Some conditions are overdiagnosed, and there is a too-cozy relationship between medicine and pharma that is disturbing to many of us.
However, to make a diagnosis based on Diagnostic and Statistical Manual (DSM) criteria almost without exception (one exception is for bipolar II disorder) require that symptoms (and several symptoms are required usually for any given disorder) must cause significant impact on one's lives, eg,
"...sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features."
or
"...symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning."
EDIT: (based on your own edit) - reserving diagnosis and treatment just to those at risk for self- or other-harm is going to harm many suffering people. I don't think you understand what depression really is. It's not caffeine withdrawal or the flu. Even when no suicidal ideation is present, it's a serious disease with real costs to the individual and to society, just as real as cancer.
Beyond depression, I think you'd agree that even in the absence of harmful behavior or ideation, people who experience auditory hallucinations in the course of depression, or OCD sufferers who are unable to work because they must wash their hands hundreds of times a day, or who have PTSD triggered simply by backfiring engines, or who have dozens of other DSM diagnoses, all have legitimate illnesses that deserve much more than the terrible, stigmatizing suggestion that their illnesses somehow are not real.
My argument is that it's not an "epidemic of depression" that we're dealing with but rather an "epidemic of over-diagnosis". I would argue that the industry is in practice being far too loose with the definition of "significant impact on one's lives". I think articles like this one blur the line even further by making it sound like everyone who has experienced a few of these symptoms suffers from depression. People read stuff like this and then start telling themselves "I'm depressed" and because of this mistaken belief many of them wind up being medicated inappropriately.
This epidemic of over-diagnosis has reached such vast proportions that I imagine the majority of people in the tech industry have been prescribed some kind of psychotropic drug to treat some form of mental illness at some point in their life. I wish I could get accurate statistics on this to prove my point.
As a side note I do think that caffeine induced psychosis is 100% real (because it's a very powerful drug) and the symptoms often mimic that of depression or bi-polar and can even be inclusive of phenomena such as hallucination. I don't have any credentials but my opinion as a layperson is that I think it's incredibly irresponsible to write a prescription or to give a diagnosis for any mental illness to a patient who has not first completely cut caffeine out of their lives.
Part of the diagnosis is that the feelings are not normal and that they interfere with day to day living.
You might have a point about medications for depression: tri-cyclics, MAOIs, SSRIs and NASAs and etc are not well understood but they sometimes seem to work. Luckily meds are not first choice treatment for most people anymore. CBT is.
Suggesting that bi-polar is in anyway a part of the normal human range of experiences is just ignorant. Mania can be incredibly destructive. Some people love the feeling of being up, but full on mania is more than that and is an unproductive giddy high.
Your last para about self harm is also ignorant. Deliberate self harm is incredibly common. Some people with very mild self harm have severe depression and would need treatment. Some people with significant self harm have mild to moderate illness and are just stuck with an un-useful coping mechanism. There's no way of gauging someone's intent to die by the severity of injuries they inflict upon themselves.
When you say 'it's perfectly natural for people to experience X', what you may actually mean is 'many people suffer from mild depression and/or bipolar disorder symptoms without ever being treated', which is absolutely true.
When people say 'clinical depression' or 'bipolar disorder', they're generally referring to natural biological mechanisms that have gotten out of hand (due to negative feedback loops, or other problems) and are so profound that they clearly require medical assistance.
Lots of people deal with clinical depression, bipolar depression, or mania by 'riding it out', sometimes using self-care techniques, lifestyle changes, or self-medicating. It's important to take this into account when considering whether something is 'natural' just because it's common.
I would argue that what people call "mild depression" IE symptoms that do not warrant a diagnosis.. is actually not depression at all but rather part of the normal human range of emotion and feeling. Many people latch on to the advertising concept of "mild depression" but that doesn't mean it actually exists
Otherwise, you're agreeing that there is a spectrum of symptoms, but somehow the symptoms on the milder end of the spectrum 'don't actually exist'?
A diagnosis is different from a prescription. Just because you have a diagnosis of depression doesn't mean you automatically need to take antidepressants; the diagnosis is used as a tool to understand the general set of symptoms you might experience and what the treatment methods are.
Again, depression is not 'abnormal' emotion or 'abnormal' feelings. Neither are the effects of bipolar. They are both 'normal' and entirely natural biological mechanisms, the problem is that those mechanisms are acting to an atypical degree and causing negative side-effects. In many cases the treatment methods are also entirely 'natural', not involving any pharmaceuticals.
Another way to put this: It is normal for someone to become depressed in response to tough circumstances or disappointment. It's normal for someone to get amped up and slightly manic in response to stress or an immediate threat. Those are natural mechanisms.
