> I do wonder whether the scope of what's deemed "mental illness" is being widened There are two questions here, I think. One is whether we're confusing regul

> I do wonder whether the scope of what's deemed "mental illness" is being widened There are two questions here, I think. One is whether we're confusing regular moods with larger conditions, and the answer is generally no. Conditions like anxiety have time thresholds of persistent symptoms to avoid this issue, and other conditions like panic disorders describe things that many people never experience. The second is whether the scope of what's diagnosable is broadening on any axis. And there, we can say: yes, consciously so. The US standards for diagnosing mental illness (the DSM definitions) have been steadily moving away from attempts to determine who has a 'real' mental illness in favor of symptoms-based diagnoses. The standard for e.g. anxiety excludes anxiety from drugs (legal or not) and physical health problems, but says nothing about whether the long-term anxiety is 'justified' or a reasonable reaction to circumstances. It's partly an acknowledgement that lots of appraisals are made quickly and on circumstantial evidence, so we might as well issue circumstantial decisions instead of assigning grand theories that might not apply. And it's partly about the fact that many treatments are circumstance-agnostic; absent other options, someone who's constantly anxious because they have high debt and a stressful job will see basically the same benefits from CBT or medications as someone without circumstantial issues. But it's also a concession to just how little we understand a lot of mental illnesses. There's no particular sign that anxiety-the-disorder is anything but high activity from the system everyone has, and we're not sure why it seems to be so much more active in certain people, so there's no objective test to run. Which means either relying on a clinician's judgement about what's 'justified' anxiety, with all the cultural biases and doctor-shopping that invites, or admitting that it's an unclear question and bypassing it. (This looks a bit different when we do understand the biological mechanisms of a disorder, or at least know that certain treatments are conditional. As an example, nicotine helps decrease the symptom intensity of schizophrenia, but doesn't for most other hallucinatory or delusional disorders. And other conditions like ASPD or ADHD have foggy partial understandings that leave them in the middle.) One way of framing this is that we're pathologizing normal reactions. But another is that we have a system built to treat certain unpleasant conditions, and we're recognizing that it can operate on more pain than we'd previously realized. A lot of historical support mechanisms have ceased to support most people, both formal (priests running confessionals and doing relationship mediation) and informal (the death of the 'third place', fraternal organization membership, etc.) If the problem is "many people are sad and stressed by their work", assigning the care of those feelings to our sadness-and-stress support framework makes sense. Ideally we might change people's work circumstances instead, but this looks like at worst a return to the historical approach.