{"id":947209,"date":"2026-05-09T00:42:57","date_gmt":"2026-05-09T00:42:57","guid":{"rendered":"https:\/\/www.europesays.com\/uk\/947209\/"},"modified":"2026-05-09T00:42:57","modified_gmt":"2026-05-09T00:42:57","slug":"are-we-over-diagnosing-ourselves-rethinking-the-language-of-mental-illness","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/uk\/947209\/","title":{"rendered":"Are we over-diagnosing ourselves? Rethinking the language of mental illness."},"content":{"rendered":"

Excerpt from The Unfragile Mind: A Physician\u2019s Call for Restoring Hope and Humanity to Mental Health Care<\/a> by Gavin Francis. Published by The Experiment. Copyright \u00a9 2026. All rights reserved.<\/p>\n

\u201cLife is inherently difficult,\u201d wrote the English psychiatrist and pediatrician Donald Winnicott, and \u201cit follows that in everyone there will be symptoms, any one of which, under certain conditions, could be a symptom of illness. Even the most kindly, understanding background of home life cannot alter the fact that ordinary human development is hard.\u201d <\/p>\n

When the feelings that filter through into our awareness are negative, then clinicians call them \u201csymptoms.\u201d When those feelings are positive, we tend to regard them simply as elements of well-being.<\/p>\n

Our states of mind can make prisoners of us, make us want to die, make us slash at our own bodies, or make us believe we\u2019re immortal or invulnerable. They can torment us with visions and persecutory voices, and distort the way we see our own bodies and those of others. They can make it impossible for us to sleep, sink us in addictions, make us incapable of focus, self-control or contentment. They can destroy our families, make it impossible for us to communicate, to love, to be part of the very communities that would help sustain us. Just about any aspect of mental life can go wrong, and how we characterize and make sense of those disturbances has huge implications for how we find our way back to a sense of ease.<\/p>\n

It has become routine to talk about mental suffering as caused by discrete mental disorders, as if the labels we give those kinds of suffering had the same empirical and verifiable reality as any disease. Many people now use the words \u201cmental health\u201d as interchangeable with \u201cmental illness\u201d \u2014 as in, \u201cI\u2019m here for my mental health, doctor.\u201d The ubiquity of this kind of language has destigmatized emotional and mental distress, encouraged sufferers to seek help, fostered communities of others with similar problems, and neutralized much of the guilt formerly associated with such difficulties. But medical words are powerful, and medical labels can become self-fulfilling spells that curse as often as they cure.<\/p>\n<\/p>\n

As Esm\u00e9 Weijun Wang writes in her memoir of schizoaffective disorder (a type of psychosis in which mood swings are prominent): \u201cMy new diagnosis bore no curative function, but it did imply that to be high-functioning would be difficult, if not impossible, for me.\u201d And as Benji Waterhouse, a British NHS psychiatrist (and stand-up comedian), puts it, \u201cSometimes I wonder if the medical-sounding diagnoses, clusters and codes that I\u2019m forced to enter on endless forms couldn\u2019t more honestly be replaced by \u2018NFI\u2019 (no fucking idea), \u2018SLS\u2019 (shit-life syndrome), or \u2018PNA\u2019 (pretty normal actually).\u201d<\/p>\n

Though many terms we use to describe mental illness have no reliable basis other than consensus among a committee of doctors, I\u2019ve known people whose lives have taken on utterly different destinies, good and bad, solely from being given the label of a new diagnosis. But in recent years, I\u2019ve encountered more people with the unfounded conviction that these labels have a fixed reality, that they are based on hard evidence and therefore confer some kind of fate. Sometimes, among those same patients, I encounter increasing disquiet with mental health labeling and a rising awareness that such labels can become self-reinforcing. Many recipients of those labels are beginning to question the authority on which they\u2019re based. Trends in psychiatry reflect trends in society more broadly, but the authority for determining what constitutes mental illness remains with committees of specialists.<\/p>\n

[My hope is] to make a plea for greater flexibility and humility in how we think about the mind, and challenge aspects of that authority. I\u2019d like us to hold those labels more lightly and with more hope.<\/p>\n

The subject is important, because the 21st century is seeing an epidemic of mental ill health, at least according to the terms of how modern psychiatry defines it. A recent survey of a thousand young people in the U.K. found that over two-thirds believed they have, or have had, a mental disorder. We are broadening the criteria for what counts as illness at the same time as lowering the thresholds for diagnosis. As long ago as 2008, a study found that in the United States half of the population would, across their lifetimes, meet criteria for a mental illness. A quarter of the population was found to be suffering one at any one time, according to the then-current edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV), often thought of as the bible of Western psychiatry (though, in truth, it has evolved into a billing manual for U.S. healthcare and was never intended to set out ultimate truths about the mind).<\/p>\n

\n

But medical words are powerful, and medical labels can become self-fulfilling spells that curse as often as they cure.<\/p>\n<\/blockquote>\n

It\u2019s been almost 20 years since then; reported problems are increasing. The DSM-5 of 2013 broadened the net of what counts as a psychiatric disorder still further (the shift away from Roman numerals from \u201cIV\u201d to \u201c5\u201d was deliberate). Other classification systems have been revised and enlarged: In Europe, it\u2019s more common to use the International Classification of Diseases (ICD) and in East Asia the Chinese Classification of Mental Disorders. Also in use are a Japanese Clinical Modification of ICD, the Cuban Glossary of Psychiatry and the Latin American Guide for Psychiatric Diagnosis \u2014 all have been revised and enlarged in recent years.<\/p>\n

Maps of the world are not the territory, and maps of the mind such as the DSM and ICD are only models of how to think about thinking. They are instruments, only useful to the extent that they help us ease suffering, and meet the many challenges of being and staying alive.<\/p>\n

Jean-Paul Sartre called emotion \u201ca magical transformation of the world,\u201d and its magic can be a dark one. Imagine for a moment life falling into monochrome. Laughter and smiles become forced, mechanical, and eventually impossible. There seems to be no beauty in art, in nature, and even music loses its power. Everything and everyone is dull, brutish and graceless, and there seems no elegance, opportunity or excitement in the world. It\u2019s the night-side of life: cumbersome, decrepit, sluggish and gloomy. I\u2019ve known people for whom episodes of depression cast a dark cloak of paranoia around each of their relationships, draining the joy out of seeing family, of friends, and attacking motivation, ambition and everything in which they once took pleasure.<\/p>\n

It\u2019s a surprising truth that science still doesn\u2019t understand how such shifts in mood are governed \u2014 neither the changeable spirits of mind that come and go from day to day, nor those background moods that move slowly, often imperceptibly, over months and even years. If feelings come and go like weather, then our background temperament can be imagined as something more stable, like climate. But climate, as we are all now perilously aware, is quite capable of changing too.<\/p>\n","protected":false},"excerpt":{"rendered":"Excerpt from The Unfragile Mind: A Physician\u2019s Call for Restoring Hope and Humanity to Mental Health Care by…\n","protected":false},"author":2,"featured_media":947210,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4317],"tags":[105,218,16,15],"class_list":{"0":"post-947209","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-health","9":"tag-mental-health","10":"tag-uk","11":"tag-united-kingdom"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@uk\/116541850052900596","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/947209","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=947209"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/947209\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/947210"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=947209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=947209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=947209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}