Dear Therapist:

Thank you so much for the column, I really enjoy it each week. I would like to know what the panelists think of the following:
Of course, there are real mental illnesses that exist and those that suffer from them should obviously get the help and support that they need. But I feel like many of the people "suffering from mental illness" are suffering from man-made problems based on the expectations of our society. For instance, as a girl in shidduchim, I am at the 'ripe old' age of 23. There are times that my friends and I feel "anxious or depressed" that we are not married (and sometimes to a point of 'will I ever get married?'). When I think about it logically, this is just so crazy. Society decided that 20 (or so) is the age to get married so all of us just start panicking even though it just does not make any sense. We also put emphasis on looking good (not to mention that shadchanim outright say "you need to lose weight to find your shidduch"). Even the Jewish clothing stores send us incorrect messages about weight. All this puts pressure on teenage girls (and adults) and eventually it can lead to an eating disorder.
There are so many examples of these "man-made" mental illnesses and the sad part is, is that these types of "mental illness" are so avoidable if we all take a step back and re-evaluate where our society has gone/headed to. I was wondering if this is indeed true, what can we do to change it? 



I think that basically your question refers to the origin of mental illness. You ask whether certain mental illnesses in particular situations are genetic or created by society. More generally, I would ask whether many mental illnesses are truly intrinsic, regardless of whether a situational trigger can be readily identified.

The debate over nature vs. nurture is at least as old as the field of psychology. Nature refers to our in-born tendencies, while nurture refers to our experiences and the impact that these have on us. The latter would include factors like societal expectations, peer pressure, and learned feelings, thoughts, and actions.

In terms of our mental health and our coping skills, does nature determine our future or are we at the mercy of our environment? For most depressive and anxiety disorders, the simple answer is probably that nature and nurture work in tandem. Although we likely have some natural tendencies, our environment is what shapes our feelings, beliefs, and expectations. It is these that ultimately lead to disorders.

There is a third, very powerful, factor, however. This is our almost infinite ability to change—to either accept the stories that we tell ourselves based on our experiences, or to challenge these. It is when we simply accept our feelings as fact that we tend to stagnate.

Another matter to which you referred is the endless labelling of people and emotions. In your question, you mentioned the words “anxious,” “depressed,” “panicking,” and “mental illness.” Terms like these have become household words. Since time immemorial, people have had similar feelings. What has changed is the fact that we now identify these feelings with mental illness. Many people who feel down or nervous on occasion assume that they have a mental illness (read deficiency). Although many recognize that their “symptoms” do not rise to the level of diagnosis, they nevertheless label their feelings and therefore themselves. 

This type of labelling is a double-edged sword. While it can be beneficial to many, for others it can lead to feelings of inadequacy and a sense of defeat. It is crucial that we separate normal feelings from those that are truly problematic, in order to appropriately deal with each. It is also important that we recognize that feelings of anxiety or depression do not in any way define us. We are incredibly capable of changing our perspective, emotions, beliefs, and actions.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer / 516-218-4200


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