Mental Health False Positives Vs False Negatives

Content warning: I talk about mental health, as the subject maybe makes obvious!

You come across those people talking about how they’re very concerned, very very concerned, oh it’s such a concern, about how many people are having anxiety disorders diagnosed and they’re taking pills, and maybe also how many people have the genders nowadays, and how they’re taking pills, and maybe people who have attention problems (about which we’re very concerned), and they’re now taking pills, and it’s all



Eventually, you’re going to hear one of these clapflaps give a name to their concern: they’re worried that these things are becoming fashionable.


Now, you may have these concerns. I want you to know that I’m going to say some mean things about that mindset, and I want you to know that I’m not really talking about you, with your caution and uncertainty. That’s possible to have without being a huge fuckin’ asshole about it. But there are people who are being huge fuckin’ assholes about it, and I am banking on them not reading this, because if you’re a huge fuckin’ asshole, you sure aren’t the kind of person who reads criticism.

The gender thing is just TERF shit. Whatever. Fuck that. They’re ignorant liars at best. What I want to focus on here is the concern about mental health problems and medication and the idea of it being ‘fashionable.’

With that in mind, here’s the thing. First, no, we’re not overdiagnosing medicable mental health problems because, no, this mental health landscape is not going to map onto history, because you’ve got a generation that society has put through wringers, and no, the Greatest Generation can’t be directly compared because they didn’t know that PTSD was and when they were growing up, you could still buy cocaine at the candy store, but also no, because mental health problems can be temporary and it’s entirely possible to move on from one set of problems without it necessarily meaning you never had those problems, and finally, no, even if that were all not the case…

False positives are better than false negatives when it comes to mental health problems.

These are things from testing. A false negative is when you run a test, and you get a negative result you shouldn’t, and a false positive is when you get a positive result you shouldn’t. It’s that simple. They’re a real thing to pay attention to in medical science, but they show up all over the place. One might notice there’s a lot of hand-wringing about what if someone gets something nice they don’t deserve? That’s the idea of a false positive.

If you have a false positive diagnosis for anxiety, what’s the likely outcome? The usual outcome isn’t suddenly getting hooked up to a methadone drip or something. Doctors work in stages, and they don’t jump to giving you anxiety medication if you’ve just turned up once and had some problems. What you get, typically, if you’re diagnosed with a mental health condition you don’t have, is going to be something like an awkward conversation now and again. And when you talk about this, there’s often this implication that hey, this would stop something else being diagnosed, but then your problem is with things not getting diagnosed.

If you don’t get help when you need it, the consequences can be a lot more damaging, and, in some situations, a lot more permanent.