The Effect of a Misguided Society on the Perception of Mental Illnesses.

By Karolina Walczyk

But it turns out that I wasn’t just shy; I have social anxiety disorder, just like 15 million other US adults (Anxiety and Depression Association of America, n.d.). Over the past few years there has been a significant increase in the number of diagnosed mental health disorders in young adults, with half of all mental health disorders starting by age 14 and three-quarters starting by age 24 (National Alliance on Mental Illness [NAMI], September 2019). From 2008 to 2017, the number of young adults who have major depression, psychological distress, and suicidal thoughts has increased drastically, in contrast to older adults who display these symptoms (American Psychological Association, n.d.). There has also been a steady rise in the presence of anxiety disorders among young adults. The National Institutes of Health (2017) predict that one in three 13 to 18 year olds will experience an anxiety disorder, and the National Survey of Children’s Health (2018) notes a 20% increase in anxiety in children and adolescents from 2007 to 2012.

But why has there been a recent rise in diagnosed mental health disorders, specifically anxiety disorders, among young adults? Although there is no certain answer or leading cause of this rise, many experts generally attribute it to: genetics, a rise in higher expectations from others, more pressure to succeed from parents, an increase in social media use, an uncertain environment, and increased education and awareness, or a lack thereof.

Before we get into the research regarding the rise of anxiety disorders, let’s define what they are first, since the term is often misused. By definition, from the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), anxiety disorders include those that share an excessive fear and anxiety, and significantly interfere with a person’s day to day life. Anxiety disorders include generalized anxiety disorder, social anxiety disorder, panic disorder, agoraphobia, specific phobias and separation anxiety disorder. However, the term “anxiety disorder” should not be confused with being temporarily anxious, or nervous, about an upcoming stressful event or decision, since anxiety (in healthy amounts) is a normal reaction to stress. The problem arises when the anxiety doesn’t go away or when it presents itself in situations that do not pose an imminent threat to the person’s life.

Throughout the years, there has been an increase in the pressure placed on young adults to be successful, leading to a significant increase in overachievement culture. Many parents, especially immigrant parents, hold high educational standards for their children, which may include attending college, maintaining a good career, or simply getting good grades in school. These aspirations for their children often reflect “their own educational and occupational struggles, their immigrant status, and perceptions of opportunity in the United States” (Langenkamp, 2019). Although most immigrant parents only want the best their children, they end up placing huge amounts of pressure on their kids, which in turn leads to the need for overachieving to please others. As a child of immigrants myself, I can relate to the educational pressure placed on me by my parents, as well as the need to constantly achieve. My parents immigrated from Poland as young adults and only my mom managed to obtain a college degree, which is why they placed a heavy emphasis on the importance of education ever since I was little. I was always expected to maintain good grades, which over time developed into this need to constantly please my parents and meet their academic standards. I formed my own high standards, based on my parents’, in order to make them proud—but if I wasn’t able to meet them, whether that be not getting high-enough gardes or being told I need to talk more in class during Parent Teacher Conference, I felt like I had failed. Apparently, this is a pretty common experience. Overachievement in students leads to many mental health issues, since many students push themselves to constantly achieve and be successful, but don’t reach out for help until they have reached some sort of a breaking point (Brown et al., n.d.).

Many parents also expect their children to attend college, adding more pressure to the already-stressful college admissions process. Over the years, the college admissions process has become more competitive, with many colleges and universities maintaining admissions rates of less than 10 percent, compared to over two decades ago, when it was rare for a university to have an admissions rate of less than 20 percent (Pérez-Peña, 2014). This increase in selectiveness from universities has caused an increase in stress in the high schoolers applying to these schools, since they must learn how to successfully “stand out” among the many other candidates. The Higher Research Institute at UCLA, which conducts yearly surveys of American college freshmen, notes that, “Students’ perceptions of a more competitive admissions process manifest in their increased likelihood to submit even more applications than their counterparts did just a decade ago” (Eagan et al., 2016). Since students are now submitting more and more college applications, they often get overwhelmed while having to balance their schoolwork, their applications, and any extracurriculars they may be involved in. But the stress regarding the college admissions process usually starts way before the process itself. Many students want to appear “well-rounded” on their college applications and force themselves to join clubs or other extracurriculars that they don’t actually enjoy, but feel the need to be a part of, so that they can “stand out” among other applicants. Pressure on being a well-rounded student often leads students to feel like they’re not good enough for a certain school, or that they have “failed” in some sense by not getting accepted to their dream school. These feelings of underachievement, especially in a culture where overachieving is a norm, may lead to feelings of weakness that many students hold with themselves in the future.

