The Mental Health Paradox | Jonathan Alpert | Ep. 85

Adam Omary (0:12)

I'm Adam Omary, a psychologist and research fellow at Human Progress. Today, I'm joined by Jonathan Alpert. He's the author of Therapy Nation, How America Got Hooked on Therapy and Why It's Left Us More Anxious and Divided.

Jonathan, welcome to The Human Progress Podcast.

Jonathan Alpert (0:28)

Adam, thank you so much for having me.

Adam Omary (0:31)

I should begin mentioning since Human Progress has an international audience and we report on international trends, including mental health trends, that though the subject we're talking about today, psychiatric overdiagnosis, the therapy of culture is a problem in America, particularly in terms of mental health spending and psychiatric medication, we're seeing similar trends across the developed world, similar trends of therapy nations.

Jonathan Alpert (1:02)

Yeah, you're absolutely right. I have heard from colleagues in Europe who have written to me and have told me that they are seeing some of the same trends that I wrote about in therapy nation in the countries where they're practicing. As America goes, so doesn't the rest of the world sometimes.

Adam Omary (1:21)

I've written about this, I've termed it the Psychological Paradox of Progress.

And many people, when they see rising rates of depression and anxiety, they might say, well, historically there was so much stigma. People were under-reporting their mental suffering in the past. We're seeing rising rates, but how do we know that this isn't actually a sign of progress? Like cancer rates are rising, but we're living long enough to see cancer develop because we're not dying of some other cause at younger ages. So could we look at these rising rates of depression and anxiety? How much of it do you think is genuinely increases in suffering, and how much of it might be greater awareness?

Jonathan Alpert (2:09)

Yeah, and it's worth discussing that. And with cancer, of course, we have better ways of detection, early detection, better tests that are available. So that makes sense. But with mental health, a lot of people will ask, well, if there's so much therapy and mental health services, why do we have higher rates of anxiety and depression? Which we seem to have. And it may simply be that there's more awareness, more people are open about their mental health issues. We do have better ways of detecting or diagnosing it. And therefore, the rates are higher. That's one possibility. The other possibility is that we actually are sicker. We have more to be stressed out about. We have more to feel anxious and depressed about. The truth is, we may not know. I think, you know, we just don't know exactly what's going on inside an individual's head and within our society.

But certainly, there's greater awareness and that's a good thing. There seems to be less stigma than there once was around mental health issues. You know, we have more celebrities and public figures coming out and talking about their struggles with mental health. Senator Federman from Pennsylvania has talked about his own struggles with depression. So this is all helpful. It helps to raise awareness. If we see people in the public eye discussing their mental health issues, then we might feel a little less uncomfortable discussing our own issues. So in that respect, it's good. But you know, my profession, I do worry, has contributed in part to some of the pathology that we're seeing. And that's really the thesis of my book, Therapy Nation. I argue in that book that therapists have pathologized ordinary life experiences. So for example, if we're having a bad day, that's a very normal life experience. And that doesn't necessarily mean that we suffer from major depression. It just means we're having a bad day or a bad week. But a lot of therapists are quick to put a label on that, put a diagnosis on that person.

We saw recently the University of Michigan, they have a new grading policy where they're eliminating grades for freshmen in certain programs.

Instead of using the letter grades, it will be pass or fail. And the reason they're doing that, they say that there's a mental health crisis that's created as a result of grades. And I think that's a perfect example of an institution that is pathologizing what I would consider a normal college experience. Sometimes we do poorly in classes, and that's part of growing up and learning.

But I see this in a lot of areas in our society, and my book does address a lot of that.

Adam Omary (5:16)

As much as it seems like a grim topic to talk about the mental health crisis on The Human Progress Podcast, it is useful to think about the context in which we talk about these ordinary struggles. My colleague here at Human Progress, Chelsea Follett, has a book coming out, The Grim Old Days, an introduction to pre-industrial life. And she talks about how throughout most of human history, the levels of suffering, day-to-day suffering, in struggle for survival, the struggle to find enough calories to find shelter, were much greater than anything most people, certainly anyone with the luxury of being able to listen to a podcast like this would face. So it's interesting to frame that from an evolutionary psychology perspective.