Tell me now how do I feel

January 22nd, 2011 by Ben Goldacre in bad science, blue monday, churnalism, survey data | 24 Comments »

Ben Goldacre, The Guardian, Saturday 22 January 2011

I’m not going to tell the same story once a year, like some kind of journalistic dirty protest, even if it crops up in parliament, every newspaper, and all over Radio 4: there are more interesting things to say than “Blue Monday is bullshit”, but before we get there, let me briefly clarify how Blue Monday is definitely bullshit.

The “most depressing day of the year” began life as a “wacky academic” equation story: this is the kind of thing PR companies offer as “advertising equivalent exposure” for companies who want their brand in the papers. The equation stunt was not the work of an academic, it was paid for by Sky Travel, and Blue Monday comes just after your first pay cheque arrives, the perfect time to book a holiday).

In the following years it was co-opted by the Mental Health Foundation, and the Samaritans, presumably with good intentions. But although it feels vaguely right, when you leave those fairly rare “SAD” diagnoses aside, there’s no reason to believe that the population really is more miserable in January.

I reviewed the evidence from over 30 studies over 130 years on the subject last year, in an act of performance anality.  Some find more suicide in spring and early summer, some in spring and autumn, some in summer only, some find no pattern at all. Many have sampled representative individuals from a population and followed their mood over a year, finding: more misery in summer, more in spring, more in winter, or no peak at all.

Antidepressant prescriptions have been tracked a few times (they peak in spring, or in February, May and October). GP consultations for depression peak in May-June, and in November-January  (you get the same pattern with osteoarthritis consultations, oddly).  Admissions for depression peak in autumn, or spring and summer, while 8 studies found no seasonal variation at all.

So Blue Monday does not put a catchy name on a simple human truth: in fact, it only really shows us how easy it is to take an idea that people think they already know, and then sell it back to them. Even if it’s entirely false. While it might be tempting to try and piggy back on nonsense, if you can think of no better way to engage people, in reality, communicating on mental health issues – like anything interesting – requires that you challenge stigma and assumptions, not reinforce preexisting ones.

But it’s also worth thinking about the wider consequences when we indulge, deploy, and therefore normalise, nonsense. This year Blue Monday has been promoted by Mentaline, a young entrepreneur’s new business venture selling online webcam counselling for £50 a session. His previous PR news story was 3 weeks ago: “Teens fake mental health issues to look cool at school” was the headline in the Mirror.

“MENTAL illness is the latest fashion accessory for teenagers, a survey revealed today”, they explain. “Youngsters are faking serious conditions… 34% admitted lying about having a mental illness in the past.” They even have a list of the “top five phantom problems” that teenagers pretend to have: “Eating disorders – 22%. Self-harming – 17%. Addiction – 13%. Depression – 12%. Bipolar disorder– 9%”.

This doesn’t feel like a constructive contribution to stigma, or the perception of serious mental illnesses. The figures are also spectacularly unlikely. I asked 10Yetis PR (who say they did the survey themselves) who was surveyed, what proportion of teens responded, what the basic demographics were, and so on. These seem like very serious allegations about a very sensitive issue, and good quality evidence would be nice. They have yet to answer.

Meanwhile the piece in the Mirror ends with entrepreneur Jesper Buch castigating teenagers over their supposed bad behaviour for which his PR company cannot even be bothered to concoct decent evidence. “Many young people are too quick to say ‘I’m depressed’ or try to gain attention by pretending to have some kind of personal issue,” he explains, with mind-bending crassness. “Your teenage years should be spent enjoying life, not convincing people that you have issues that should be taken extremely seriously.” And so on.

Bullshit is a slippery slope. At the top is an okay charity endorsing fatuous PR nonsense as a one-off, and normalising it. At the bottom, the health correspondent of a major national newspaper is standing in a river of sewage, shouting at a million readers that teenagers are malingerers who invent serious mental health problems. All I suggest is that you should think a bit before you step onto the crest.

If you like what I do, and you want me to do more, you can: buy my books Bad Science and Bad Pharma, give them to your friends, put them on your reading list, employ me to do a talk, or tweet this article to your friends. Thanks! ++++++++++++++++++++++++++++++++++++++++++

24 Responses

  1. TriathNanEilean said,

    January 22, 2011 at 1:28 am

    Nicely done Ben, and it wasn’t the same column as last year at all.

  2. thatgingerscouser said,

    January 22, 2011 at 3:50 am

    I don’t care if Monday’s blue
    Tuesday’s grey and Wednesday too…

  3. Ian said,

    January 22, 2011 at 7:46 am

    Judging by the number of mentions this had on Radio 4 last week I thought the BBC were sponsoring it now; how depressing.

  4. Mwezzi said,

    January 22, 2011 at 10:09 am

    My friend Kier Liddle was wrote about this very article over at The Twenty-First Floor with a little more statistical analysis.

