Are We Over-Diagnosing Mental Issues?

If you spend even a few minutes on social media, you’ll notice how easily mental health terms now enter everyday language. “Oh! I’m so OCD about cleanliness.” “Everyone has ADHD these days.” “That gave me trauma.” What began as awareness has quietly slid into casual diagnosis and this shift has ignited a serious question across medicine, media and policy: are we over-diagnosing mental health conditions?

Recent debates in the UK have brought this issue into sharp focus. A new survey of physicians suggests many doctors feel everyday stress, grief and dissatisfaction are increasingly being medicalised. Policymakers have echoed similar concerns, questioning whether rising diagnosis rates reflect worsening mental health or a system struggling to distinguish illness from normal human distress.

The truth, as with most things in psychiatry, is nuanced.

Downside of Self-Diagnosis

One of the biggest unintended consequences of over-diagnosis is trivialisation. When everyone casually claims to have ADHD, OCD or anxiety, those who actually live with disabling symptoms can feel dismissed. A person with severe obsessive-compulsive disorder who may be spending hours trapped in compulsions hears from someone who self-diagnosed themselves from a few social media posts, “Oh, I’m OCD too,” and feels their suffering is minimised. What should be a validating diagnosis becomes a diluted label.

There’s also a systems-level cost. Mental health services are already overstretched. Over-diagnosing mild or transient distress risks diverting limited resources away from those with severe, chronic or life-threatening conditions. In public health systems, this has downstream effects, such as longer waiting lists, shorter consultations and delayed care.

At an individual level, diagnosis shapes identity. A mental health label can be helpful when accurate, but harmful when premature or incorrect. Some people begin to see themselves as permanently “broken,” avoid challenges, or accept unnecessary medication not because it helps, but because a label told them something was wrong.

Under-Diagnosis Is Still Widespread

Focusing only on over-diagnosis risks missing a critical truth that there are still millions who need help, who are still not being diagnosed at all. Large population studies suggest that for every person who may be over-diagnosed, many more remain under-diagnosed, particularly in depression, anxiety, trauma-related disorders and substance use. Increased diagnosis rates don’t automatically mean over-diagnosis; they often reflect better awareness, reduced stigma and people finally seeking help.

What Diagnosis Actually Is versus What It Is Not

Psychiatric diagnosis is not a personality test or a permanent stamp.

• A diagnosis is a clinical tool, used to:
• Identify patterns of symptoms that cause significant distress or functional impairment
• Guide evidence-based treatment
• Provide access to care, accommodations and support
• Track change over time

What diagnosis is not:

• A life sentence
• A fixed identity
• A single-symptom label
• A verdict on character or capability

Mental health conditions can be comorbid, evolve over time, fluctuate in severity, and go into remission much like diabetes, asthma or even cancer. Someone can meet the criteria today and not meet it tomorrow. That does not invalidate the diagnosis; it reflects the dynamic nature of mental health.

Who Can Diagnose and Why That Matters

In India, mental health diagnoses are legally and clinically made by:

• Psychiatrists (MD or DNB Psychiatry, who are medical doctors)
• Clinical psychologists (with formal training and licensing)

This matters because self-diagnosis, online quizzes and social media checklists cannot account for differential diagnoses, medical causes, cultural context or functional impairment. Without professional assessment, the risk of both over- and under-diagnosis rises sharply.

Bottom line is that: We don’t need fewer diagnoses, we need better diagnosis. Diagnosis that is careful, contextual, longitudinal and paired with real treatment.

Our constant endeavour as a society at large should be to make mental health a household name and reduce the stigma around it.