I do believe we have over-medicalized "problems of living."

My diagnosis is recurrent major depression. Actually, I think of depression as a symptom. To say I'm sad because I'm depressed is circular thinking. I would say I'm depressed because my approach to life isn't working well for me.

I have a very different way of conceptualizing psychological pain. I think a mood disorder is seldom primary. Rather, I think a mood disorder is a manifestation of something else. That something else, IMO, is a personality disorder or what used to be called a "neurosis."

I look at personality disorders differently from most people. I think they are way more common amongst the psychologically afflicted than we admit. People don't like to be diagnosed with personality disorders. That is the real stigma that I would like to get rid of. People would rather say, "I have PTSD." or "I have bipolar disorder." than consider that they have an axis 2 problem. This is vanity, IMHO. The former problems are seen as "Something bad happened to me." while the latter is seen as "I am bad."

The Holy Grail in psychiatry that most patients are looking for is: "It's not your fault." That's why we get so enamored of "chemical imbalances" and "chromosomal aberrations" and "amygdala-altering traumas." If my problem is physiological, then it's "not my fault."

I don't think a personality disorder is any more an individual's fault, than is a mood disorder. When a person has a durable, maladaptive pattern of behavior (the basic definition of a per. disorder,) there is a story behind that which is just as deserving of compassion as having been a trauma victim. Sometimes, part of the story is that the person has embraced some bad ideas, not understanding that they are bad ideas. Sometimes the problem is in the mind, rather than in the brain.

What has happened, I believe, is that the purveyors of psychiatric services and the consumers of the same are complicit in the perpetuation of a grand delusion: Being "mentally ill" means one is innocent. Our modern, guilt-averse mindset means we lust for justification. People "believe" in modern psychiatry because it tells them that they are suffering from "what was done to them, or what happened to them," rather than from who they are. In exchange, psych-professionals get to earn their livelihoods peddling a lot of pseudo-scientific interventions that don't really help people. It's mutual delusion.

This grand collusion-in-delusion is not serving us well. We end up talking out of both sides of our mouths and making all manner of assertions that can't be sustained simultaneously: "The serial killer must be mentally ill." "If you do a heinous crime because you are mentally ill, then you are not, necessarily, a bad person." "So nobody is bad; people who do bad things are just sick." "There would be no evil in the world, if everyone had enough healthcare to treat all their problems." "There is no such thing as evil. There is just too much untreated illness." "I can't help the way I am because I was abused by others during childhood." "If I abuse another person, it's because I am sick; if another abuses me, it's because they are evil." "I had to go on disability because I have a mental illness, not because I wasn't an excellent employee - which I was." "I can't sustain a relationship because everyone I meet turns out to be a narcissist, which is so unfair, when you consider how perfect I happen to be." "I wouldn't have an anger problem, if people would just stop pi$$ing me off." "How can I possibly have courage, when I am made to feel unsafe?" "You would agree with me, if you just understood that things are the way I say they are." "My humility helps me get along with inferior people." "How can I work with a therapist who wants me to change, instead of respecting who I am?" "I think my life will change for the better, now that I've found a therapist who approves of how I've been doing things." "I'm glad the doctor told me I have a mental illness. Otherwise, I was beginning to think there was something wrong with me." "I don't mind constructive feedback, as long as you don't trigger me with criticism." "The only time I get triggered is when someone says something I don't like."

Maybe we are all equally blameless . . . equally innocent. Maybe we are all doing the best we know how. Maybe it just seems like others have despicable faults, while we ourselves merely make mistakes, or breakdown under intolerable stress.