  5. skyesteve said,

    January 22, 2011 at 12:51 pm

    Reminds me of all the rubbish stuff about A&E departments being busier on full moons. Some are, some are not but there is no consistent, demonstrable link (unless anyone else can point me to something that shows otherwise).
    When I worked in one of Europe’s busy A&E departments in the mid 1990s on of my bosses looked into the whole full moon/A&E attendances thing. He found no connection (but interestingly he did find a link with sun spot activity!).
    He was a cool dude. I recall coming back from visiting family in Belgium and telling him I had been to Waterloo. He proceeded to do a complete reconstruction of the battle on his desk using books and boxes!
    @thatgingerscouser – you beat me to it! Although I prefer “it’s Friday, I’m in love”

  6. skyesteve said,

    January 22, 2011 at 12:53 pm

    P.S. anyone trying to accuse teenagers of using mental illness as a fashion accessory or just to be cool needs their own head examined!

  7. therighteousharlot said,

    January 22, 2011 at 5:20 pm

    Although teenagers remain at the forefront when it comes to adapting new words for personal use (usually for insults, as in “Don’t be so OCD, Dad!”), bless ’em.

  8. fragmeister said,

    January 22, 2011 at 8:54 pm

    OFSTED phoned my school on Monday and said they were inspecting later in the week. So, yes, for me it was Oh Shit Monday.

  9. squitchtweak said,

    January 22, 2011 at 10:52 pm

    The teenagers faking mental illness article is pretty disgusting, but I’m sure some teenagers do do that. More to get attention than look cool, though. They are nothing on the number of teenagers who will avoid, ridicule or otherwise make life more miserable for teens who actually are mentally ill.

    And there’s a big difference between saying ‘I’m depressed’ and ‘I have depression’.

  10. reprehensible said,

    January 23, 2011 at 12:50 am

    if it makes you feel any better Ben the tracks always gettin remixed as well

    vandalism freshened up the beat recently fot a younger audience:

    but new orders hardfloor mix is still the best version:

  11. extranea said,

    January 23, 2011 at 11:45 pm

    Excellent Ben. Having dealt with mental health issues for some time it is beyond belief (well not really), that people are so cynical. So many people have been going on about “Blue Monday” recently its not surprising there is some money making scheme behind it. Are there really people who think anybody actually fakes feeling depressed to be “cool”?

    By the way I can more relate to having an oh shit Monday!

  12. 4tytwo said,

    January 24, 2011 at 5:44 am

    teenager faking mental issues – no – never. They have all the mental issues that come with puberty

  13. fontwell said,

    January 24, 2011 at 11:22 am

    Perhaps, in the spirit of the scientific method, next year you could make a prediction of a phenomenon called Bullshit Monday…

  14. biomedgirl said,

    January 25, 2011 at 1:48 am

    I keep trying to think about this post intelligently, but each coherent thought is interrupted by New Order’s awesome drum lick…Damn you, 80s new wave…

  15. BitFit said,

    January 25, 2011 at 1:17 pm

    To be fair, while the PR might be ill-judged, the product itself is a good idea.

    I caught the launch at the end of last year and is a pretty reasonable service that might help to address a critical public health need, one woefully under-serviced by the government and that will continue to be so for many years to come (

    For those who cannot get out of the house to see a counsellor (common among sufferers of profound depression), or more likely those for whom the NHS cannot provide immediate long-term care (I’m among that number), might be able to provide a reasonable alternative.

    Private mental healthcare is never very cheap and good practitioners with whom sufferers can build effective and lasting relationships can be very hard to find; at least here it is possible to meet an array of counsellors in one convenient location.

  16. Ben Goldacre said,

    January 25, 2011 at 1:26 pm

    hi bitfit, i dont usually bother with this, but do you have any connection with mentaline or their slightly douchey founder that you’d like to let us know about? just because at face value, i think i’m possibly inclined to call PR sockpuppet on the above comment. anyone else? it mentions the website by name twice, both times with full URL, very keen to defend the product but no engagement with the pretty damning issues raised in the piece. i’m also not sure anyone wandering in afresh would seriously shepherd someone with mental health problems towards Mentaline after reading about their and Buch’s demonstrably crass and bizarre attitude. just a thought, apologies if i’m mistaken, though it is common practice for ppl to do this. over to you BitFit.

  17. skyesteve said,

    January 25, 2011 at 3:18 pm

    Is it any better than MoodGym?

  18. baratron said,

    January 25, 2011 at 8:11 pm

    Ben, I hope you’re going to be covering this news story this week:

    What the FLYING FUCK?!

  19. Guy said,

    January 27, 2011 at 8:51 am

    Bitfit, thanks for pointing out Mentaline to us. Potentially an excellent service. It doesn’t make clear however whether its therapist have any qualifications at all. No mention of the UKCP and BACP, who are the reputable registration bodies for counsellors. So can I just join without any training / qualifications / experience? Looks like it.

