, create a risk of dependency, and offer no meaningful exploration around what might be causing  the problems.

The DSM has been criticised for medicalising perfectly normal and understandable reactions to what, is in reality, distress.For example, the latest edition even lowers the threshold for the diagnosis of Generalised Anxiety Disorder. In the past, at least three out of six symptoms needed to be present for a period of at least three months.The latest edition suggests that at least one out of four symptoms needs to be present for one month. I think that this has the effect of categorising what might be seen as everyday worries as something that requires treatment or even medication.

The DSM includes ‘grief’ as a causal factor in a Major Depressive Disorder diagnosis.Surely, grief, whilst undoubtedly a painful, upsetting and difficult process is essentially a normal human process that needs to be worked through as wereaction to loss and change.An illness? No!

Mental health symptoms concern feelings, beliefs and emotional reactions.

Every person’s experience is unique – my own experience of ‘low mood’, for example, may be very different to yours.

I would argue that the many forms of distress constitute a normal, human reactions to challenging life events….and no-one’s story is the same!

Of course, I accept that this ‘medical model’has a place in our society.It is embedded in the way our society is organised and in the ways we access help. ButI also believe there is a real place for exploration to help us make sense of our complex and unique experiences. To me, this is a fundemental part of being a human being: as humans we need to make meaning from our experiences. After all, every part of our behaviour is communication – right from birth communication begins: babies communicate to have their needs met- they want to be understood!

Approaching human distress from a medical perspective tackles it from the end of the process.I think we need to start at the beginning and attachvalue to exploration around the causes of distress.

Personally, I don’t want a label, or to be viewed as abnormal.I want to be truly heard.I want to be understood, respected and valued as an individual.

I want my reactions, my behaviour to be recognised as communication.

I take comfort that counselling can offer a simpler, warmer, optimistic, forward thinking way to help explore how problems may have come about and what the pathway to feeling better might look like.

It respects the humanity of the individual.

Science shows that when a person experiences the empathy and trust that a counselling experience can offer, the brain releases oxytocin (the feel – good hormone)and levels of cortisol (a stress hormone) decrease. Don’t you think that this is amazing?

So, as a counsellor, I will never ask what’s wrong with you?

I’m interested you as a person, what happened?, what’s your story? I’m here to listen.

Where would you like to begin?