Are We Thinking Ourselves Sick?

When I was 23, my roommate, who worked in sales but had majored in psychology, caught me in the midst of an internet rabbit hole and told me she thought I was on the autism spectrum. I laughed, but she said that she was serious, and started ticking off my symptoms: I often didn’t make eye contact with people when I spoke to them, I had a nervous tic that caused me to twist my hair, I worried too much, and I had a tendency to develop niche interests. She gestured to the article I was reading about Uzbek cotton exports. 

I shrugged her off. I’d been working customer service jobs—at a grocery store, a museum, various restaurants—since I was 16, and was successful enough at them not to get fired. I went on dates, and I was doing pretty well in college. If I was on the autism spectrum, it wasn’t affecting my life in any negative way, so who cares? 

At least, that’s what I told my roommate. 

Secretly, the idea made me anxious. In the following days and weeks, I began to analyze my conversations. Was I being awkward? If I was, how would I know? Online, I discovered my hair pulling might be a disorder called trichotillomania and that, in addition to my autism symptoms, I also fit much of the diagnostic criteria for generalized anxiety disorder. I started wearing baseball caps to avoid touching my hair. I made intense—probably too intense—eye contact with everyone I spoke to. I no longer felt nervous about money or exams. Instead, I felt nervous about feeling nervous, fearful it might be an indication of a deeper disorder. 

My experience, which I predict many young people can relate to, is investigated in Thank You for Sharing, a new indie documentary by Canadian filmmakers Sonia Zawitkowski and Jenna Taylor, which premieres August 8 at the Greenpoint Festival in Brooklyn. It proposes that our collective focus on our mental health is making our mental health way worse. 

In addition to pointing out that mental health metrics have only gotten worse—43 percent of American adults reported feeling more anxious than they had the previous year, up from 37 percent in 2023, and 42 percent of Gen Z has a diagnosed mental health condition—the film explores mental health care in early nineteenth-century asylums. As more asylums were built and filled, the number of mentally ill increased as a percentage of the population. This was an early example of what the narrator of the film calls the treatment-prevalence paradox: “A sort of social iatrogenesis where attempts to solve mental health problems coincide with an increase in them.” Iatrogenesis is a term for adverse effects caused by medical interventions, such as incorrect diagnosis or errors in treatment. 

This problem was only made worse in 1980 with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, a sort of psychiatrists’ bible. Before then, psychiatrists had only a paragraph of descriptions of mental illnesses to rely on. In the DSM-III, more detailed criteria were listed. Dr. Edward Shorter, who studies the history of medicine, and appears in the film, says the thinking went something like this: “Well, we’re going to have a set of operational criteria in order to qualify, for example, depression. There are plenty of symptoms you could have. If you can check five boxes and you’ve had these symptoms for two weeks, then you qualify for the diagnosis of depression.” 

“This sounds like science,” Shorter says. “In fact, it’s not really.” 

Then, in the early ’90s, the DSM-IV updated its autism criteria, allowing, for the first time, individuals without significant language or intellectual incapacities to be diagnosed. Additionally, it lowered the number of traits required for a diagnosis from eight to six.

Last year, Dr. Allen Frances, a world-renowned-psychiatrist who helped loosen the definition of autism for the DSM-IV, told the New York Post he regretted his decision: “More clinicians began labeling both normal diversity and a variety of other psychological problems as autistic.” Dr. Frances estimated that his changes would triple the rate of autism. According to the CDC, it has more than quadrupled since 2000.

The idea that overdiagnosing mental health disorders has deleterious effects is catching on quickly. “I think it’s only a matter of time before it reaches a saturation level and people start to question a little bit,” Zawitkowski, the filmmaker, told me. Abigail Shrier, in her new, best-selling book Bad Therapy: Why the Kids Aren’t Growing Up, argues that mental health professionals are pathologizing normal childhood behavior. Shyness has become social anxiety, sadness replaced by depression. “Obtaining a diagnosis for your kid is not a neutral act,” writes Shrier. “It’s not nothing for a kid to grow up believing there’s something wrong with his brain.” 

But there is little incentive for the mental health industry itself to change. Lawsuits hang over the heads of clinicians like a sword of Damocles. They can’t just tell kids to walk it off, even if they wanted to. A psychologist who diagnoses a child with something like depression, based on their self-reported symptoms, and provides treatment accordingly, can avoid a malpractice lawsuit, say, if he didn’t treat the child and then he commits suicide. 

Luckily, I didn’t have health insurance and couldn’t afford to see a psychologist who might have diagnosed me with autism spectrum disorder, generalized anxiety, trichotillomania, and possibly something else I hadn’t even heard of. I would have probably ended up on an SSRI I didn’t need, which carry the risk of side effects like suicidal thoughts, sexual dysfunction, and weight gain. 

Eventually, I stopped reading about autism because I realized how neurotic it made me feel. It was up to me, and it’s up to all of us, to stop pathologizing our personalities as disorders, our quirks as maladies, and our problems as traumas. We must come to grips with the terrifying, ego-destroying realization that most of our problems are ordinary. We must realize that an entire industry is dedicated to convincing us otherwise and that we’d do ourselves a favor by avoiding it altogether. 

River Page is a reporter at The Free Press. Follow him on X @river_is_nice, and read his piece “How Rednecks Like Me Hear J.D. Vance.”

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