    Ben, perhaps your dead cat would care to join? Another certificate for the toilet wall to go with his Gillian McKeith degree.

  20. heavens said,

    January 31, 2011 at 4:21 pm

    “Your teenage years should be spent enjoying life, not convincing people that you have issues that should be taken extremely seriously.”

    Isn’t adopting various postures to get people to take you extremely seriously the primary goal of all teenagers?

    I’m with 4tytwo: Between hormone changes and re-wiring the brain, teenagers have both moods and behaviors that would be considered pathological in middle-aged adults, but are normal for people age 14 or 15.

  21. Tim OLeary said,

    January 31, 2011 at 4:41 pm

    The nonsense about moods and seasons could be easily checked by doing studies in different hemispheres. It might be that everyone is depressed at December irrespective of season because its xmas. However what about countries that don’t have christmas.

    Or countries that don’t have any real difference between summer and winer – say on the equator?

    Is it light, temperature, rain, snow?

  22. RCP said,

    February 3, 2011 at 5:11 pm

    This kind of rubbish “research” is done constantly by PRs
    but they won’t stop until papers stop picking them up and writing
    about them. It works. The one I received today is a particularly
    splendid example as it’s not for release until Monday 7 Feb. So
    bosses are, apparently, braced for something that they’re also not
    bothering to do anything about and that we don’t even know will
    happen… (and that’s without worrying about the mixed metaphors or
    the attitude that says all employees are malingerers). “Bosses
    brace themselves as record numbers throw a sickie Bosses are
    increasingly taking their eye off the ball and allowing staff to
    get away with avoiding work – paving the way for record numbers of
    Brits phoning in sick today (Feb 7). Research by North West-based
    business advisors, ELAS, suggests that Post-Christmas blues, wintry
    weather, credit card bills and a long wait until the next holiday
    all make the first Monday in February the day Brits are most likely
    to phone in sick. This year, a combination of low morale, the worst
    flu outbreak in a decade and managers’ lenience on minor points of
    procedure mean as many as 375,000 workshy staff are expected to
    “pull a sickie” today – at a cost to the economy of £32 million.
    Peter Mooney, head of consultancy at ELAS, said: “It’s
    understandable that managers, up to their eyeballs in ensuring
    their business will survive a challenging environment, take their
    eye off the ball a little when it comes to procedure. “But what
    they are finding is that if you give some staff an inch, they will
    take a mile and allowing workers to text in sick, for example, is
    an open invitation to some people to pull the wool over your eyes
    and grant themselves some free time off. “With morale at rock
    bottom thanks to nearly three years of working in a stuttering
    economy, and with the worst flu outbreak in a decade providing a
    handy alibi, we expect absenteeism to soar this winter. “And on no
    day will that be as obvious as today, with hundreds of thousands of
    workers across Britain ringing in sick for one reason or another.”
    ELAS estimates that as many as 375,000 UK workers will “throw a
    sickie” today, with around half of bosses admitting to not
    believing those who complain of being ill. When taking into account
    the lost work and business opportunities, together with the cost of
    salaries and overtime payments, today’s absenteeism could cost UK
    Plc more than £32 million. Mr Mooney warns that employers are
    unwittingly making it easier for workshy staff. “Businesses in all
    sectors are still having to perform magic tricks at the moment just
    to keep going, so the prospect of a costly legal battle is yet
    another reason to turn a blind eye once or twice. “Meanwhile, more
    and more bosses have drifted into accepting text messages and
    emails as confirmation that staff will not be heading into work –
    making it much easier for staff to get away with taking a duvet
    day.” Sorry about the long post, but I thought it was worth quoting
    in its full hideousness… (it was sent by Beattie Group)

  23. tragiclifestories said,

    February 3, 2011 at 9:30 pm

    Pedantry barrage @ reprehensible:

    “but new orders hardfloor mix is still the best version”

    Correct, the hardfloor mix is the best version of Blue Monday subsequent to the original 12″ version. However, it is not by New Order – Hardfloor are a production outfit from Germany, most famous for their acid trance classic Acperience 1, who now spend their days doing middling minimal techno AFAIK.

    On topic, that faking mental health issues business made me quite angry. But I have worked up to it by reading the entire Wiki page on AIDS denialism just now so…call it Red Thursday.

  24. Peter3 said,

    July 15, 2011 at 8:48 am

    I used to get headaches when I was a kid and then I read a book that we could be faking them. That made me wake up. But in this case I did not know I was creating the situation. Anyway I do like moodgym but I also use clarifylife. I helps when I am alone with no support and I need more of a free form conversation. Although the conversation can be annoying I have notice that it helps when I am anxious and along.
    Has info on both.