A new perspective from neuropsychiatrist Dr. Alastair Santhouse challenges readers to consider whether mental health awareness is veering into over-diagnosis. In his book No More Normal: Mental Health in an Age of Overdiagnosis, he argues that while raising awareness is vital, it may also prompt more people to identify with symptoms that do not meet clinical criteria. For Thai audiences, this global discussion has meaningful local implications for how mental health is understood and treated.
Dr. Santhouse describes a shift in how people interpret emotional experiences, suggesting that ordinary distress is increasingly labeled as a psychiatric condition. The core concern is distinguishing normal emotional responses from genuine mental illnesses. He also highlights resource pressures facing health systems, including extended referral wait times for ADHD and autism evaluations, which can strain services in any country, including Thailand.
The article draws on cases from Dr. Santhouse’s practice to illustrate where the line between sadness and depression, or between typical behaviors and ADHD, can blur. He stresses that true depression involves persistent, pervasive changes in speech, behavior, and social interaction. In Thailand, where cultural narratives shape attitudes toward mental health, stigma remains a barrier to seeking help for many people.
Dr. Santhouse notes a rise in adult diagnoses of ADHD and autism, describing a “looping effect” in which greater awareness prompts more self-identification, sometimes without rigorous assessment. This resonates with Thai public health campaigns that have raised awareness but may not always be matched by diagnostic capacity or mental health literacy.
A key point concerns the evolving use of the term trauma. He argues that contemporary usage often differs from its original meaning—severe, life-threatening experiences. This debate is relevant in Thai society, where traditional notions of resilience are valued, yet modern definitions of trauma can challenge those concepts.
Finding balance between recognizing mental health needs and avoiding over-medicalization requires thoughtful dialogue. Dr. Santhouse endorses alternatives such as social prescribing—approaches that align with Thai community values that emphasize social ties and communal support. Activities that strengthen social connections can improve well-being without medication.
As Thailand continues to blend global mental health practices with local realities, the conversation underscores the importance of culturally informed approaches. The book offers a prompt for professionals and the public to consider when distress should be labeled a disorder or approached as an opportunity for personal growth and resilience.
For individuals and policymakers, the path forward includes boosting mental health literacy, ensuring robust diagnostic practices, and expanding non-medication pathways to well-being. Thai readers are encouraged to engage with these ideas and examine their relevance to local context and needs.