Feelings don't get you fed

A New York Times opinion piece pushes back on the epidemic of social-media-fed self-diagnosis, but misses the most crucial piece

I saw the New York Times headline: I’m a Psychiatrist. I’m Hearing Something New From Young Women — and gritted my teeth, wondering what fresh hell I would find.

Depression because Taylor Swift’s marriage is a win for “heteronormativity”? Demands to cut off parents who vote Republican? Anxiety about European heat waves? All presented in an I-feel-your-pain, sister voice.

But no.

What Dr. Suzanne Garfinkle-Crowell turns out to be hearing is a lot of self-diagnosis from women who have gone to TikTok Medical School, where the curriculum is light on organic chemistry and heavy on vegan cheese.

In 2021, these young ladies all wondered why they were getting Covid during their hot vaxxed summers. In 2024, they went brat on the road to nowhere with Kamala. Now they plop their rear ends down in Dr. Garfinkle-Crowell’s Manhattan office in their $200 jeans (sorry, I meant denim, anyway, sooo cute, where’d you get them?) and tell her exactly what’s wrong:

These young women were announcing their diagnoses — attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety, depression — almost before telling me their names…

They had researched their symptoms on Instagram; they’d taken TikTok quizzes about them; they had cross-indexed their conditions with those of their friends.

Garfinkle-Crowell clearly finds being told how to do her job annoying.

But, good shrink that she is, she manages her counter-transference. That is, she resists the urge to tell these uptalking and bronzed youngsters (sunscreen is the real threat!) she didn’t get a master’s in “theoretical psychoanalysis” along with an MD to hear them prattle about Bipolar 2.

After all, the rent on a Greenwich Village office suite doesn’t pay itself.

Instead, the good doctor does her work in reverse, going from the self-anointed diagnosis to the behaviors underlying it:

Someone who says she has A.D.H.D. may or may not fit the clinical definition, but she’s probably telling you she feels scattered, overwhelmed or afraid she’s a mess. If someone says she has anxiety, you can be pretty sure she’s nervous, uneasy or unsure of herself…

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(Unreported Truths. For when you’re feeling uneasy or unsure of yourself!)

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As advice from Manhattan psychiatrists goes, this is… not bad.

A bit obvious, maybe, but not bad.

But Garfinkle-Crowell seems to be blocking out (or should I say repressing) what her patients — a bunch of them, anyway — really want from her.

They don’t need her validation. That’s what ChatGPT is for!

They don’t need the coping skills she can teach, or the introspection she may be ablet to help them find. Well, they do, but they don’t think they do.

What they need — or what they think they need, and what she and only she can (legally) offer them — is access to all manner of pills that come in various shapes and sizes and provide various forms of recreation. One pill makes you larger, one pill makes you small, one pill keeps you up all night to dance, one pill sends you to sleep on a soft white cloud.

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(Xanax. From your favorite company and mine. For the relief of anxiety. The very temporary relief.)

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And the savvy young ladies coming to see Garfinkle-Crowell are well aware that drugs are given for diagnoses, not for feelings. Being “unsure of yourself” doesn’t open the way to Xanax. Anxiety does, though.

Does Garfinkle-Crowell know how many of her patients are seeing her fully or mostly because they want the magic of what not-so-long ago was called a prescription pad?

She must. All shrinks do (and many spend most of their time these days on what is politely called “medication management”). But calling out the little darlings for drug-seeking would undercut the gentler, more positive message she’s sending:

[T]ranslation is an exercise in empathy, in jumping out of the limits of your own perspective. Making that effort is a powerful way to help another person feel better. Language can illuminate certain parts of the truth while obscuring others.

Sure. Like when a drug company brands dextroamphetamine-amphetamine as Adderall.

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(Get addicted to the truth!)

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Garfinkle-Crowell seems like a good doctor, one who won’t blindly accept what her patients are selling. But the fact even someone like her won’t (publicly) acknowledge the hidden drug-seeking driver here shows just far down the well psychiatry has fallen.

And I’d love to know how many times she won’t give her patients what they want for their self-diagnosed conditions — and how many of those women wind up finding new doctors less interested in therapy and more interested in "medication management.”