Mental Health: Observation, Not a Diagnosis — And Why Big Pharma’s Role Matters
Mental Health: Observation, Not a Diagnosis — And Why Big Pharma’s Role Matters
By TD Goodman Books
Mental health has become a buzzword in recent years — rightly so, as more people seek help and understanding. But beneath the surface of this growing awareness lies a complex and often misunderstood reality: mental health issues are primarily clinical observations, not absolute diagnoses.
This distinction is crucial because it shapes how we understand, treat, and even commodify mental health.
Mental Health as an Observation, Not a Concrete Diagnosis
When we say someone has depression, anxiety, or bipolar disorder, we often think of it as a fixed medical condition with clear-cut boundaries, like diabetes or asthma. But psychiatry doesn’t work quite that way.
Dr. Francis Allen Frances, a leading psychiatrist and former chair of the DSM-IV task force (the manual that defines mental disorders), emphasizes in his book Saving Normal that mental disorders are syndromes based on clusters of symptoms — clinical observations — not definitive diseases with biological markers.
“The boundaries between normal sadness and clinical depression are not sharply defined. Psychiatry deals with a continuum, not binary categories.” — Saving Normal
This means mental health diagnoses depend on subjective assessments, criteria that can shift over time, and cultural perceptions of what counts as “normal.” As a result, many people are labeled with mental disorders when what they may be experiencing are natural human emotions or reactions to life stress.
The Risk of Overdiagnosis and Overmedication
One of the biggest dangers of treating mental health as a fixed diagnosis is overdiagnosis — where normal variations in mood or behavior get pathologized and medicated unnecessarily.
Dr. Frances warns that “lowering the threshold for diagnosis” leads to millions being diagnosed with disorders they do not truly have, increasing medication use without proven benefits.
Big Pharma’s Role: Profits Over Patients
This is where the problem intensifies. The pharmaceutical industry — Big Pharma — has a vested interest in expanding the market for psychiatric medications.
It is no secret that drug companies often incentivize doctors with bonuses, speaking fees, and gifts to promote specific medications. The medications prescribed may help some, but the aggressive marketing tactics can push doctors to medicate rather than explore alternative therapies or address underlying issues without drugs.
“Pharmaceutical companies aggressively market to psychiatrists, influencing prescribing practices more than scientific evidence.” — Saving Normal
Doctors, often overwhelmed by time constraints and influenced by pharma promotions, may lean on medication as the first line of defense, sometimes at the expense of patient-centered care.
What This Means for You
- Mental health symptoms are a signal, not a fixed label. They require thoughtful evaluation over time.
- Medication can help many, but it’s not a cure-all, and it’s not the only treatment option.
- Be wary of quick fixes that come with a prescription. Ask questions about risks, benefits, and alternatives.
- Advocate for yourself or loved ones to have a holistic approach — including counseling, lifestyle changes, and social support.
Final Thoughts
Mental health is complex. It requires care, respect, and a critical eye on the systems that influence treatment.
As Dr. Frances points out in Saving Normal, the overmedicalization of normal human experience risks making us all “patients” unnecessarily. Instead of broadening the definitions and expanding medication use, we need to preserve the line between normal and abnormal to protect mental health’s true integrity.
Interested in diving deeper?
Saving Normal by Francis Allen Frances is a powerful resource to understand the history, challenges, and politics behind modern psychiatric diagnosis and treatment. It helps readers navigate the complex world of mental health with clarity and caution.




