Does Everyone Have Mental Illness

Every year it becomes increasingly common for people to self-diagnose themselves with various mental disorders. Suddenly, everyone is somewhere on the ADHD spectrum, has post-traumatic stress disorder, or a personality disorder. And indeed – we all have problems and traits that also characterize these mental disorders. Raw scores from self-report questionnaires (e.g., MMPI[1]) show that modern people’s scores often fall into ranges that, at the time those instruments were created, were considered pathological compared to the norm. (Although, for example, large longitudinal studies of Estonians’ EEK-2 depression symptoms show that they have not significantly increased over time, even when using the original cut-off point from the early 1990s [2]). This means that if we were evaluated by a psychiatrist from 1950, they might very likely diagnose many of us with several mental disorders. But in 2025, do we want to think of this as a pandemic of mental illness, or does this shift and its widespread nature say something different about us as human beings?

To understand this better, it is useful to briefly reflect on how mental disorders developed in the first place. In the form familiar to us – lists of symptoms – mental disorders were codified in the DSM in the 1950s. These symptom lists were based on the clinical experience of doctors with long practice and described different clusters of problems seen in patients, which for practitioners appeared to be distinct from one another. Later, these lists were supplemented and reclassified with empirical data, but in essence they remain very similar to how they began at that time.
Second, they were created in the belief and expectation that they (or at least some of them) represented separate biological phenomena, similar to somatic diseases, for which future science would discover specific and distinct mechanisms [3, 4].

By now, as we have more systematically gathered descriptive data about psychological phenomena, including symptoms of mental disorders, it can be said that neither of these assumptions has been confirmed. Syndromes classified as different disorders share many overlapping symptoms in practice, they often occur simultaneously, and a single causal mechanism can result in very different mental disorders in different people.

What contemporary neuroscience may suggest is that the psyche functions as a whole, as an individual whole. The human organism, to which the psyche belongs, adapts to its environment in ways that take into account its individual resources and characteristics [5]. At the same time, the human psyche has certain features common to all people – we all have attention, memory, the ability to plan and regulate our behavior, the capacity for language functions. This means that although we are each individual and shaped by our unique life experiences, the number of possible problems in our organism is limited. If something goes awry, or environmental demands exceed our capacity, we all encounter similar difficulties, such as trouble concentrating or lowered motivation. Just like with physical illnesses – regardless of what pathogen is in the body or where something is broken – we get a fever.

One way to look at the widespread prevalence of problems familiar from descriptions of mental disorders is as adaptation to environmental demands/changes [6]. We all have trouble concentrating and regulating ourselves, because the information society’s flood of information and constant stimuli exceed the human brain’s capacity to process and attend. We all show personality-disorder-like difficulties in relationships, because from a young age we spend so much time in front of screens and thus fail to acquire the skills to interact effectively with others and regulate ourselves in their presence. We all experience something akin to post-traumatic stress disorder, because the lower our baseline capacity to cope with stress (already depleted by information overload), and the smaller our social support and self-regulation capacity (limited by reduced interpersonal competence), the more likely even less extreme events will affect the body like trauma – and the same conditions will also hinder a return to normal functioning after a traumatic event.

Is this a mental disorder? That depends on the criteria by which we define disorder. If the definition is based on subjective norms, then yes. At the individual level, it is a disorder in the sense that it disrupts daily functioning, the abaility to carry out our roles, and causes unpleasant inner experiences. If the definition is based on statistical or cultural norms, then no. Such reactions are no longer statistically rare or unusual in most cultural contexts. If the definition is based on normative norms, then the answer is both yes and no. On the one hand, our psyche does not function in an optimal, “normal” way. On the other hand, it is adapting to the environment, which is one of the hallmarks of an adaptive, "healthy" psyche.
One way to understand this contradiction is to think of it as a disorder of the human psyche as a whole: we have created an environment for ourselves that humans as a species is not yet adapted to handle. We will certainly adapt in the future, but these processes take a lot longer than the speedy progress of the information society.

But even we, living now in this society designed to exceed the limits of the human brain’s capacity, can support our ability to cope. We can do this by being aware of what psychological functions we have and what their limits are, and by respecting those limits as much as we possibly can. Psychology already knows quite a lot about these limits (think of popular science books like The Dopamine Nation, 4000 Weeks, or Slow Productivity (and SOOO many more)). 

What is unlikely to be helpful is us labeling this natural (adaptive) reaction as a disease and trying to suppress it with various medications or other methods that mechanically push it down. Because as long as environmental demands remain as they are, our brains must adapt to them, and so these adaptive reactions will always find one way or another to reappear.

References

[1] Twenge, J. M., Gentile, B., DeWall, C. N., Ma, D., Lacefield, K., & Schurtz, D. R. (2010). Birth cohort increases in psychopathology among young Americans, 1938–2007: A cross-temporal meta-analysis of the MMPI. Clinical psychology review, 30(2), 145-154.

[2] Laidra, K., Reile, R., Havik, M., Leinsalu, M., Murd, C., Tulviste, J., ... & Konstabel, K. (2023). Estonian National Mental Health Study: Design and methods for a registry‐linked longitudinal survey. Brain and Behavior, 13(8), e3106.

[3] Clegg, J. W. (2012). Teaching about mental health and illness through the history of the DSM. History of psychology, 15(4), 364.

[4] Spitzer, R. L., Endicott, J., & Gibbon, M. (1979). Crossing the border into borderline personality and borderline schizophrenia: The development of criteria. Archives of general psychiatry, 36(1), 17-24.

[5] Barrett, L. F. (2017). The theory of constructed emotion: an active inference account of interoception and categorization. Social cognitive and affective neuroscience, 12(1), 1-23.

[6] Sterling, P. (2012). Allostasis: a model of predictive regulation. Physiology & behavior, 106(1), 5-15.