When Mental Health Awareness Helps—and When It Hurts

Mental health awareness has surged in recent years, particularly among young people. Platforms like TikTok have become hubs for open conversations, with the #mentalhealth tag amassing over 50 billion views as of 2023. These conversations reflect a powerful cultural shift—one where teenagers are breaking stigmas by sharing personal stories of anxiety and depression.

Mental health is also at the forefront of discussions about childhood and adolescence. With teenagers sharing their psychiatric diagnoses and treatments on social media platforms like TikTok and Instagram, and school systems incorporating emotional self-regulation and mindfulness into their curricula, mental health awareness has never been more prominent. However, some researchers warn that this heightened awareness may have unintended consequences.

The Paradox of Awareness: Help or Hindrance?

A phenomenon where over-awareness leads to interpreting normal emotions as signs of serious mental health issues poses a Catch-22. Researchers Lucy Foulkes and Jack Andrews from the University of Oxford suggest that mental health awareness campaigns might lead to "prevalence inflation," where mild or transient symptoms are reported as more severe disorders. On one hand, awareness can identify those who need help; on the other, it can magnify minor issues, creating unnecessary stress.

This concept of prevalence inflation bears similarities to the Hawthorne Effect, where individuals alter their behavior simply because they know they are being observed. Just as awareness of observation can lead to exaggerated actions, heightened awareness of mental health symptoms might cause people to over-identify with certain behaviors or emotions. The very act of paying closer attention to these feelings could amplify them, leading to over-interpretation and unnecessary worry.

This brings us to a Catch-22 situation: On one hand, increased awareness can help identify those who genuinely need help; on the other, it can lead to over-interpretation of symptoms, causing unnecessary stress and rumination. Awareness can be a double-edged sword: it might lead to increased resilience for some while causing others to spiral into unnecessary worry.

When Mindfulness Backfires: Lessons from the MYRIAD Study

In the summer of 2022, the results of a landmark study on mindfulness training in British classrooms landed like a lead balloon. The MYRIAD trial followed about 28,000 teenagers over eight years, hypothesizing that mindfulness would improve their mental health. This study was highlighted in a New York Times article, which delves into the complexities of mindfulness training in educational settings. You can read the full article here. However, the study found no support for this hypothesis. In fact, students at the highest risk for mental health problems did somewhat worse after receiving the training.

Researchers speculated that mindfulness training might bring awareness to upsetting thoughts without providing solutions, especially for societal problems like racism or poverty. Another explanation is that mindfulness training could encourage "co-rumination," where unresolved group discussions churn up problems without finding solutions.

Drawing Our Attention to Prevalence Inflation

The above study highlights the importance of how we teach mindfulness. Providing context about prevalence inflation can help ensure that students don’t learn and practice mindfulness in a way that creates issues or makes a mountain out of a molehill.

Simply drawing attention to prevalence inflation can make us more aware of it and less susceptible to over-interpretation. Related to this, in DBT we put a lot of focus on non-judgmental awareness—this allows us to simply observe our thoughts and emotions without judgment. This is easier said than done, but when we are non-judgmental, we are more likely to put our thoughts and emotions in a broader context.

Other DBT skills from other modules come into play here as well. For example, the Emotion Regulation skill "Check the Facts" can help us put what we are experiencing in the context of a normal range of experiences.

DBT Solutions: Building Resilience Amid Over-Awareness

Wise Mind in Action: A core component of DBT is the concept of Wise Mind. Wise Mind is the balanced part of us that comprises both our Emotional Mind and Rational Mind. It is from Wise Mind that we can make effective decisions, balancing emotion with logic. Learning to access Wise Mind takes training and practice. Here are some questions to help you gain perspective on your situation:

• Am I interpreting mild or transient symptoms as more severe than they are?
• How has my awareness of mental health influenced my perception of my symptoms?
• Can I identify any instances where opposite action might help improve my mood?
• Am I seeking professional help for issues that might be manageable with self-care strategies?
• Am I making decisions from my Wise Mind, balancing emotion and logic?

Opposite Action Step-by-Step: Dialectical Behavior Therapy (DBT) offers a useful skill called "opposite action," which can be an antidote to rumination. Opposite action involves deliberately engaging in behaviors that counteract your current emotional state. For instance, if you feel like withdrawing because of anxiety, you might choose to engage in social activities instead. This action can change how you feel and help break the cycle of negative thoughts.

Additionally, DBT skills and practices can help gain perspective. The "observe and describe" skill from the Mindfulness module can help us better understand how we feel from moment to moment. Practicing these skills can help us gain perspective on the true acuity of the issues we’re experiencing.

Using standard assessment tools can be a helpful way to understand your experiences. Explore more resources on this at TheraHive’s blog. also be beneficial. Another valuable resource is using Diary Cards, which can help track your experiences and emotions. Learn more about how to use them effectively in your DBT journey here.

Finding Balance

It's important to strike a balance between being mindful of mental health issues and not over-diagnosing oneself. While awareness campaigns are well-intentioned, they need to be carefully implemented to avoid the pitfalls of prevalence inflation.

In conclusion, while mental health awareness is crucial, we must be cautious about how it affects our perceptions. Utilizing DBT skills like opposite action, observe and describe, and Wise Mind can help mitigate the negative effects of over-awareness and promote resilience. By asking ourselves critical questions and reflecting on our experiences, we can navigate the complexities of mental health with greater clarity and confidence.

When in doubt, it's always advisable to consult a professional. Ultimately, you're the one who really has to make the call about what's best for you, even as professionals have their own incentives. If you find yourself struggling with these issues, feel free to reach out to your TheraHive team for more personalized assistance.