By most measures American kids are struggling. Epidemic levels of anxiety, depression, self-harm, suicide. Most experts point the finger at the explosive growth of smartphone and social media use, which happens to coincide with these increases in mental health disorders.

Seems reasonable.

Except that a global survey on happiness says kids in other countries are actually doing better than their American counterparts – that their mental health is trending up. Yet these kids have access to the same technology. So what’s going on?

Turns out a pretty big clue can be found in the ‘bible’ of the American psychological profession, meaning the DSM or Diagnostic and Statistical Manual of Mental Disorders. But not for the reasons you might think.

Turning Normal Challenges Into Disorders

The DSM is considered the authoritative guide for diagnosing mental disorders in the U.S. The first volume (DSM-I) published in 1952 was roundly criticized for leaning heavily on Freudian ideas and for defining homosexuality as a mental illness).

The newest version (DSM-V published in 2013), has similarly drawn fire, first for pathologizing the kinds of struggles that virtually every human faces at one point or another, and for inflating the number of such maladies. The grief of losing a loved one, for example, or binge-eating, are now considered bona fide mental disorders.

Speaking on the release of the DSM-V, Roger McIntyre, a professor of psychiatry and pharmacology at the University of Toronto, said: “I’m cringing at this new DSM. How can someone trust a manual that is pathologizing bereavement?”

And to give you an idea of just how much ‘diagnostic inflation’ we’re talking about, the DSM-I weighed in at 32 pages with 102 cited disorders. The DSM-V, on the other hand, is a staggering 947 pages with nearly 300 mental health diseases.

It’s All In Our Heads

In his book, Saving Normal, psychiatrist Allen Frances warned that this huge spike in the classification of mental illnesses risked convincing otherwise perfectly normal people into believing they were mentally ill. Equally important, these diagnoses, and the psychiatrists who made them, would justify the use of pharmaceuticals in their treatment – pharmaceuticals that often do not work, backfire, and include serious side effects.

“[Frances] might have been right,” writes Derek Thompson, a staff writer for The Atlantic. “By 2016, the share of people in the U.S. using antidepressants was more than twice as high as in Spain, France, or Germany, and nine times higher than in South Korea.”

Thompson believes that while smartphones and social media do in fact play a role in explaining the disparities between mental health disorders in American kids vs their global counterparts, he thinks it has far more to do with culture. In a nutshell, he argues:

“In the past generation, the English-speaking world, led by the U.S., has experimented with a novel approach to mental health that has expanded the ranks of the ‘worried well,’ while social media has surrounded young people with reminders to obsess over their anxieties and traumas, just as U.S. news media have inundated audiences with negativity to capture their fleeting attention.”

To borrow from Thompson’s own words, he may be right.

No, Your Kid Probably Isn’t Sick

As we noted in a previous post on how ‘trigger warnings’ can, ironically enough, trigger the very anxiety they’re warning against, so too is it likely that the recent explosion in mental health diagnoses may be leading to American kids (and their parents) mistakenly believing they’re mentally ill when they’re not.

In his immensely popular Ted Talk, Do Schools Kill Creativity, Sir Ken Robinson describes a child – Gillian Lynne – who school administrators assumed had a learning disorder. “She couldn’t concentrate; she was fidgeting. I think now they’d say she had ADHD. Wouldn’t you? But this was the 1930s and ADHD hadn’t been invented yet. It wasn’t an available condition. People weren’t aware they could have that.”

Fortunately, a forward-looking specialist recognized the culprit: Lynne needed to move. She thought and performed best when she was able to move more. It should be noted Lynne went on to a stellar career with the Royal Ballet and became a multimillionaire. “Somebody else,” noted Robinson, “might have put her on medication and told her to calm down.”

In his book, Crazy Like Us: The Globalization of the American Psyche, author Ethan Watters explains how America’s preoccupation with mental health disorders – encapsulated not just in the DSM-V but in our widespread embrace of pharmaceutical interventions for those disoders – has created a cultural mindset that leads countless millions to unnecessarily believe they are mentally ill.

Watters offers many examples, but one that stands out is a period of time in Victorian England when there was widespread concern over female hysteria. Suddenly and quite mysteriously women began to suffer from a variety of unknown mental health maladies, including leg paralysis, hysterical blindness, and convulsions to name a few.

Nothing was actually wrong with these women. But, to borrow from Robinson, as hysterical illness became available, numerous women succumbed to it.

The bottom line: an awful lot of the American kids being diagnosed with mental illnesses of one kind or another may be perfectly fine. They may simply be going through the very same trials and tribulations faced by previous generations, when the DSM-V and its nearly 300 designated mental health disorders weren’t available.