‘Therapy speak' is everywhere, and it's not healthy

Boston Globe

2 days ago

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As psychiatrist Allen Frances
,
the boundaries of diagnosis have expanded so far that ordinary variations of mood and behavior are increasingly pathologized. On social media, it's common to encounter posts that begin with phrases like 'As someone with ADHD …' or 'My autism makes me …,' followed by content that is not clinical but ordinary: frustration in relationships, a quirky trait, or a moment of emotional overwhelm.
What was once sadness is now 'depression.' Distractibility has become 'ADHD.' Social discomfort reads as 'autism.' Where we once described a range of emotional experiences, people now jump to a diagnosis. The full range of human emotion — grief, longing, shyness, intensity, awe — is too often collapsed into the language of therapy.
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This shift reflects more than just growing awareness of mental health struggles. It speaks to a cultural hunger to be seen, validated, and understood by our parents, peers, and society at large.
Many people aren't necessarily looking for help. Some are looking for a framework that confirms what they already feel: that their pain is real, that their difference matters, and that their suffering is not their fault.
The rise of diagnosis-as-identity has been
Under these circumstances, a mental health or behavioral diagnosis becomes less a tool for treatment and more of a mirror. It reflects confusion, alienation, and suffering back to the viewer. This can feel especially clarifying or validating for adults who are struggling but have never had access to a therapist. But validation is not the same as accuracy.
I once evaluated a woman in her early 30s who believed she was on the autism spectrum. She had spent months immersed in videos and essays about women diagnosed with autism late in life — she watched accounts of sensory overwhelm (when your brain takes in more information than it can process), an aversion to small talk, and always feeling out of place. Those stories resonated deeply with her. She had spent years feeling unseen, and for the first time, she thought she had an explanation for her feelings.
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But as we talked, what emerged wasn't a picture of neurodevelopmental difference or autism. It was a life shaped by people-pleasing, perfectionism, and a deep discomfort with conflict. Her sensitivities were real — but they weren't signs of autism. They were the marks of a life spent managing other people's needs while neglecting her own. The label she found gave her some language, but not the right language to help her deal with her struggles.
This search for understanding is deeply human. When people are suffering — feeling disconnected, overwhelmed, or just fundamentally different from the norm — turning to online communities, TikTok influencers, or even celebrity examples for answers is natural. But all too often, I end up working with people who, having found a diagnostic label that resonates with them, begin using it not as a starting point for growth but as a way to avoid accountability.
One man I evaluated at age 29 was convinced he had ADHD after months of viewing online content, despite no childhood history of the condition. He had not pursued a formal evaluation but had begun attributing every missed deadline, forgotten commitment, and interpersonal conflict to ADHD.
As we explored his history together, a different picture emerged: His 'inability to focus' coincided with a high-stress job he'd grown to resent, his forgetfulness spiked during periods of relationship conflict, and his impulsivity was most pronounced when he felt cornered or criticized. What looked like ADHD was actually avoidance — a pattern of checking out when life felt overwhelming. 'I can't help it; it's my ADHD,' became his default response to frustrated partners and disappointed supervisors, but the real work for him lay in understanding why he'd learned to retreat rather than engage.
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The diagnosis he found online gave him an explanation, but it also gave him permission to stop trying. The risk is that such self-diagnosis becomes less an invitation to understand oneself better and more of a shield against self-reflection or growth.
Self-understanding should lead to more ethical behavior, not less.
This is not to say that people are exaggerating their suffering, but to challenge a system in which distress must be labeled as a disorder to be acknowledged. Why is sadness not enough unless it's called depression? Why is social unease dismissed until it's reframed as autism?
To adopt a psychiatric label today is not just to have a condition. It is to gain legitimacy for one's experience in the world. It confers seriousness, because medicalized distress is treated as more legitimate. It offers structure by providing language and categories. And it creates a form of protection — social, legal, even moral. But what happens to people whose pain doesn't map neatly onto a diagnostic category?
We risk treating unlabeled suffering as suspect, unserious, or unworthy of support. The answer is not to abolish all diagnoses of mental health problems. It is to remember that these clinical tools should describe impairment, not identity. They should serve people, not define them. And they should never be the only way we listen to others' pain.
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There is still value in saying, 'I am grieving.' 'I am struggling.' 'I don't know why I feel this way.' These are human truths — not clinical conditions.
And we must remember that not all pain is pathology. Not every quirk is a condition. Not every story needs a diagnosis to matter.