The project of psychiatry¹ is an exercise in classification. It does not, for the most part, concern itself with measurable causes. Even when researchers attempt to do this, they quickly find that their efforts were in vain—see, for example, the long history of failed attempts to prove the “hormonal imbalance” theory of depression. Instead, psychiatry consists of listing and grouping symptoms.

The biggest problem with this is what I call “stomach pain disorder” conditions. If you presented to a real doctor with “stomach pain”, he would investigate further. The difference between indigestion, food poisoning, stomach cancer, etc, is very great, and an appropriate remedy for one would be inappropriate, perhaps even harmful, for another. But if you presented to a psychiatrist, she would confidently diagnose you with “stomach pain disorder” and immediately prescribe you a life-long course of anti-stomach pain pills, plus perhaps a talking therapy where you could discuss your lived experience of stomach pain. The majority of stomach pain patients, with mild conditions like indigestion, would recover naturally and falsely attribute their recovery to the miraculous anti-stomach pain pills. The minority of stomach pain patients, with conditions like stomach cancer, would ail further and further until death as the psychiatrist prescribed them more and more anti-stomach pain pills and longer and more frequent talking therapies.

Another problem is social or political interference in the classification process. This can go in both directions. On the one hand, real psychiatric problems can be not classified as psychiatric problems. On the other hand, fake non-conditions can be classified as psychiatric conditions. Both of these problems can be at least somewhat mitigated by having a realistic taxonomy of types of situation that might or might not be classified as psychiatric conditions.

When looking at the types of situation that might be classified as a psychiatric condition, it becomes clear that the pre-moderns had, as usual, a generally (though not infallibly) astute understanding of nature. I present below a rough classification of these situations / conditions. It is important to note that conditions in their different aspects can fall under multiple categories. These categories are not mutually exclusive, though I hope they are at least close to collectively exhaustive with broad definitions.

Psychosis

example: Schizophrenia

innate psychiatric conditions involving a disconnect with reality

Malaise

example: Depression

innate psychiatric conditions involving low mood, apathy

Trauma

example: PTSD

psychiatric conditions caused by psychic injury

Neurology

example: Parkinson's

psychiatric symptoms caused by well-defined neurological conditions

Hysteria

example: Long Covid

psychiatric and other symptoms of highly-strung women, especially in middle age

Badness

example: Sociopathy

pathologisation of being a bad person

Eccentricity

example: Asperger's

pathologisation of personal eccentricity

Reaction

example: Drapetomania

pathologisation of rightful reaction against social conditions