The mental health terms ‘anxiety’ and ‘depression’ have become increasingly pathologised since the 1970s, according to analysis by Australian researchers of more than a million academic and general text sources.
Publishing in PLOS ONE, psychology and computer science researchers from the University of Melbourne tracked the frequency and meaning of the concepts ‘anxiety’ and ‘depression’ from 1970 to 2018, and words that occurred in their vicinity.
Using natural language processing, the team analysed more than 630 million words across 871,340 academic psychology papers, as well as 400,000 texts from general sources such as magazines, newspapers and non-fiction books.
Paper co-author psychologist Professor Nicholas Haslam has a long standing interest in how mental health terms change their meanings over time, particularly the way harm-related words like bullying, abuse and trauma tend to expand over time, incorporating new, and often less severe kinds of experiences.
Haslam says that trend reflects progressive social change and a rising sensitivity to harm and suffering in our culture. “We emphasize [that’s] mostly a good thing,” he says.
The terms ‘anxiety’ and ‘depression’ were selected for analysis as prevalent, prominent mental health concepts.
The researchers expected the emotional intensity and severity of the two terms to reduce over time as the frequency of their use increased.
That expectation was informed by previous research using a similar approach, co-authored by Haslam and publishing in Sciendo, where increasing use of the word ‘trauma’ since the 1970s was associated with a shift in meaning including a broadening of use and declining severity.
They hypothesised a similar trend for ‘anxiety’ and ‘depression’.
“Well, we didn’t find what we expected,” Haslam says.
Contrary to expectation, the emotional severity associated with anxiety and depression increased linearly over time.
The authors say this is possibly due to growing pathologising of the terms, given their analysis shows use of the words increasingly linked to clinical concepts.
In particular, the terms ‘disorder’ and ‘symptom’ have become more commonly associated with ‘anxiety’ and ‘depression’ in more recent decades, the paper says, finding similar patterns in both the academic and general texts.
Anxiety and depression were also increasingly used together, compared to use in the ‘70s where the terms were more likely to refer to separate things.
Haslam says, these shifts in meaning could reflect growing awareness of mental health in society and more research is needed into the implications, he says.
But he notes this is an area where there can be “mixed blessings”.
On the one hand, greater awareness of anxiety and depression can help people to seek appropriate treatment; and on the other, pathologising more ordinary variations in mood can risk become self-fulfilling or self-defeating.
At a more systemic level, pathologising the milder end of the mental health spectrum could risk leading to a misallocation of resources away from the more severe and urgent mental health problems, Haslam says.
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