https://www.nytimes.com/2023/05/05/...MdoBuVAh7_iPvVhB974NrScDhcF-iz&smid=url-share In my work as a psychologist for people dealing with the aftermath of significant injuries, I am often presented with the question of whether low mood in my patients is best understood as a normal reaction to a serious health event — it’s reasonable, for instance, to respond to news that you may never walk again with questions about how life might be different and more challenging — or as clinical depression that should be treated. This is an extremely difficult determination to make. Part of the reason it is so hard is that there are serious disagreements about where to draw the line between the two and even whether it can be drawn at all. Psychiatry’s guiding paradigm is that some extremes of mood are sufficiently severe that they constitute illness. But a longstanding criticism of psychiatry claims that the issues it professes to treat are just ordinary aspects of the human condition (or “problems in living,” as the psychiatrist Thomas Szasz, a staunch critic of his own profession, would have it) that are being unnecessarily pathologized. This argument isn’t restricted to questions about diagnoses; a version of it plays out across multiple mental-health-related debates. At first glance, these can look like separate discussions, but they tend to boil down to the same central questions: Is happiness always the goal of mental health treatment? How can we know when we’re happy enough? How miserable are we supposed to be?