On top of the pressure to get into a good college and to meet high expectations in school, the pressure to pick a successful career and to obtain the “proper” number of degrees adds to the stress many young adults face today. Over the years, there has been an increase in the number of students who intend to pursue a master’s degree or doctorate, while the number of students who intend to finish their studies with just a bachelor’s degree has dropped (Eagan et al., 2016). This can be referred to as a “credential inflation,” meaning that many people now consider a master’s degree to hold the same value as a bachelor’s degree did before, technically devaluing a master’s degree. The pressure of pursuing the “right” career builds in college graduates as employers start to seek those with master’s degrees instead of only a bachelor's, causing levels of stress and self doubt to skyrocket. It is common for many people to abandon their dream careers or any educational interests, in hopes of studying something “more practical” that will yield them a better paying job in the future. A recent high school graduate interviewed for TIME said, “You’re more apt to go do a job that you don’t really like because it pays better and you’ll be in less debt” (Schrobsdorff, 2016). All of these factors result in increased anxiety faced by students applying to college and those in college who are trying to plan their futures.

The stress resulting from the emphasis placed on the importance of school and finding a good job, is only heightened by the impact of the current environment. Young adults today are known as “the post-9/11 generation, raised in an era of economic and national insecurity. They’ve never known a time when terrorism and school shootings weren’t the norm” (Schrobsdorff, 2016). Most have experienced their parents dealing with the economic recession in 2008 and with the current economic hardships—that even they themselves may be facing—brought forward by the outbreak of the 2019 novel coronavirus. Even though adolescent minds often crave stimulation, the current environment they’re in may be providing too much—and when there’s too much stimulus that teens either don’t know how to or can’t get away from, that’s when their mental health starts to decline.

Currently, many people are experiencing increased amounts of stress due to the outbreak of the coronavirus. The fast spread of the virus has significantly changed the everyday lives for many people, creating higher levels of uncertainty and a lack of control of the situation, which may be potentially anxiety-inducing or really hard for people with anxiety disorders. Uncertainty about the situation leads to the fear of the unknown, which in turn raises the levels of anxiety in both people with preexisting mental health disorders, and in those without (Shigemura et al., 2020). Experts note that the outbreak of the coronavirus, and events of a similar nature, produce a wide scope of mental health concerns. These concerns include distress reactions, such as anger and an extreme fear of contracting an illness; health risk behaviors, including increased alcohol intake; a lower perception of physical health; and mental health disorders, including depression and anxiety (Shigemura et al., 2020). Therefore, it is especially important to care for your mental health, on top of caring for your physical health. However, given the current situation, experts say, “in any biological disaster, themes of fear, uncertainty, and stigmatisation are common and may act as barriers to appropriate medical and mental health interventions” (Xiang et al., 2020). With the many regulations put in place for the coronavirus, many people are unable to receive help for any of their mental health issues in person, but still have to continue to live and function in a very uncertain time, adding more stress to their already-stressful lives.

Major events, such as the outbreak of the coronavirus, receive a lot of attention from the media, but this attention is not always entirely beneficial. In the 21st century, the existence of various media platforms makes any news highly accessible and available for sharing with the touch of a button. This easy access poses quite a few problems including the accuracy of the news and information read online, and the inability to detach from potentially stressful situations. Fake news is often spread online, and it is important to fact check and to avoid spreading rumors. Also, our constant connection to the internet through our phones or computers makes it hard to detach from a stressful situation, if it is all that we see when we go online. If access to the news is so easily available, what effect does the access to other content in the media have on the rise of mental health disorders?

One of the most popular types of media today, and the one that is most often associated with the rise of mental health disorders, is social media. Since current young adults and adolescents are the first generation to grow up alongside the constantly-evolving technology and social media, it is understandable that they appear to be the most connected to it and the most affected by it. With over 90 percent of adolescents using different social media platforms, like Instagram or Twitter, many feel emotionally connected to these sites, and therefore very disconnected from the world when unable to access them (Woods & Scott, 2016). This attachment often leads to issues with relaxing before going to sleep, or not getting enough sleep due to the need to constantly check social media. The lack of sleep in adolescents has been named a key factor in the rise of mental health disorders, namely by Jean Twenge, who has done extensive research on people born between 1995 and 2012, who she calls the “iGen.” She believes that sleep disorders are heavily linked to the development of mental health disorders. Those who sleep less and meet the requirements of a sleep disorder, are more likely to develop mental health problems in the future.

