Commentary: Instead of worrying whether you have a mental disorder, focus on healing
By focusing too much on diagnosing mental disorders, we are teaching people to understand and label their distress in unhelpful ways, says psychologist Joanna Barlas of JCU in Singapore.
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SINGAPORE: Scroll through social media and you’ll likely find posts dispensing mental health advice. Some go so far as to provide checklists of symptoms for conditions like attention-deficit hyperactivity disorder (ADHD) or social anxiety disorder – to help users recognise disorders in themselves and others.
With rising mental health awareness, the number of people diagnosed with mental disorders has increased over the past few decades. A 2025 study in The Lancet found that there was a 70 per cent increase in cases of mental disorders from 1990 to 2021 across Southeast Asia, with Singapore seeing a 75 per cent increase.
These numbers may suggest that we are getting better at recognising and detecting mental health problems. However, there is also a possibility that we are over-recognising mental health problems and reframing everyday struggles as mental disorders. This is called the prevalence inflation hypothesis, a term coined by researchers Lucy Foulkes and Jack Andrews.
Mental health content online often focuses on raising awareness by promoting symptom identification, that is, teaching people to recognise symptoms of common mental disorders. Those who suspect they have a disorder might come across posts or websites inviting them to complete a short online quiz.
These quizzes often draw from DSM-5-TR diagnostic frameworks, which classify more than 250 mental disorders and underpin mental health treatment, services, research and policy. While such quizzes may not explicitly advocate for self-diagnosis, users may do so anyway based on the results they get.
MENTAL DISORDERS MAY NOT BE DISTINCT
Though getting diagnosed with a mental health condition can be transformative for some and can provide access to appropriate intervention and support, there is growing evidence that diagnoses do not translate to distinct disorders.
Scientists have found that the same genes are linked to many different disorders, and that people’s symptoms often overlap. A 2025 study by Chunyu Liu and colleagues found that the same genetic variants were linked to multiple disorders, suggesting shared biological roots.
In one long-term study by Avshalom Caspi and colleagues, published in 2014, researchers discovered that instead of fitting into neat boxes, people’s symptoms reflected one broad pattern of distress, which they called the “p factor”. This means that people are more likely to present with general mental distress and dysfunction rather than specific disorders.
How does this all relate to self-diagnosis? If the underlying foundations of our attempts to raise awareness and our mental health questionnaires are inaccurate, then we are giving people the wrong assessment tools. We are teaching people to identify whether they have depression or ADHD, but they are more likely to be experiencing general problems with their mood or attention.
THE SELF-FULFILLING NATURE OF SELF-DIAGNOSES
As the boundaries blur, the very meaning of mental health terms begins to stretch, a phenomenon psychologists call concept creep. Milder and everyday emotional struggles like sadness become framed as depression, worry becomes anxiety, and struggling to pay attention to boring tasks becomes ADHD. Online communities where young people trade symptom checklists illustrate how easy it is to slip from self-reflection to self-diagnosis.
This can lead to further problems, of which the two main ones are the self-fulfilling nature of self-diagnosis and the obscuring of causes of distress and dysfunction. Interpreting your fear of giving presentations as an anxiety disorder may lead you to manage your anxiety by avoiding doing future presentations, and yet avoidance is a strong mechanism for fuelling further anxiety.
More broadly, by framing distress and dysfunction as a disorder or problem inside an individual, we draw attention away from social causes, such as poverty, inequality, discrimination and workplace stress. We place the burden of responsibility to recover on the individual, rather than on the system to change.
None of this is to suggest that mental health problems are not real. They are very real, and people can be hugely debilitated by them.
But by focusing too much on diagnosing mental disorders, we are teaching people to understand and label their distress in unhelpful ways. These labels risk becoming glamorised by social media in a way that does not improve self-management and overwhelms mental health services with requests for assessments of specific and trending diagnoses.
FOCUS ON PROCESSES, NOT LABELS
The alternative is to teach people about unhelpful psychological processes. These processes are known as transdiagnostic processes, common patterns that cut across many diagnoses.
For instance, rigid thinking patterns can underlie both depression and OCD, and avoidance can fuel both anxiety and attentional problems.
We would then need to see these processes on a continuum, and to recognise when self-care and peer support might be sufficient and when professional help might be warranted.
Rather than asking “Do I have a disorder?”, perhaps we should be asking “What process am I stuck in – and what might help me shift?” We could also consider its impact: “Does this process limit me from doing the things that are important to me?”, and the context it occurs in: “Is this a normal reaction to a social or environmental stressor?”
The next wave of mental health campaigns could focus less on labels and more on nurturing flexibility, functionality and community, and on creating social environments that reduce distress in the first place. After all, understanding how and why we struggle may be the first step to healing, without needing to name a disorder.
Associate Professor Joanna Barlas is an Associate Professor in Clinical Psychology at James Cook University (Singapore Campus).
