The Diagnosis Trap

Have we really become that unwell - or are we medicalising and pathologising life’s difficulties?

Earlier this week, I published a piece in UnHerd about the alarming rise in disability benefit claims for conditions like autism, ADHD, anxiety and obesity.

You can read the article here: “Britain’s overdiagnosis crisis is stretching the welfare state” – UnHerd

Some of the numbers are staggering.

In 2019, just over 26,000 people in the UK were receiving the enhanced rate of PIP for autism. By 2025, that figure is expected to surpass 114,000 — a 335 percent increase. ADHD claims have risen from just over 4,000 to 37,000. Anxiety and depression from 23,000 to more than 110,000. Even obesity, a controversial inclusion in any diagnostic framework, is now cited in over 11,000 claims.

These increases raise urgent questions — not only about funding, but about how we now think about health, identity and human suffering.

Why are so many people being diagnosed? Why are so many actively seeking diagnoses? And why are these diagnoses so often embraced as explanations not just for a person’s challenges, but for their entire sense of self?

The shift we are witnessing requires analysis. It reflects a much broader cultural and institutional transformation, one that has quietly redefined what it means to understand the difficulty of being human.

We used to understand personality as a broad range of traits, quirks and temperaments. A person could be eccentric, sensitive, anxious, obsessive or intense without being treated as medically unwell. These qualities could be challenging, yes, but they were still understood as part of who someone was — not necessarily as clinical disorders to be managed.

Now, we interpret many of those same traits through a diagnostic lens. And that lens has been shaped, more than anything else, by the expansion of the DSM — the Diagnostic and Statistical Manual of Mental Disorders.

The DSM was never just a book of definitions. It is a cultural document as much as a clinical one. Every few years it is updated by committees, and with each revision, new diagnoses are introduced, old ones are broadened, some are quietly discarded, and the boundaries of disorder stretch further into ordinary life.

What once required extreme impairment may now be diagnosed on the basis of self-report, social difficulty or distress. The threshold for what counts as a mental disorder has changed significantly. And as it has changed, the number of people who qualify for treatment, accommodations and financial support has risen dramatically.

This is not simply the result of new scientific discovery. It reflects shifts in values, expectations and priorities. It reflects the growing idea that pain, discomfort and difference should always be treated — and that diagnosis is the pathway to that treatment.

Of course, for many people, it is. I have worked with clients who have received a long-overdue diagnosis and finally felt understood. But I have also worked with others who felt trapped by their labels. They began to speak about themselves only through the language of dysfunction. They limited their ambitions and avoided responsibility. Not because they were malingering, but because they had internalised the idea that their brain was broken, and that their distress made them fragile.

This is what happens when diagnosis becomes identity.

We are not just seeing more people diagnosed. We are seeing diagnosis become a way of making sense of the world. Young people now describe themselves and each other in clinical terms. TikTok feeds are saturated with symptom lists and neurodivergent “content creators” sharing personal anecdotes framed as universal truths. Online communities form around shared conditions. And in many cases, the label is worn like a badge — a signal of uniqueness, but also of legitimacy.

There is a reason for this. In schools, workplaces and welfare systems, labels matter. A diagnosis can unlock time, money, support, adjustments. In some cases, it is the only route to help. So the incentives are clear. But the long-term consequences are rarely discussed.

What happens when a child grows up believing they are disordered? What happens when every setback is filtered through a clinical lens? What happens when we stop encouraging people to develop resilience, because society tells them that they are too impaired to cope?

I have seen this unfold in real time. I have worked with families who are desperate for help, and who are told, bluntly, that without a diagnosis their child will be left behind. I understand the impulse. But I also understand what it does to a child’s developing sense of self to be told, from a young age, that their struggles are evidence of pathology.

We are teaching a generation that difficulty is a condition that needs treatment, that diagnosis is proof of defect and that identity is best understood in diagnostic terms.

And yet the truth is, over-diagnosis can cause a good deal more long term pain than under-diagnosis. Not everyone is mentally ill. Not every hard feeling is a symptom. Not every bad day is a crisis. Some things are just extremely difficult. Some traits are just annoying. Some people are just different.

The solution is not to go back to silence and shame. But we cannot keep pretending that the current model is working. The welfare system is under strain. Schools are overwhelmed. And most importantly, people are losing faith in their ability to handle hardship. If you are always told you are unwell, you will start to live like someone who is.

We need a cultural reset, so that we can reclaim a space between sickness and health. We need to teach younger generations that resilience is something we develop, not something we inherit.

A diagnosis can be helpful. But it should not become a way of life.