The phenomenon of “mental health disorder” has become so influential that, according to recent studies, every second person has—or will have—at least one diagnosed mental illness in their lifetime. This figure presents an existential and statistical impossibility: when more than half of the population is inflicted with psychological abnormality, the norm has become abnormal.
How can it be that the majority of us are sick? To answer this troubling question, some point to modern realities—social media, social isolation, environmental doom—while urging for societal change.
Others see an aggravating factor. Maybe, they argue, there isn’t a true rise in mental illness, but that one distinctive force is inflating what is a relatively stable emotional landscape—no worse or better than before.
In such a scenario, the seeming escalation of mental illness is largely due to an increase in the identification of psychiatric disorder, and not a rise in genuine illness. That is, people are not suffering more, but rather, normal suffering is, more and more, being called “sickness.”
The result, academically known as the “psychiatrization of society,” is one in which emotional states and behaviours that used to be considered typical forms of reactivity, are now branded bona fide diagnoses. What used to be “panicking about a challenging exam” is now an “Anxiety Disorder.” What used to be “desperately chasing a man in the name of love” is now “Borderline Personality Disorder.” What used to be “thinking school is boring and inapplicable in life” is now “Attention Deficit Disorder.” And so on.
Psychiatrization has a trickle-down effect. The more people hear about the all the ADHD, PTSD, BPD, etc., the less they are reticent to expose their suffering and seek help for it. And when they do, they don’t go see a friend, a family member, a counsellor or even a religious figure, as they might have in the past. Now, for their mental illness, they go see a doctor.
If you go to a doctor with a problem—any problem— their responsibility is to address the problem with a solution. Since psychiatry is the branch of medicine that manages the mind—and the thoughts and behaviours that emanate from it— its mandate is to address psychological issues with the same intervention approach as any other: first, to identify the “irregularity” and then, hopefully, to provide a way to solve it, heal it, and fix it.
But defining what is psychiatrically “abnormal” is not attainable with blood tests and CT scans. Psychiatric diagnoses are not objectively identifiable entities, proven and verifiable, they are concepts and ideas, arrived at by committees of professional people seeking to classify behavioural patterns of dysfunction. If there was any doubt about its arbitrariness and creativity, one should note that over the last 70 years the Diagnostic and Statistical Manual of Mental Disorders (the DSM) has almost tripled its list of mental illnesses from 106 to 297.
With its vastly accessible compendium of “certifiable ways to be dysfunctional” the DSM has become an exciting encyclopedia of self-discovery used by everyone who wants to “really understand” themselves. Psychiatric verdicts are no longer just the property of those who deliver them. They reach far past medical walls, into the offices of psychologists, therapists, counsellors, social workers and the rooms of teachers, parents, aunts, friends, and neighbours. They are for everyone, available to everyone and almost universally used to define, characterize, and diagnose everyone’s periodic and patterned moods.
This is possible because the DSM’s diagnostic criteria is very relatable. There is validity to the patterns of emotional reactivity that generate the lists of “symptoms.” People who tend to act one way are also likely to behave in other ways. The problem with mental health disorder is not its clustered classifications—they often apply—it’s the conceptualization of these clusters to be illnesses.
Getting informed that you have a “disorder of emotion” is not like being told you have a disorder of the pancreas or the liver. Your emotion affects your thinking, your feeling, your talking, your being. If your emotion is disordered, it might as well be you that’s disordered. But there is appeal to this sentence to sickness: when you are given the endorsement of “illness” to understand yourself, it does something beyond defining you: it validates your extreme emotional reactivity. Being identified as a disordered person for having emotional behaviour means it makes sense for you to feel the way you feel and act the way you do. It makes sense that you’re so intense and inappropriate— of course it does, you’re diagnostically ill.
The initial reaction to having your emotion validated as a disorder is to ease off it. Without the need to defend yourself, you feel relief. You feel ok, at least temporarily. But soon after this form of endorsement is provided, you will invariably experience an increase of negative emotion due to the specific paradoxical predicament of attaining relief from being told that, well, you’re sick. Because if being sick is how you are then, it seems, being sick is how you’ll stay.
Thinking that the disorder you have been assigned is the cause of your problems is a huge misunderstanding that even some doctors seem to subscribe to. Mental diagnoses do not explain why you are how you are, they just describe how you are in medical terms. You do not suffer from “feelings of emptiness” because you “have” Borderline Personality Disorder. You don’t organize your sock drawer for 45 minutes a day because of “your” OCD. The experience of strong emotion feels like an uncontrollable energy within you because that’s what it is: your instincts are taking over your rationality. This is your inner animal overreacting for reasons that are evolutionary and developmental. A sickness diagnosis doesn’t explain the altered state of emotionality. A primal force in you does.
Emotion is not a medical condition, but if calling it one was helpful, then it wouldn’t really matter. But handing out mental health disorders to people because they have instinctive feelings is not helping anyone. The mental health “epidemic” is a fast-growing movement that, naturally, is far more about managing emotion by seeking the validation of psychiatry, than it is about treating an illness. To be sure, if the psychiatric disorders that people are touting were actual sicknesses, they would not be sought out like prizes, or self-diagnosed as hopeful resolves. If mental health labels were indisputable syndromes, people wouldn’t argue with their doctors about which one they have and which one they want to have, nor would professionals disagree with each other (and themselves) about which ones are most suitable.
On this World Mental Health Day, we must address the very real possibility that people who are emotionally dysregulated are not actually disordered. That the state of mental suffering is not one of complex pathology—nor has it ever been. And that the medicalization of emotion isn’t the solution because when it comes to feelings, sickness is simply not the problem.
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Ilana Kronick, Ph.D. is a senior clinical psychologist at the Montreal University Health Center (MUHC) and an assistant teaching professor for McGill University. She is founder and director of Clinic 308, a psychology clinic based in Montreal, where Animal Theory is practiced in a 10-week therapy program. She has been conducting group therapy since 2011 and, using Animal Theory, has helped over a thousand people lose their diagnostic identities, better manage their emotions and personalities, and better understand themselves.
Instagram: @animal_theory_of_emotion