Twenge (2017) also links the time spent online to the onset of various symptoms of mental health disorders. She says that, “Teens who spend more time than average on screen activities are more likely to be unhappy.” She highlights the importance of spending less time online, given the positive correlation between time spent using social media and depressive symptoms. Those who spend less time on social media are more likely to spend their free time maintaining in-person connections with family and friends, rather than the many online connections available through social media. Ironically, those who spend more time online, and appear to be connected to a lot of people through social media, typically end up being more lonely than those who spend less time on social media. The loneliness is often accompanied by a slowly-worsening self esteem from the constant comparison to the “perfect” lives of those online. It’s hard not to compare yourself to people you see online, especially when they're “prettier” and “more successful” than you, and then wonder where you went wrong. The loneliness and low self esteem that many face because of social media, may be a leading cause of mental health problems (Twenge, 2017).

However, not everyone fully agrees with Twenge. Research published in The Lancet Child and Adolescent Health, suggests that, “Social media itself might not be to blame for mental health issues; rather, it takes away from girls' sleep quality and exercise while exposing users to cyberbullying” (as cited in Asmelash, 2019). Here, the content of social media is blamed for a lower well-being and unhappiness, and said to lead to mental health problems, rather than the time using social media itself. Other research shows that there actually isn’t a link between social media use and mental health problems—even calling any social media concerns in regards to the mental health crisis, “unwarranted” (Berryman et al., 2018). Social media use is not an accurate predictor of mental health disorders, such as anxiety or depression—with the exception of suicide and suicidal thoughts, which should be taken seriously. Although the various research may disagree on the extent that social media affects young adults' mental health, it all seems to agree that how social media is used is more important than the actual time spent using it.

Now that we’ve gone through some of the potential causes of the rise of diagnosed anxiety disorders in young adults, let’s address a new question: Does the rise in diagnosed young adults show an increase in cases themselves or rather an increase in proper diagnoses? There are mixed responses to this question, with some believing that there is an increase in proper diagnoses and others believing that there actually is an increase in young adults with anxiety disorders. Gil Noam (2019), a clinical psychiatrist and psychologist, says, “Unfortunately, I believe that we are witnessing real increases, though most likely not as dramatic as reported in the media.” He quotes evidence coming from multiple time-lag cohort studies, which compare results of the same age group over time. However, two German researchers, specializing in anxiety disorders, believe otherwise. In their research, Bandelow and Michaelis (2015) discuss a 17th century book which contains descriptions of symptoms of anxiety attacks caused by social anxiety disorder, and the writings of Hippocrates, which describe symptoms of one of his patients that would be classified under social anxiety today. They conclude that, “Pathological anxiety, such as social phobia, has always existed in humans. Is there a reason to believe that anything has changed in the 21st century?” (Bandelow & Michaelis, 2015). Similarly, others believe that there aren’t necessarily more people who suffer from anxiety disorders compared to the past, rather there are more people who are properly diagnosed and treated for them (Noam, 2019). Over the years, there have been many efforts to destigmatize mental illnesses and to educate the public about them and the potential symptoms. The increased education in how to help yourself, or others, has been beneficial for the most part. But is it enough?

Even with this raised awareness that is leading to more young adults being properly diagnosed with mental health disorders, there is a significantly lower percentage of those who seek and receive treatment for them. The National Alliance on Mental Illness (2019) states that 50.6% of US youth (ages 6-17) with a mental health disorder were receiving treatment for it in 2016, while only 43.3% of adults in the US received treatment in 2018. They also note that on average, the delay between the first appearance of mental illness symptoms and receiving treatment is eleven years, despite the fact that many mental health disorders, including anxiety disorders, are treatable. These statistics are especially concerning since there is good data “to support an evidence-based approach to the diagnosis and treatment of anxiety” (Siegel & Dickstein, 2012). But why are so many people hesitant to reach out for help?

