The Myth Gambit (Haidt's After Babel)
A 2018 NY Times opinion about anxiety trends by R. A. Friedman is an early example of an attempt to downplay troubling mental health indicators among teens.
In September 2018, psychiatrist Richard A. Friedman wrote a NY Times opinion, titled The Big Myth About Teenage Anxiety, in which he dismissed concerns about recent anxiety trends among youth.
Haidt classified Friedman’s argument, along with that of Vicki Phillips, as “the kids are alright” because the kids have a “more honest relationship with their mental health” (see The Teen Mental Illness Epidemic Began Around 2012) — but that is a misunderstanding of Friedman, as we will see soon.
Mild Symptoms?
Friedman starts by portraying troubling anxiety trends among youth as involving merely mild symptoms:
There are a few surveys reporting increased anxiety in adolescents, but these are based on self-reported measures — from kids or their parents — which tend to overestimate the rates of disorders because they detect mild symptoms, not clinically significant syndromes.
In reality the reasons for concern were not limited to reports of mild symptoms.
For example, the 2011-2015 ACHA National College Health Assessment surveys of young college adults included the following questions:
Have you felt overwhelming anxiety in last 12 months?
Within the last 12 months, have you been diagnosed or treated by a professional for anxiety?
If ‘overwhelming’ anxiety is to be classified as a ‘mild’ symptom then we might as well give up on the English language.
The second question involves medical diagnoses of anxiety by professionals.
Friedman never mentions the actual survey questions nor the magnitude of the 2011-2015 spikes in these indicators.
Fragile Generation?
Although Friedman’s dismissal of anxiety trends was fatally flawed, let us look at how he explained increases in (supposedly) mild symptoms:
I fear that it reflects a cultural shift toward pathologizing everyday levels of distress. […] What I have noticed is that more of my young patients worry a lot about things that don’t seem so serious, and then worry about their worry.
Friedman in essence accuses kids of being fragile (and accuses their parents of raising them to be fragile).
This is the opposite of what Phillips asserts (see Gen Z: Hopeless Or Hopeful?):
Gen Z is in fact embracing a new, more open and honest relationship with their mental health, one that destigmatizes the issue so that it can be addressed. This is leading to more people reporting their mental health challenges and seeking support, and contributing to the rising numbers of reported cases. More effective diagnoses and increased connection to care are both good by any measure.
So Phillips in essence accuses Millennials of being dishonest due to the stigmatization of mental disorders, a deficiency corrected by Gen Z. Friedman, on the other hand, sees Gen Z as needlessly elevating everyday distress to pathological levels.
Friedman’s view is therefore close to that of Haidt & Lukianoff in their 2015 essay The Coddling of the American Mind — the crucial difference being that Haidt & Lukianoff view fragility as a direct cause of depression and anxiety disorders:
A campus culture devoted to policing speech and punishing speakers is likely to engender patterns of thought that are surprisingly similar to those long identified by cognitive behavioral therapists as causes of depression and anxiety. The new protectiveness may be teaching students to think pathologically.
Friedman did not offer an argument as to why fragility would not lead to outright disorders. We will look into this issue later. First, however, we will examine, in the next article, a remarkable reversal of Friedman’s view.
Conclusion
Friedman’s dismissal of anxiety trends as involving merely mild symptoms was incorrect. Friedman’s presumption that increasing youth fragility need not lead to an increasing prevalence of mental disorders (at the population level) was left without justification; its plausibility is an open question worth investigating.
Notes:
The first link in the online text of The Big Myth About Teenage Anxiety occurs in the third sentence: Despite news reports to the contrary, there is little evidence of an epidemic of anxiety disorders in teenagers.
The link leads to a NY Times opinion by Benoit Denizet-Lewis titled Why Are More American Teenagers Than Ever Suffering From Severe Anxiety? that asserts neither an epidemic (the author writes of a spike) nor an increase in clinical anxiety disorders.
It may be that an editor, rather than Friedman, added this link — in either case the link is misleading and unfair.
Richard A. Friedman is a Professor of Clinical Psychiatry at Weill Cornell Medical College. I’ll email Friedman and add anything relevant below should he reply.
May 21: I changed psychologist to psychiatrist in reference to Friedman, as that is more accurate. I also slightly modified the ending so that the next article can be about Friedman’s 2020 alarm over suicides rise rather than about fragility.