"Mental health professionals have no good way to define the scope of their expertise, and so they have expanded that scope, along with the domain of "disorder," in ways that amount to the over-medicalization of suffering and invite scepticism about this claimed authority."
This statement from a recent article on Psychiatry Margins captures a real and growing problem in the field. It deserves serious attention, particularly for those of us who write about medicine
Mental illness is undeniably real. Conditions such as schizophrenia, bipolar disorder, and severe major depression involve profound suffering and often have clear biological elements. Many people benefit from proper diagnosis and treatment. The mistake is not in recognizing these serious disorders. The mistake is in stretching the definition of disorder so far that it begins to swallow normal human experience.
The DSM has expanded with every new edition. Thresholds have been lowered. Everyday struggles now qualify as clinical conditions. Normal grief, ordinary anxiety before major life events, sadness after a breakup, or even strong frustration with political events get turned into diagnosable disorders. This over-medicalisation transforms the natural difficulties of life into pathologies that supposedly require expert intervention, often with medication. It can leave people feeling broken rather than simply human.
Psychiatry and clinical psychology lack the objective tests that other branches of medicine rely on. There is no blood marker for depression or brain scan that definitively confirms ADHD in the same way an X-ray confirms a fracture. Diagnosis depends heavily on subjective reports. Without clear boundaries, the field tends to keep growing its territory. More diagnoses mean more patients, more relevance, and more authority. What used to be handled by family, community, faith, or personal resilience is now claimed as the domain of mental health professionals. This expansion naturally breeds scepticism.
The problem becomes especially clear when politics enters the picture. Strong disagreement with a political figure or movement is increasingly labelled as a mental condition. The casual use of terms such as Trump Derangement Syndrome is a perfect example. Intense political passion, whether positive or negative, is not a clinical disorder. It is human nature amplified by modern media and social platforms. When mental health language is used as a weapon against political opponents, it reveals how far the profession has drifted from its proper role. Instead of engaging with ideas, one side tries to pathologise the other. This does not heal. It divides and discredits the field.
Similar overreach appears in many areas. Climate anxiety, gender distress, and ordinary ideological conflict are sometimes framed in clinical terms. Real mental illness becomes diluted while normal human responses are treated as pathological. Climate Anxiety is indeed a socially constructed myth.
We can accept that serious mental illness exists without giving mental health professionals unlimited authority over human suffering. The field would benefit from greater humility. Clinical diagnosis should be reserved for cases involving significant and persistent impairment, not the ordinary emotional ups and downs of life. Resilience, meaning, relationships, and personal responsibility deserve more emphasis alongside professional help.
Over-medicalisation does not just invite scepticism. It weakens our ability to face life's challenges directly. When normal suffering is turned into disorder, we lose something important about human strength and growth.
The ground beneath the clinic is less solid than many claim. Recognizing genuine mental illness while firmly resisting its over-extension offers the most honest and balanced approach.
https://www.psychiatrymargins.com/p/the-ground-beneath-the-clinic