Tools for Pain: How Psychiatric Frameworks Help and Limit Us
Berkeley students discussing fear of intimacy on a bathroom divider: one girl replies, "You won’t be afraid with the right person," reframing the fear as situational.
As part of the Sociology of Health and Medicine course at UC Berkeley in 2017, I explored how psychiatric diagnoses shape our understanding of emotional pain. Through interviews with three individuals navigating depression and related conditions in Taiwan, I examined how psychiatric diagnoses act as tools for empowerment while also constraining the ways we interpret suffering.
The results offered a vivid picture of how diagnoses like major depressive disorder (MDD) function as both scientific and cultural constructs—narratives that provide meaning, enable action, and shape identities, yet remain products of their time.
Disrupting Normalcy, Finding a Name
For Evan, a college student, seeking psychiatric help began at 16 after a crisis over family expectations. His parents wanted him to study medicine, but his passion for literature clashed with their ambitions. After self-harming to convey his despair, Evan sought professional help but initially resisted the label of "mentally ill." It wasn’t until years later, after further struggles, that he accepted the diagnosis and used it to understand his emotional pain and regain stability.
This act of naming—accepting a diagnosis—can be transformative. Psychiatric frameworks offer individuals the language and tools to articulate their struggles and take actionable steps toward healing. However, as Evan’s story shows, these frameworks also risk medicalizing distress that might otherwise be seen as a natural response to life’s challenges. They may also lead individuals to act in ways that conform to societal expectations of depression, perpetuating the belief that they are inherently ill and making recovery feel even more elusive.
The Loops of Diagnosis
For Chloe, a graduate student with chronic depression, joining an online melancholics community was a turning point. There, she found solidarity and language for her feelings, learning from others with similar experiences. She actively embraced this identity, becoming a vital member of the platform. This process exemplifies sociologist Ian Hacking’s “looping effect,” where diagnostic categories transform how individuals experience and interpret their problems.
From this perspective, as these frameworks gain cultural prominence, the number of diagnoses may increase—not necessarily as a reflection of deteriorating mental health, but because of the framework’s popularity as a coping mechanism. The rise in diagnoses could signal the growing influence of psychiatric narratives rather than a straightforward decline in mental well-being compared to earlier generations.
Empowerment and Constraint
For Lena, who has Tourette Syndrome, the diagnosis initially provided validation and a way to explain her symptoms to others. Over time, however, she rejected the medical framing of her condition, viewing it as a social construct shaped more by others’ reactions than by her own experience. She stopped treatment, explaining, “Tourette doesn’t really affect my daily life—only how others react to me.”
This tension between empowerment and constraint is central to the stories of all three participants. Psychiatric diagnoses stabilize and categorize the ungraspable, but they also impose limits on how suffering can be understood.
Reflecting on Loops and Networks
This project was an attempt to explore my interest in how systems of knowledge stabilize and shape the ungraspable. Psychiatric diagnoses, as ideological and technological objects, illustrate how knowledge systems shape and are shaped by the realities they aim to manage.
Through the stories of Evan, Chloe, and Lena, I saw how psychiatric diagnoses function as floating concepts—solidified enough to serve as useful tools, yet limiting in what they allow their users to do. Diagnosis as an actionable framework is, in this sense, similar to architectural plans: both lay out wayfinding options, helping us navigate and make sense of a complex world, yet ultimately define the boundaries of this navigation.