Based on not just one but three ongoing discussions I want to write down a few things I, based on my professional and other experience, consider truths. Relevant background: I am a child psychiatrist working in children and youth community level mental health services. I hold a PhD in data analysis. I've dabbled in practical epidemiology. I am a parent. My values can be described as left liberal. I am NOT a psychotherapist. Welcome to my not-TED talk that will go on for some hours probably. 0/🧵

1/🧵: Humans did not evolve in conditions where being easily content was a survival trait. It was better to get a little restless and start looking for things to improve and food to store than to sit around feeling nice.

Your mind does not exist to make you feel good. It has evolved to help you survive in extreme conditions.

Calm, content, peace of mind, etc are not the default normal state of a human being. Periodically rising restlessness, that pushes us to Do Something is what is "normal".

2/🧵: In fact, if you always were 100% happy and content, you would die of thirst. Discontent and unhappiness caused by the thirst is what gets you off the sofa and to get a glass of water.

When things are wrong and you can and need to do something about that, it is appropriate to feel bad - anxious, angry, depressed, in pain, whatever. The goal is not "to feel good" all the time.

3/🧵 : So-called "negative" emotions should function like an instrument panel. It has gauges and warning lights to tell you that something might be wrong. The gauge on red or the light is not a problem as such. Getting rid of warnings altogether would be dangerous (see previous post).

But it is also not always an emergency. It can warn you about a thing you already have a plan to deal with. It might warn you about something you cannot fix and just have to live through. Or it can be broken.

4/🧵 : There is no "real you". It is normal and healthy that you are different in different situations and that sometimes you have to struggle to present in a socially fitting way. All of the versions of you are "real" even if some are more comfortable than others.

Feeling awkward in a social situation is not a sign that something is wrong. Awkwardness is a feature of complex situations. It tells you something new, interesting or important is happening or about to happen.

5/🧵: Because there is no "real you" and we all are formed in social contexts, to some extent everybody "masks". It is as such not a sign that something is wrong.

However, people differ a lot on how much work this all is. Everybody has the right to try and arrange their life so that they do not need to struggle all the time. No one has the right to expect to feel comfortable all the time.

This means that people with more flexibility need to adjust to others more to make room for everyone.

6/🧵: You might have noticed that I have refrained from using diagnostic words in this thread I will continue to do so.

Medical diagnoses have their uses in medical contexts. Outside of it, categorization of humans into medical groups almost always does more harm than good. Categorical groups are strict and narrow and fail to capture the true variety and the true similarities of human beings.

It makes sense to decide how to treat you based on your diagnosis only if you are my patient.

7/🧵: Humans do not neatly divide into two distinct groups of neurotypical and neurodiverse. At least 85% of people have some "neurodiverse" feature (I am almost face blind and a couple of other things myself). Around 50% of people have several. The ends of the spectrum are rare. Neither neurotypical nor neurospicy people are all the same, and most people are somewhere in between anyway. Binary division works here as badly as it does with gender.

8/🧵: Just like the socially acceptable you that you struggle to present is real, the you who does bad shit is real.

It makes no sense to say of someone who acts violent or racist or sexist or mean, "they are not really like that". If they do those things they are a person who does those things.

They might be a person who does not want to, and wishes to do better. That's great and we should help them. It does not make the things they do less real, though.

9/🧵: We really need to go back a little on what "nursing" and "healing" mean.

In many mental health problems, treatments alone do not heal. Mental growth, regular healthy life, and supportive social contexts do. Treatments - and medicines and therapies have this in common - are often necessary, but to remove obstacles and increase flexibility, not to do the work.

Mental health problem *prevention* is mostly social policy and the work of politicians, not doctors and nurses.

10/🧵: In the end, none of this matters. There is no "meaning of life". Values are a human social construct, and the universe does not give a damn. Only people do.

That means that you are 100% free to choose what matters to you. If you are a good person who wants to do good - and the vast majority of us are - you do not have to justify it.

Because nothing matters, it does not matter if it is naive. Or hopeless. Idealistic. Meaningless. Cringe.

You really can be good just for the hell of it.

@JankaWessman the subjectivity of values does not make them meaningless. They do matter.

And this is an important part of social struggle.

But even granted the subjectivity of values, as living things shouldn’t it be universal for us to value life? As a social species shouldn’t we value other people?

It is amazing to me that American culture has so atomized individuals into economic units that we lose touch with such basics.

We do have a context. We are living beings who require each other to survive and thrive.

@subterfugue I agree they do matter; they matter to humans. My point is that the fact that "in the end nothing matters" does not for most people mean they might as well be bad. They don't *want* to be bad. If nothing really matters, we might as well be good, which is what we want.