Tobold's Blog
Wednesday, September 13, 2023
Mental Health

As I mentioned yesterday, I was feeling slightly depressed for a few days. So it was of some interest to me to hear that the upcoming iOS 17 would add features to the Health app to track mental health. Because mental health generally has a threshold problem. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and its international counterparts, which are the “bibles” of mental health, usually define mental disorders as “clinically significant distress or impairment in social, occupational, or other important areas of functioning”. So while it recognizes for example autism spectrum disorder as *being* a spectrum, it doesn’t really concern itself with people who are so far on the mild side of that spectrum that they can still function in society. But if you look at the definition of autism spectrum disorders as “characterized by deficits in social communication and social interaction, and repetitive or restricted patterns of behaviors, interests, or activities”, you probably know some people you called “nerds” that fall into this definition on the mild side. I certainly was that kind of guy at school and university, and had to work on my deficits in social communication and social interaction to overcome them. And yes, this blog is part of that process.

In a similar way, lots of people can feel mild depression sometimes, a sadness without reason. Or they can suffer from anxiety attacks. But as long as they can “get over it” and still go to work, this isn’t considered as a mental disorder. As opposed to physical illnesses, which we can identify and treat at much earlier and milder stages. We wouldn’t dream of waiting with a diabetes treatment until the patient was non-functioning from the illness. The threshold issue of identifying and treating lesser mental health problems can lead to other, more severe consequences; for example people “self-medicating” with drugs and alcohol, leading to addiction.

Society is getting better at recognizing lesser mental health problems and doing something about it. Mental health counselors are getting more common, also at schools. And Apple including mental health tracking on their iPhones is certainly also a step in the right direction. However, we are still far away from fully undertanding mental health problems, for example most of them can’t be easily tested for clinically. And the medication we have, for example antidepressants, is only recommended for medium and severe cases, and doesn’t really cover mild depression. Children with high emotional intelligence and low IQ are much more likely to get help from parents and at school than those with low emotional intelligence and high IQ, because the latter tend to have better grades, and their social deficits are considered less of a problem.

And Apple including mental health tracking on their iPhones is certainly also a step in the right direction.

I'm absolutely not as positive as you towards the "throw more tech at it". As you say in the text, we're getting better, but we have no real tools to automatically and reliably detect problems early on. And devices like smart watches which monitor your physical health have already turned out to be a lot less useful that it seemed. Sure, when the values are out of the scale you can bet that there's a problem, but a lot of people seem to obsess over minor, irrelevant, variations.
This grey area opens up the field for a lot of snake oil medicine, which has been exploding in the past and increased even more with COVID and which the only result has been moving money in the pocket of scammers without providing any benefit. The same snake oil has been going on with mental health, as you can see from the proliferation of "self-help" books/videos/courses/etc. I see this kind of tracking devices as just one more tool for people to self-diagnose with whatever they think sounds more or less right or fits the current TikTok trend.
I have a 2 hours and a half video from Dr Mike on the subject at the top of my playing list, where I'll see how far (or close) to the mark I am.....
I think Helistar is probably right, this will be used by gloomy obsessives self-diagnosing with whatever vague syndrome appeals to them. Maybe the app is harmless, of course, it is not as if this sort of thing was unknown before computers.
The Apple way to present their watch as a lifesaving tool was quite disgusting, to be honest. The entire video with happy people, happy families, blacks, Asians, etc... It was really, really bad. It felt extremely forced and fake. At least for me. They are pushing the "health" agenda to sell more devices and that's it. Just like the "green" and "carbon neutral" crap, when they used to submit Chinese workers for years. Just like they pushed their propietary charging cable until they were forced to use USB-C (the audacity to consider it a "feature", in 2023...).
Your point about mental health issues being ignored as long as they are not too debilitating hits home Tobold. Some friends who like me are close to retirement age recently underwent testing for neuro diversity. My initial reaction was "Why"? They have already succeeded in life both socially and professionally. Even if the faced extra challenges along the way surely it is just narcissistic to want a new label for yourself at this stage. We all have our own personal challenges and struggles and we learn how to deal with them and get on with living. However I also realise the tremendous value of self discovery and knowing yourself. Self discovery is something that we do naturally in the teenage and early adult years but then adult life happens and we get to busy for introspection. Perhaps it makes sense to kick start that process again in the later post career years.
I hope that you're getting support (if you want it) and that things are getting better. I've been dealing with some health issues that has me pretty depressed and it sucks. For me it seems to come in waves and when it hits I'm pretty much useless for a short period. As I am still in the workforce it does affect my work performance. However, I will never mention that to those I work with.

As much as I hear about mental health being important I sure don't get that feeling when things need to be done. No one wants to hear that you've missed a deadline due to mental health issues. If I had a speaking engagement and had breathing issues that is something that people can understand. If I had a report due and couldn't focus to finish it due to mental health, that is something in my experience that people either can't or will not understand.

I wear a Garmin watch with lots of sensors. I noticed a trend in the data of one of those sensors that that combined with how I felt led me to the decision to go to the doctor. Without that "data" I might have just "pushed through" how I felt thinking it would change. If Apple or any other manufacturer can provide people with their own health data to make informed decisions then I think that's good.

Anyway, I hope you're feeling better or are on the path to feeling better.
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