My psychological research doesn’t usually lend itself to comedy, but recently, during a standup show in London, those two worlds collided. One of the jokes was about how everyone seems to be getting diagnosed with ADHD these days—poking fun at social media videos that encourage viewers to label common human experiences, like daydreaming or talking a lot, as signs of the condition. The audience laughed because they recognized it; they’ve all noticed how widespread it seems to have become in recent years. When something becomes this common and puzzling in society, it’s no surprise it ends up as a punchline.
Part of my work as an academic involves trying to understand why so many more people, especially young people, are reporting symptoms of mental illness compared to even five or ten years ago. (ADHD is a form of neurodivergence rather than a mental illness, but both have seen an increase, so the questions are related.) Whenever I discuss this—with colleagues, school staff, or parents—it doesn’t take long before someone brings up that loaded, hot-button word: overdiagnosis.
Originally, overdiagnosis was primarily a critique of medical professionals. But in today’s public debate about mental illness, the focus often shifts to people overdiagnosing themselves. The concern is that individuals are using the language of disorder to label mild or temporary life struggles.
Is this happening? Yes. There’s evidence of “concept creep”—where terms once reserved for mental illness are now applied to milder experiences. On social media, people use mental health language more casually and often inaccurately. Clinicians report that more patients arrive at appointments with self-diagnoses. Given the evolving language around mental health and the complexity of diagnosis, at least some of these are bound to be false positives. Existing research confirms that overdiagnosis is happening to some degree, and it’s one piece of the puzzle behind rising rates of reported mental illness.
But puzzles have many pieces, and treating overdiagnosis as the sole cause is a dangerous oversimplification. For starters, some of the increase may ironically stem from a more accurate and compassionate public understanding of mental illness. Stigma hasn’t disappeared, but over the past 15 years, mental health awareness campaigns have made a measurable difference—reducing stigma and increasing willingness to seek help.
We shouldn’t be surprised that public health initiatives have had this effect; that was the whole point. But if fewer people suffer in silence and more feel able to recognize and admit they’re struggling, it can make the numbers appear to rise more than they truly have.
Then there’s the possibility that things really are getting worse, especially for young people. Mental illness is often triggered or worsened by stressful lives, and there’s plenty of evidence that life over the last 15 years has been difficult. Financial insecurity has grown, major geopolitical and environmental events have taken a toll, and the lingering impact of Covid has added to the strain. Services that once helped protect mental health, like youth community programs, have faced funding cuts. Smartphones and social media have also become a big part of most people’s lives. While they can’t fully explain the changes we’re seeing and shouldn’t be used as a scapegoat, they likely play a role.
It’s hard to know the exact contribution of each factor—overdiagnosis, improved awareness, or genuinely increased risk. To answer this confidently, we’d need research that not only shows each factor rising alongside mental illness rates but also demonstrates a causal link. That would require well-designed longitudinal orIn experimental studies, researchers can control or change different factors, but this is often impossible in real life due to practical or ethical constraints. Our challenge is to keep all these possibilities in mind. Too often, when people see rising rates of mental illness, they treat it as a simple either-or debate: either the increase is “real” or it’s “made up,” with overdiagnosis blamed for the latter. But this is the wrong way to look at it. Overdiagnosis might be happening for some individuals or groups, while a genuine rise could be occurring for others. Underdiagnosis could also be a problem at the same time, especially in communities where stigma is high and access to care is limited. We need to recognize that multiple things could be happening simultaneously.
Most importantly, the possibility of overdiagnosis should never be used to dismiss anyone who reports psychological distress or other symptoms of mental illness. There is a long history of people not being taken seriously when they share such symptoms, particularly young people. It’s easy and convenient to label them as “snowflakes” or to claim that talking about mental health is just a sign of their fragility. But this misrepresents the issue—in fact, it’s actively harmful. Being dismissed during a crisis not only increases distress, but it can also lead people to use stronger language to describe their symptoms, fearing they won’t be believed. This only adds to the already complex shifts in how we talk about mental health.
When I was in the audience at that concert, I thought about the people who truly have ADHD, some likely sitting near me. ADHD can be deeply disruptive and disabling, even with good support. Comedians should be free to joke about cultural trends—that’s part of their role. And it’s fair for anyone to question whether overdiagnosis might be contributing to rising rates of ADHD or mental illness at a population level.
But when it comes to individuals, we must be cautious. Many people aren’t getting the help they need. It’s impossible to fully understand someone’s struggles from the outside. If a person tells you they are having a hard time, you should believe them.
Dr. Lucy Foulkes is a psychologist at the University of Oxford.
Further reading:
The Age of Diagnosis by Suzanne O’Sullivan (Hodder, £10.99)
Bad Influence: How the Internet Hijacked Our Health by Deborah Cohen (Oneworld, £10.99)
Normally Weird and Weirdly Normal: My Adventures in Neurodiversity by Robin Ince (Pan, £10.99)
Frequently Asked Questions
FAQs Are We Diagnosing Mental Illness Too Often
BeginnerLevel Questions
1 What does it mean to overdiagnose mental illness
It means giving a formal mental health diagnosis to experiences that might be normal temporary emotional reactions to lifes challenges rather than signs of a lasting disorder
2 Why is this a concern now
Awareness and acceptance of mental health have grown tremendously which is good However some experts worry that the line between everyday distress and clinical disorder has blurred leading to more people being labeled with a condition when they might not need that level of medical intervention
3 Whats the harm in getting a diagnosis if it helps someone
A diagnosis can be very helpful but potential harms include unnecessary stigma overreliance on medication when therapy or support might suffice and defining ones identity too narrowly around a label It can also divert limited resources from those with severe debilitating illnesses
4 Isnt more diagnosis a sign were finally addressing a hidden problem
Yes in many cases For decades many people suffered in silence Increased diagnosis often reflects better access and reduced stigma The concern is about balancemaking sure we dont pathologize normal human variation while still helping those in genuine need
Advanced Practical Questions
5 How do economic and pharmaceutical factors play a role
Insurance companies often require a diagnosis for reimbursement of therapy or medication This creates pressure to assign a label Additionally directtoconsumer advertising by pharmaceutical companies can shape public perception making people seek diagnoses for conditions they see marketed
6 Are some diagnoses growing faster than others Why
Yes Diagnoses like ADHD Autism Spectrum Disorder and certain anxiety disorders have risen sharply This is due to expanded diagnostic criteria better recognition in underrepresented groups but also possibly due to social and academic pressures
7 What is medicalizing normality
This is the core criticism It refers to framing normal albeit painful human experienceslike grief shyness or childhood exuberanceas medical problems requiring treatment This can undermine peoples natural resilience and coping abilities
8 What about the opposite problemunderdiagnosis
This remains a critical
