Is Depression Normal? Challenging the Mental Health Diagnosis System
does everyone have a disorder?
Over the last few months, I’ve been conducting psychological evaluations and finding myself thinking, “What a monumental crock of shit.” Evaluations are so tidy. Tell me your symptoms and I’ll cross reference them with this handy checklist. Because your feelings and behaviors align with this criteria, you shall be neatly placed in a box and go home with the reward of a (often stigmatizing) label.
I do acknowledge the usefulness, and sometimes necessity, of this system, particularly for insurance purposes and guiding treatment approaches. However, when you become aware that the sharp rise in depression diagnoses coincided with big pharma’s aggressive promotion and sales of antidepressants, the correlation becomes undeniable.
Some may ask, "Which came first, the chicken or the egg?" Did demand necessitate supply? In his book, Making Minds and Madness: From Hysteria to Depression, Mikkel Borch-Jacobson asserts, “Far from arriving on the market to treat a previously existing psychiatric disorder, these new drugs actually promoted it. Modern, Western depression, we might say, is a side effect of antidepressants.”
In our late-capitalist culture, this isn't all that surprising. Susan Rosenthal writes, “The capitalist class seeks to avoid responsibility for the many problems it causes.” One way that clinicians diagnose clinical depression is the level to which the symptoms impair our ability to function in the world, and thus contribute to the capitalist system. Herein lies another chicken and the egg concept.
When I speak with individuals who display symptoms matching the criteria for clinical depression, I find myself wondering, "Don't many of us feel like that to some extent? Isn't depression, in lots of cases, a direct response to our experiences? Couldn't depression be more accurately viewed as a spectrum, and don’t all of us, at least at some point, exist on that line?”
Of course, there are genuinely organic conditions, such as psychotic and cognitive disorders, and for some, depression can be a debilitating and all-consuming struggle, leading to tragically high suicide rates. However, I can't help but contemplate how many people could be helped if we discarded the stigma and isolation that often accompany a depression diagnosis.
“Psychiatry supports capitalism by ‘diagnosing’ socially-created problems as individual cognitive or biological defects, providing pseudoscientific ‘evidence’ for blaming the victims of the system.” - Susan Rosenthal
Dr. Kari Jantz, a fellow Substack writer, distinguishes between two common types of depression:
“1. Your life is actual dogshit and everything’s gone wrong - you got evicted, the wife left, the kids hate you, you lost your job and now you’re at the bottom of a bottle. This is hell but there is a way out (or through, rather, as Winston Churchill so eloquently put it);
2. Your environment is fine and you ‘should’ be fine but you’re not.”
According to Dr. Jantz, the second type often stems from an inner conflict between our values and actions, leading to shame because we're not living up to who we believe we should be.
Many people I encounter seem to fall into one of these categories. It's understandable that life's hardships can lead to depression. When faced with tragedy, crisis, or chronic stress, feeling discouraged and downtrodden is a normal reaction. And yet we lament, “Why aren’t I feeling like everyone else in my socials feed, or those ecstatic revelers in the ads?”
Less clear is the cause of inexplicable depression. However, if you dig deep enough, often times people aren’t living in accordance with their dreams and/or values. Easier said than done, I know. One of my values is to uplift others, yet every time I classify someone with a "mental health disorder," I worry that I might be reinforcing a belief system that leaves many feeling ashamed, disconnected, and stuck. For some, the diagnosis becomes a crutch, an excuse for not taking action to improve their lives.
Likewise, my dream is to travel the world, but instead, I find myself tied to my desk, working away. Dreams are often unattainable, which is why they're dreams. Yet society relentlessly pressures us about why we aren't living our dreams like Oprah did. Should the disappointment of not achieving our dreams or living in accordance with our values be labeled depression? Certainly these dilemmas can cause “clinically significant distress.”
What if we called a spade a spade, and stopped labeling and medicating people for suffering in an unjust world? What if we acknowledged that depression is a natural response to life's challenges? Would knowing that depression is a common experience help people feel seen and understood? Could it encourage us to normalize the struggle and foster empathy?
Change starts from within, and we should be the change we wish to see in the world and all that. With this in mind, I find myself devoting more time to normalizing what society labels as depressive "symptoms" these days. If, as a culture, we could be more candid and open about our hardships and genuine emotions, we could create a space for others to do the same. When people feel truly understood and validated, genuine connection happens, and that connection can be a powerful antidote for depression.
Let's reach out to others, encouraging real conversations and vulnerable sharing, and in doing so, we can dismantle the myth that depression is always a disorder requiring treatment. By fostering empathy and understanding, we can create a more compassionate and supportive environment for everyone's mental well-being.
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