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If you’ve recently been informed that you have a mental health condition such as depression or anxiety, you are not alone. The rates of these diagnoses have dramatically increased in recent years. A 2021 literature review published in The Lancet reported a 26 percent global increase in anxiety disorders during the first year of the pandemic, along with a 28 percent increase in depressive disorders. Certain groups are particularly affected, as stated in the extended afterword of the 2018 book “The Coddling of the American Mind” by psychologist Jonathan Haidt and journalist Greg Lukianoff. For instance, over half of politically progressive white women in their 20s reported being diagnosed with a mental health condition in early 2020.
The COVID-19 outbreak and subsequent lockdowns have caused widespread feelings of loneliness and distress, which continue to persist. However, studies have shown that this phenomenon started before the pandemic, indicating other contributing factors. Excessive use of social media is a commonly identified factor, as it can replace in-person relationships, fuel social comparison, and increase feelings of loneliness. Additionally, political polarization has been linked to increased depression and anxiety among individuals who direct hatred towards out-groups.
Another explanation for the significant increase in population-wide mental health diagnoses is the tendency to view stress and sadness as signs of internal brokenness. While anxiety and depression are certainly medical conditions that require treatment for many individuals, there are cases in which perfectly healthy emotions have been pathologized. This leads people to believe they are sick simply because they are reacting normally to challenges in their lives.
When it comes to physical illness, we typically make two basic assumptions. First, feeling bad is seen as evidence of pathology. It’s unlikely that anyone would visit a doctor and say, “I’ve been feeling strangely good lately, so I thought I should get it checked out.” However, we know that feeling pain or discomfort doesn’t always indicate something is wrong. Often, these sensations are the body’s way of protecting itself, such as when you strain your back and it needs time to heal. Stress can even be beneficial, like when you push yourself during a workout and experience sore muscles.
The second assumption we make is that ailments are binary – you either have them or you don’t. Saying “I have prediabetes” may sound precise and indicate the existence of a reliable treatment, but it actually means your glycated hemoglobin level falls between 5.7 percent and 6.4 percent. Meeting this diagnostic criterion prompts doctors to believe that without changes to your diet and lifestyle, your level may rise further and pose significant health risks. However, it is not a straightforward ailment in itself.
Mental health treatment is influenced by these assumptions, further blurring the line between reality and pathology. Positive mental health is often defined by professionals and laypeople alike as “feeling good,” which means avoiding negative emotions like anger, sadness, fear, and disgust. However, this normative assumption raises questions about what it means to feel “good” and whether it aligns with middle-class ethics, democracy, societal status quo, individual happiness, or the betterment of mankind.
The binary framework for psychiatric diagnosis is even more problematic. The World Health Organization reports that in 2019, approximately 970 million people around the world were living with a mental disorder, equating to one in every eight individuals. This means that seven in eight people are not living with a mental disorder. But how do you determine whether you are among the seven or the one? Taking an online test for depressive symptoms will likely yield a positive score, suggesting some level of depression. However, the classification of that level as a “disorder” is subjective and depends on the individual’s consultation and the perceived interference of symptoms in their life.
Researchers increasingly emphasize the high costs of these assumptions. Stress and sadness are normal, even beneficial, reactions to everyday events. They are evolutionary responses that help us navigate life and behave effectively. While these emotions can become excessive, everyone experiences stress for valid reasons, which enhances our ability to focus and respond appropriately to different situations. Additionally, people often regulate their emotions downward in response to failure or threats, recognizing the value of experiencing some degree of anger.
This dial-versus-switch problem has led health scholars like Allan V. Horwitz and Jerome C. Wakefield to argue that the current depression epidemic is partly a result of diagnostic inflation. In their book “The Loss of Sadness: How Psychiatry Transformed Normal Sorrow Into Depressive Disorder,” they contend that by equating feeling bad with a disorder, we blur the line between normal sadness and clinical depression.
Some researchers even propose scrapping the entire psychiatric diagnostic system. British psychiatrist Sami Timimi argues that diagnostic labels like “depressive disorder” or “generalized anxiety disorder” do not aid treatment decisions, worsen long-term prognosis for mental health problems, and impose Western beliefs about mental distress on other cultures.
None of this suggests that seeking psychiatric or psychological help for emotions is unnecessary. As psychiatrist Robert Waldinger explains, there is both underdiagnosis and overdiagnosis of mental health conditions. Many people lack access to basic mental health care, even if they don’t have a diagnosable disorder. Just as physically healthy individuals can benefit from learning how to stay fit and take care of their bodies, emotionally healthy individuals can benefit from help with emotional management.
The important point is that feeling uncomfortable and seeking help doesn’t automatically mean you are ill. You may be emotionally healthy and simply dealing with unusual pressures, a transitional period, or the challenges of life itself. If you are concerned about your mental health, it is crucial to seek medical help and never suffer alone. Various treatments, such as talking therapies and medication, can be beneficial. In your lowest moments, remember these three things: we all experience anxiety and sadness, distress is a dial, not a switch, and seeking help doesn’t equate to illness.
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