When the depression or stress response lasts for days or weeks, that is where it starts to enter into territory where a physician might diagnose it as clinical depression, or hypomania, or mania. Again, the problem is not the feelings, it's the duration and magnitude of the feelings - the feelings and physical effects lasting well after the initial triggers are gone.
For example flu-like symptoms do not necessarily mean that you have early onset AIDS or ebola virus even though those diseases do produce flu-like symptoms. Therefor people shouldn't refer to those common symtoms as "mild ebola" or "mild AIDS". The same principle applies to mental health and words like "depression".
> Another way to put this: It is normal for someone to become depressed in response to tough circumstances or disappointment
I would argue that this is incorrect. If a certain human condition is normal then by definition it is not an illness! Therefor to use the word 'depression' to characterize normal circumstances is not only a misnomer but a dangerous charade that downplays the seriousness of the genuine mental illness. A whole generation is confused on this point in my opinion due to advertising campaigns that are designed to confuse them and the doctors don't seem to be motivated to help clear up this confusion and I can only assume that is due to profit incentive.
There was talk of including some limited use of the term spectrum in the planning of the DSM-V but that's all it was, talk.
The problem is that your argument, even if it is true for a significant portion of people diagnosed with mental illness (which I personally am not convinced of, but also have no hard numbers on hand), makes it more difficult for those people who currently are afraid of how society will react if they attempt to treat their illness. It creates a bar that someone has to be "this sick to get diagnosed". It creates a fear of being told that your problems aren't really problems, and you're just not dealing with them correctly (regardless of the intent of your original argument).
I think that it's not appropriate _right now_ to deal with over-diagnosis as a serious issue in comparison to under-treatment. Maybe, in a future when it's socially acceptable to get help for mental illness, we can deal with over-diagnosis if it's a serious issue. But trying to stamp out over-diagnosis right now contributes to a more dangerous stigma.
You're using incorrect language there. It creates a bar where a person has to show "this many symptoms" in order to be diagnosed with a particular illness. This is how modern medicine works and none of us question this model when it comes to physical illness so why should it be different for mental illness ? For example flu-like symptoms alone should not be enough to diagnose someone with the ebola virus or AIDS and the same principle applies to mental illness.
>It creates a fear of being told that your problems aren't really problems, and you're just not dealing with them correctly (regardless of the intent of your original argument).
No. It creates an expectation that one should refrain from automatically assuming that normal human experiences are indicative of mental illness. It's normal for human beings to experience certain problems (such as fatigue, anxiety, trouble sleeping, weight gain/loss, etc) during the course of their life and it doesn't mean they are necessarily sick.
The view that "almost everyone is sick but most people are hiding it out of fear" is a ridiculous notion that is probably being injected into the cultural conversation for commercial reasons and I doubt many people take it seriously.
It's never been more socially acceptable to start taking drugs for mental illness due to the pervasiveness of drug advertising. I think it's easy to make an increasingly strong argument that it's been over-normalized to the point where misdiagnosis is commonplace
Go read the DSM-V, or the DSM-IV. (In fact, don't, but at least read up on how they work.) They are the diagnosis guides which are used as a baseline across the USA, and in fact for some things across the world.
They quite explicitly list out symptoms, and how many of them one has to have in order to be diagnosed as having a mental illness, and even within those a scale which allows doctors to prioritise care.
I think that one can end up promoting self-diagnosis and over-diagnosis simply by using the term "mildly depressed" to refer to the general idea of "being upset" or "being in a bad mood" which is becoming increasingly common in our vernacular. I would argue that it's becoming increasing common because commercial interests set out to promote it's use in that way.
Thankfully the system exists whereby one person (you) doesn't get to decide that.
Over-pathologization might be an issue, but isn't really the topic of discussion. Trying to misdirect the argument from "there's widespread depression" to "it's probably something else" is exactly part of the problem.
The OP is putting forward the same, tired arguments that "feeling like this is normal, get over it". Clearly and admittedly he has no experience or qualifications, so how the hell does he know?
http://hyperboleandahalf.blogspot.ca/2011/10/adventures-in-d...
Your assertion that credentials are needed in order to form an opinion about what is and is not normal human experience is in my opinion ridiculous, and it borders on the "appeal to authority" logical fallacy.
I'm not suggesting that these symptoms don't exist, but rather that they've been a perfectly normal part of human life since the dawn of man.
It's perfectly natural for people to go through periods where they have less energy than other periods, overeat or under-eat, have difficulty concentrating or making decisions, feel anxious. This is normal stuff depending on the life circumstances especially if you're drinking any amount of coffee because that will lead to periods of highs and lows. It does not mean you "have depression" as if there was some flu virus that you became infected with it simply means you're a human being.
I would argue that legitimate diagnosis should be reserved for people who are either suicidal or who's symptoms strongly suggest elements of self-harming or harming others.