[denton-scratch]

> take a few steps back and look at mental health and psychiatry as a whole.

Indeed.

Consider, for example, the diagnostic criteria for bipolar. There seems to be half-a-dozen conditions wrapped up in that term, not all of which have poles. Not all people with bipolar are psychotic (that is really important; if you're dealing with someone with bipolar, it makes a huge difference if they are subject to delusions or paranoia).

I believe (might be wrong) that "schizophrenia" is now a discredited diagnosis. Even depression is a fuzzy target. How do you distinguish ordinary sadness from depressive illness? Anti-depressant pills seem to work on both. And there's no "chemical imbalance" theory of depression that hasn't been discredited.

My sense is that we haven't progressed much in understanding mental illness since Victorian times, with their diagnoses of "melancholy".