The biggest obstacle many people still face today is stigma. Even though these disorders are becoming more common and there is widespread awareness, many people are still not as accepting of them as they should be. The problem here lies with the way society perceives and interacts with the concept of mental illness and people with mental illnesses. Society’s perception of mental illnesses, their symptoms, and the traits they attribute to people with mental illnesses is most often heavily shaped by the media—and usually not in a good way. The media is notorious for romanticizing and glamorizing mental illnesses, meaning they make them seem more appealing and more desirable to society. Having a mental illness becomes like a competition of who can “have it the worst,” in order to try to fit in with society’s desire of having one and the desire to be relatable, yet this only reinforces faulty stereotypes. Although stigmatization and romanticizing/glamourizing are technically opposites of each other—since stigma belittles people for their symptoms, while romanticizing makes them seem desirable—both have the same detrimental effect in society.

Since romanticizing and glamorizing have turned mental illnesses into such common concepts, essentially trivializing their severity, many people have begun to misuse mental illnesses terms in daily conversations. It is very common to hear people saying: “I’m so OCD,” when they want to emphasize that they like to clean; “psycho,” “autistic,” or “retarded” to criticize someone’s behavior; or even “mentally ill person” in which the person’s mental illness becomes their defining trait, rather than saying “person with a mental illness” which not only is more respectful, but it also accepts that the person isn’t defined just by their mental illness. These terms are all extremely insensitive to those who actually deal with these mental illnesses on a daily basis. In my own experience, people have glamorized the concept of social anxiety so much, that it has become a common way to describe introversion or feeling nervous in front of a large group of people.

In regards to the way mental illnesses are portrayed in the media, we can clearly see that the media’s main concern is entertainment, not education. Dominika Sozańska (2014), who conducted research on the effects of the media’s faulty portrayal of mental health disorders on society, notes that the public appears to have a fascination with concepts outside of their sense of normalcy. She discusses the prominent themes in Leo Tolstoy’s Anna Karenina, unhappiness and suffering, which she believes Tolstoy used specifically with the public audience in mind. Through this story, Tolstoy ended up reinforcing the idea that unhappiness and suffering are much more appealing than happiness. The media and the film industry take advantage of this fascination and often portrays individuals with these disorders, as outcasts from society. The mental illnesses shown on TV or in movies often appear to be oversimplified, more dramatic or more dangerous than they are in reality (Tartakovsky, 2018; Sozańska, 2014).

This miseducation caused by the media leads to a misbelief about how people with mental illnesses should act and what their symptoms should be. Society’s perception of people with mental illnesses is so clear-cut, even if most disorders are assessed on a spectrum basis, and every person experiences mental illnesses differently. In order for society to accept your symptoms and feelings, and deem them as valid, you have to exhibit particular symptoms. Or more importantly, your life has to completely fall apart for others to actually believe you. But why should I have to justify my feelings until society decides to deem them as valid?

That’s not to say that the media doesn’t use its widespread reach in a beneficial way either. There are some shows and movies that do a better job of portraying mental illnesses in a more sensitive way, though it is important to remember that no show is perfect. Some of these shows and movies include: The Good Doctor, where the main character has autism; Girls, which depicts OCD and how it may worsen when facing extreme stress; This is Us, which has a rather accurate portrayal of a panic attack and the overall nature of anxiety disorders; Inside Out, which was praised for its portrayal of emotions in reaction to a new stressful situation; and A Beautiful Mind, which is based on the experiences of John Forbes Mash, Jr. who had schizophrenia. There are also many books that have authentic portrayals of mental health disorders. Kia Jane Richmond, a professor at Northern Michigan University, published a book that discusses various 21st century young adult texts that accurately portray mental illnesses and offers a list of related titles after each text that she discusses. Richmond said, “Most of the books I feature show young adults seeking help. Not all of them have happy endings, but they're realistic … Incorporating these books is one way to shed light on issues that impact how people interact and function” (as cited in Evans, 2019). Shedding light on the experiences of people with mental illnesses is important for both society and the people dealing with them, so that society is more educated about the topic and people with mental illnesses can feel understood and not as singled out. Different media platforms, like Youtube, are promoting more educational content—there are many videos from licensed therapists and psychologists, scientific channels, or even people sharing their own experiences. Hopefully, with this deeper understanding of how to properly portray mental illnesses in media and literature, we can eventually destigmatize them and help people get the support they need.

“People start to heal the moment they feel heard” - Cheryl Richardson

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