8 Aug 2023

Do 'anxiety' and 'depression' mean what we think they mean?

From Nine To Noon, 9:30 am on 8 August 2023

Free, open conversation about mental health seems like a good thing, but research is suggesting that there are downsides to the overuse of terms like 'anxiety' and 'depression'.

A new study by the University of Melbourne explores how 'concept creep' - in which the definition of a psychological concept broadens over time - may be contributing to overdiagnosis and increased fragility.

"There's been this tendency, we're arguing, for both of those terms to be pathologised over time, to be seen as more severe, to be seen through a clinical lens," psychological science professor Nick Haslam tells Susie Ferguson.

woman with hand on face

Photo: Cottonbro / Pexels

The cultural evolution of the word 'bullying' is an example of concept creep, Haslam says.

"Bullying, when it was introduced to psychology back in the 1970s, referred to a very specific type of aggression - intentional and repeated aggression by children towards less powerful peers."

In the last few decades, the definition of 'bullying' has expanded to include bad behaviour by adults at work that doesn't have to be intentional, repeated or carried out by people in power.

"People are using the word 'bullying' … because they're finding the word useful to refer to unpleasant behaviour that they experience."

While Haslam's research team's previous study of the word 'trauma' founds its meaning has been diluted over time, he says the opposite has occurred with the words 'anxiety' and 'depression'.

In recent decades, these two words have come to be frequently discussed in relation to symptoms and disorders, Haslam says, and people are now much more inclined to view 'anxiety' and 'depression' as things that need to be treated.

"People are tending to see anxiety and 'depression - including relatively ordinary low-intensity variants of those - as problematic."

Haslam speculates that this 'concept creep' is leading to self-overdiagnosis, the seeking of unnecessary treatment and also the inference that everyday experiences of unhappiness require professional help.

Over time, 'depression', once a clinical term, has come to mean "everyday sadness", he says.

"Depression itself isn't necessarily a pathological state that needs clinical attention, that needs to be treated with medications or therapy."

Likewise, anxiety is actually a very healthy emotion: "If you didn't have it you'd get in all sorts of trouble, you wouldn't avoid all sorts of difficulties and dangers."

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