Disorders are labels for things which significantly negatively impact people’s lives. Thinking of them in terms of a spectrum generally means stretching a label past the point of meaning.
Well, if you're approaching this as a hard-scientist that's not the case (for psychology).
Because "disorder" may be on a spectrum, because "negative" and "impact" may be on a spectrum. Conditions like depression follow a bell-curve, there's no clear line between depressed and not, and we can draw a line in the sand, but statistically there's no justification for where that line falls.
One way to try to draw a line is "the point at which a certain intervention is no longer effective."
For example studies find CBT therapy reduces depression scores for depressed people ~.8 standard deviations (for a while).
But why not try CBT therapy on happy people? Maybe it's even more effective on people who are already happy. Well the reason why not is likely just because of the clumsy nature of healthcare -- interventions are thought of as "treatments" for "conditions", even though that lens doesn't always make sense.
There’s a meaningful line in the sand for treatments with major side effects. CBT therapy may be “fine” for normal people, but the most effective treatment for depression is ECT which has major side effects. Including a ~1 in 50k chance of death.
Saying something is a bell curve distribution is an approximation, it doesn’t mean there’s actually a continuous function out to infinity and negative infinity.
When to resort to ECT is a subjective decision of doctor and patient. It is clear it should come after other treatments failed. But there is no clear line.
Spectrums extend continuously from normal to disorders. So if you believe depression is a spectrum you must also believe that no treatment is necessary for some people with depression. However if depression is a disorder there may be some cases that are on the margins that aren’t quite depression that still warrant some forms of treatment.
DSM V has depression as depressive disorders, but lists “Schizophrenia Spectrum” and “Autism Spectrum” so I invite you to consider what distinction for spectrum is being used.
> a key facet of a "diagnosed" disorder tends to be whether or not it (negatively) affects your life.
Which also brings us to an important point that is totally missed in the article and most of the discussion imo: maybe one of the (many) things that have changed is that lives are more negatively affected by stuff nowadays (or more reported to be so). We live in increasingly complex societies, we have to socialise with more and more people and navigate more demanding and fluid social dynamics. Traits that can be advantageous in a certain context can be disadvantageous in another (and affect one's life negatively).
An engine is an assembly of parts. When an engine breaks down it does so because it broke down. An engine does not exist without its cylinders, fuel system, gaskets, lubricants, etc.
I believe your analogy is flawed. Can you restate your first statement in any other way?
Someone who is clinically depressed isn’t just sad, they are unable to return to normal. Things that help normal people feel better simply fail, it’s a meaningfully different situation. Similarly treatments for depression like electroconvulsive therapy shouldn’t be applied to normal people.
OCD, clinical addiction, etc are all more involved than just feeling the desire to do something. The lack of control is the issue not just the momentary impulse.
Intrusive thoughts are fine, acting on them isn’t.
What is normal human behavior though? Is it some combination of things that's gonna end up being so rare that only so many people fall under it, and is it normal if it's so rare? Is it gonna be "what most/average people are", and if so, well then, isn't everybody gonna have something going on, and isn't that just normal then?
With how widespread it is, labeling, self-diagnosing, inquiring about yourself, is kind of normal human behavior. It is everywhere, and has been historically. Putting it like it's just 'labels for significant things' and then 'normal', and that these things would stand far enough apart to actually make a clear distinction without dismissing people in between is pretty much just wishful thinking. There's way too many things and even more combinations of then. It's gotten so complicated and convoluted only because it is that way. Wishing for a binary clarity in a complex world.
Full range is a specific set. What does that range consist of? Also, seems odd to go from going on about "stretching a label past the point of meaning", but then put normal as some range that's just about vaguely everything. Can normal not be defined? Is it somehow more deserving of being afforded to be a vague spectrum or being under less specific definitions? Where is the point of meaning with "normal"?
By specific set I mean the behaviors actually exhibited, someone either grows a beard or doesn’t you can’t be doing both. Meanwhile either choice is normal.
The “full range” is anything that doesn’t cause you or another significant distress, major impairment, or prevent functioning in society. Eating hot sauce is uncomfortable, amputating a limb is several steps beyond uncomfortable.
> Can normal not be defined?
It’s defined by what it isn’t. There’s ~8 billion people in the world and the majority of them are functioning as should be obvious by our societies continuing to function.
I’m sure ECT is being misused occasionally, but what I’m referring to is the underlying condition such treatments are addressing as well as the research associated with finding what treatments are useful in which situations.
Seasonal affective disorder and bereavement-related depression may have similar symptoms on the surface, but there’s different treatments due to differences in underlying causes.
Some conditions may be a continuum with the same underlying cause taken to different extremes, but that continuum need not be continuous down to normal human behavior.
