2026-03-06
26 分钟This is The Guardian.
What I see in clinic is never a set of labels.
Are we in danger of over-diagnosing mental illness?
By Gavin Francis, read by Nuf Uzalam.
Someone is shot and almost dies.
The fragility of life is intimately revealed to him.
He goes on to have flashbacks of the event, finds that he can no longer relax or enjoy himself.
He is agitated and restless.
His relationships suffer, then wither.
He is progressively disturbed by intrusive memories of the event.
This could be read as a description of many patients I've seen in clinic and in the emergency room over the years of my work as a doctor.
It's recognisably someone suffering what has in recent decades been called PTSD or post-traumatic stress disorder.
But it isn't one of my patients.
It's a description of a character in the 7,000 year old Indian epic the Ramayana.
Indian psychiatrist Hitesh Sheth uses it as an example of the timelessness of certain states of mind.
Other ancient epics describe textbook cases of what we now call generalized anxiety disorder,
which is characterized by excessive fear and rumination, loss of focus and inability to sleep.
Yet others describe what sounds like suicidal depression or devastating substance addiction.
Research tells us that the human brain hasn't changed much in the past 300,000 years and mental suffering has surely been with us for as long
as we've experienced mental life.