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Diagnostic Labels
I've been thinking about mental illness diagnosis. For me, looking back at the time when I was depressed, I know that I didn't know why I was feeling how I felt, I could only understand that things were bad in my life and these things made me unhappy all the time. But it was more than unhappy- it was obsession with the unhappiness. I couldn't move on, I couldn't find things to be glad about, I couldn't function as a normal 11- or 12- year old.
This is most certainly not the case now. When something bad happens, I feel terrible for a while, but then I acknowledge that I need to continue on and that things will get better eventually. Eventually I will stop being mad with mother, eventually my father will forgive me, eventually. This crucial thought had no effect while I was depressed, but now it is comforting, and I can trust that things will, eventually, get better.
I was depressed long before I knew what depression was- what its symptoms were, how depressed people acted or responded to their world, or how depressed people could handle depression. And yet I still recognized that this specific part of my life was more miserable and very different from any other part after it was over but before I was taught about depression. I felt no real need to define it- 6th grade was rough, but I wasn't that way anymore so it's ok.
Depression is merely a label for a story. In my case, depression was 6th grade, moving to an enormous new school, not being able to stay friends with the people from my old school, not making friends in the new one, not having my parents notice that I was unhappy, having my academic work graded for the first time, being ostricized, getting my period for the first time, going through puberty without support, being unhappily different and feeling as if life was just not worth it anymore.
Physically, I was tired all the time, I felt constantly lethargic, I cried at anything at anytime for any reason, and was unable to explain why.
Biologically, depression is a label for when a person's brain is acting strangely: serotonin levels are off, and the LHPA axis- the Limbic Hypothalamic-Pituitary-Adrenal axis- is hyperactive. In other words, the parts of your brain that control mood, stress, metabolism, [I'm forgetting a few] are talking to each other too much.
Names for mental illness are descriptive labels that indicate how a person's brain is acting and how these actions that differ from normal brains effect that person's emotions and physical actions. These labels have specific indicators: if a person does not show any of these indications, they do not have the mental illness. If an x-ray of a person's arm shows no break, only even, clean bone lines, then the person probably does not have a broken bone. Some exceptions: if the break is too small to be easily seen or if the x-ray was taken improperly.
It's the same with mental illness- sometimes it's hard to see, sometimes the tests are done incorrectly, sometimes people lie to try to seem healthy or sick. This does not change the fact that if a person is mentally ill, it is visible after examination.
Yes, psychiatric doctors can be poorly trained, yes, patients can lie, yes, tests can be rigged, yes, all of these things happen. But I firmly believe that they do not count for many cases. Which means that most children diagnosed with ADHD probably actually have ADHD. Most people diagnosed with depression probably are depressed. And while I agree that medicine should not always be the first answer, I think that a great number of people need to be medicated to be healthy, to function closer to normally, to be happier.
The exceptions are not the rule.