Judging my circumstances and thinking about the different paradigms of mental illness

Psychological distress isn't perhaps the right word. I may be deadened to the distress. Self medicated and exhausted neural circuitary barely respond as other might and my tolerance levels are pretty fucking high. Doesn't mean it doesn't hurt.

Depression comes with other things than the simple medicalisation of misery. In fact the clinical concept is far different from a person's self report of subjective unwellness.

In a very, very small way this is a good thing. It encapsulates the seemingly paradoxical depression without low mood diagnosis. The cluster of symptoms approach includes it because low mood can be left out as a symptom and the clinical criteria still met.

It's because psychopathology relates to social disability and exclusion/isolation. I'm not sure self report of subjective unwellness is often consider in research however my desperate hope is there are still some good doctors left in the mental healthcare system who listen to patients and what they want.

Here it's perhaps useful to consider the already accepted dual continua model of mental health. Theirin lies 2 continua: psychopathology and psychological distress. This is an incredibly simplistic model.

My personal experience might help to refine additions - all theorectical. First there's the measure of patient report of subjective unwellness. In practice this is not the same as psychological distress unless it is a very broad term which, currently, the mental health system does not cover conceptually.

There's the problem of false report by patients too. This is why doctors and psychiatrists must give diagnoses, because their system makes it hard for people to fake it without knowing it. Once it is known it is easy to fake because the operational cluster of symptoms are designed to be simple.

With me there is also the problem of natural reaction to circumstances. I should be feeling like shit because in many ways to the old me I am someone I wouldn't want to be.

This aspect of self stigma or part of how poorer life outcomes relate to psychological distress is probably well studied if people with lived experience had any influence on the pursuit of research.

My recent failure in work is bad luck and bad timing but...fuck...the event hurts like shit. So it's natural to feel down.

The problem is I'm already down. While this natural reaction might be acceptable as an individual trait I have had a bad time already by my standards. There is the problem of the value of pain and the risk of excessive pain which can harm.

There's social disability and poorer clinical outcomes, two things which are perhaps facets of psychopathology or are distinct concepts.

I am alone. Isolated and isolating myself. I have little self care. I am making little social contact and destroy the ones I do have.

Accept me as an individual who is going through something but makes a choice to go through it and its an informed choice. But the compassion in people would want to change that. And they have evidence to back up that I will do worse in life and die earlier because of what I chose to experience.

And be.

...

This theory is irrelevant. There are times I need help and I feel like I'm falling. Falling quicker and faster than I can handle. Overcome with the world and circumstance.

I'm self sectioned. As much as possible. I have my freedom but I withdraw for safety and know I'm ill.

So how important is the measure of one thing? Self report of unwellness, by any name.