From Internet sites like WebMD to blogs and news articles, we are a society that is becoming more attuned and aware of symptoms -- be they physical or mental. These benefits, however, come with a number of drawbacks.
For example, there has been a push in medicine to make people more aware of the negative consequences of overdiagnosis and overtreatment, occurring when we treat a symptom that is not a threat to health. This issue highlights the fact that symptoms are not necessarily synonymous with problems or danger.
I believe a similar type of issue has emerged in psychology. While it has been encouraging to see more news and commentary directed toward mental illness in general, there too arises the potential for people to see problems where none truly exist.
The term "pathologizing" refers to the act of interpreting something innocuous and normal as being threatening and abnormal.
As we all improve in our ability to recognize mental illness, there comes the risk of categorizing normal mental health events as symptoms of disease. This is especially true when it comes to the common emotions of anxiety and depression.
Emotions, what are they good for....?
Emotions are everywhere -- we read about them, talk about them and see them in TV and movies. Yet, more information does not always mean good (or accurate!) information. Indeed, emotions tend to be viewed very simply as being positive (ex: love) and negative (ex: depression and anxiety).
A more helpful way of understanding emotions is to consider their two main functions: feedback and motivation.
Emotions didn't come from nowhere -- they evolved over time just like any other part of the brain and body. Given that they emerged through evolution, they must do something for us -- or at least, they must have served a useful purpose at some point in our past.
The first function of emotion is to give us feedback, which is very similar to the purpose of physical pain. Pain lets us know that damage has likely occurred to our body. Similarly, emotions tell us about things that affect us. Each emotion gives us particular information.
For example, anger tends to occur in response to injustice or the frustration of one's goals. When we perceive something unfair, it tends to cause a feeling of irritation or anger.
Anxiety occurs in response to threat. Anxiety provides feedback that we might be in danger.
Depression typically occurs in response to loss. The loss could be of a person, relationship, hope, pleasure, control, or your sense of self. When we lose something important to us, our brain and body become depressed in response.
Why would this feedback be useful? This is where the second function comes into play -- motivation. Remember that pain gives us feedback that our body has been damaged? Well, this feedback is useful because it then motivates us to take action -- to stop the damage and heal.
Similarly, emotional responses give us information which can then motivate change if necessary. For example, anxiety motivates us to do something to prevent the threat from harming us. Anger motivates us to seek justice and fairness.
Depression can serve various functions depending on the type of loss. For example, depression from the loss of a relationship (ex: rejection) might motivate the person to isolate themselves from others. How could this be useful? Evolutionary psychologists have postulated that an advantage of depressive symptoms could be that spending time alone prevents further rejection, like a sanctuary from others. As I wrote in The Need to be Liked, there are other aspects of emotional pain and depression that might be functional as well.
Good psychotherapy always includes an examination of emotions, in part because the emotions give us (psychologist and patient) useful information. If you want to understand what is happening in your life and the cause of problems, knowing the specific emotions involved is an important part of gathering clues.
Occasionally, emotions will give incorrect feedback. Sometimes we experience anxiety when there is no threat, like a false alarm. For example, having a panic attack out of the blue is a false alarm and there is no need to take action. Or, we might feel anger that is exaggerated because of a faulty interpretation. For example, if you incorrectly believe that your spouse is being unfair with the household chores, you will see injustice (and therefore feel anger) when there is none.
The main point is that, like the experience of pain, emotions are normal and serve a useful function in our lives. Therefore, we should not strive to get rid of emotions. Rather we must recognize and take advantage of their value.
Depression and anxiety are normal
It is not uncommon for new clients of mine to set the following goal in therapy: "I want to get rid of my anxiety," or "I sometimes feel depressed and I want to just be happy."
I completely understand why they might want to reduce these emotions, because these emotions don't feel good. But this is like wanting to detect damage to the body, but not feel pain. You can't have it both ways.
Occasionally feeling anxious and depressed is normal. Whenever I drive on a busy highway, I get a bit anxious. On a scale of one to 10, my anxiety while driving on the highway is about a three (mild anxiety). This is helpful because the anxiety is like a boost -- it makes me more aware and vigilant of other drivers and the road conditions. Arguably the most dangerous drivers are those with no anxiety.
Alternatively, if I have not had much time to engage in activities that I enjoy (loss of pleasure), I might get a bit depressed (again, about a three or four out of 10). The depressed mood is a signal that I need to make going to the gym and spending time with friends more of a priority in the coming weeks.
Anxiety and depression are only problems when they significantly reduce quality of life or impair functioning. But then they are no longer simple emotions -- they are clinical disorders, and this distinction is important. If my depression is lasting weeks or I stop driving on the highway to avoid feeling anxious, then I have a more serious problem.
Pathologizing normal emotions tends to make things worse, sometimes by creating a self-fulfilling prophecy. For example, if we fear anxiety symptoms (ex: shakiness and heart racing), our reaction to small increases in anxiety can cause panic. Or, fear of depression leads us to become hopeless when we have an afternoon of sadness ("I am not going to feel happy for a long time"), which then causes more serious depression.
There is good reason to believe that the massive increase in anti-depressant medications like Prozac is due, at least in part, to people pathologizing normal emotions. As mentioned earlier, it's great that we are becoming more aware of mental illness and how it impacts society; however, it is just as important to be able to recognize what normal mental health looks like as well.
Normal mental health includes a full range of emotions that occur from time to time, and they are an important part of the human experience.
There is such a thing as healthy and unhealthy anxiety (and guilt and shame and depression, etc.) and learning to differentiate the two types can be key to preventing overtreatment of mental health problems.
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