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.
I’ve worked in education for several years now. Previously as a Secondary School Biology Teacher, and for the past 4 years in the University Higher Education sector. The situation is dire. Students are so utterly pandered to. They are most educated in the fact it seems, that they can claim offence, distress or trauma at the drop of a hat because it will strike fear into staff that have no way to contest it (I’ve heard way too many times how ‘traumatised’ students are about events that are no such thing; as a society we are too fond of exaggerating and misusing the English language in order to twist standard and mundane daily happenings into major dramatic events. Completely stretching the truth). Staff are often blamed for students’ failings; personal responsibility isn’t taken and if they complain, the bias of empathy is usually towards them.
Most of my colleagues indulge ‘mental health issues’ because educational institutions are so dogmatic about it. The great thing about facts is they can’t be argued with but feelings and subjective views can be used as a manipulative tool. Quite honestly I remember skipping classes at school and Uni - because that’s what many students will do. Most of us at some point don’t want to go to school or work and would love the opportunity to get out of it. Particularly those with crappy jobs or better things to do. The difference now is the student (or employee) can claim some mental health issue (of questionable diagnosis), whereas back when I was a student there was no excuse for skipping - it was just a fair cop if we were caught; we knew we were taking the p***, it was our fault. Because there was no excuse so readily handed on a plate to us. And this extended to working life thereafter - you got your butt into work or you didn’t get paid.
Our current culture has created a lack of resilience, and encourages self diagnosis which becomes a popular card to use - to claim false victimhood and wear it as a badge of honour. If it wasn’t a badge of honour and it didn’t bring financial or societal benefit then it wouldn’t be a prominent issue. Simply misdiagnosed or over diagnosed. Many have lost perspective and possibly their nerve to tell students it might be better for them not to dwell too much and move on from their circular angst… but parents on the other hand do say this to their children with confidence when they’re pulling a fast one or are catastrophising - it would serve our society much better if we did the same in educational institutions and the workplace. Then maybe we wouldn’t have a society of people constantly obsessing about themselves and focusing inwardly so much. They might then instead just be forced to get out there, and get on with experiencing an authentic life with all the positives and negatives that brings. After all, that’s just life…
I am currently reading The End of Trauma, which notes how society is over estimating the number of cases of PTSD and how important resilience is for all of us. That’s how these diagnoses of mental health disorders feel. Why can’t we just accept the fact that everyone is different?