Adolescence is often referred to as a time of “storm and stress.” Rapid physical growth, emotional intensity, risk-taking, and identity exploration are all normal aspects of adolescent development. However, in today’s mental health landscape, the line between normal adolescent behavior and mental health disorders has become increasingly blurred.
Since the 1970s, experts have cautioned that the medical field may unintentionally cause harm by turning normal human experiences into diagnosable conditions (Suhr & Johnson, 2022). This raises an important question for parents, educators, and clinicians: Are we overdiagnosing and pathologizing normal adolescent development?
Changing Definitions of Normal
Historically, behaviors such as emotional volatility, anxiety about social acceptance, and occasional defiance were understood as expected parts of growing up (Steinberg, 2014). Today, many of these same behaviors are increasingly viewed through a clinical lens.
As a result, diagnoses of anxiety disorders, depression, and ADHD among adolescents have risen (Twenge et al., 2019). While increased awareness of adolescent mental health has improved access to care, some experts argue that medicalizing normal developmental experiences may inadvertently stigmatize teens and undermine resilience (Frances, 2013).This shift reflects what Levin and Bradshaw (2024) describe as the “tyranny of the normal”—an unrealistic, idealized standard of functioning that may not actually exist.
Expanding Diagnostic Criteria
One major contributor to rising diagnoses is the expansion of mental health diagnostic criteria, particularly in newer editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). DSM-5 broadened definitions for many disorders, making it easier for developmentally typical behaviors—such as mood swings, risk-taking, and peer conflict—to be interpreted as signs of mental illness (Frances, 2013).
Allen Frances, former chair of the DSM-IV Task Force, has warned that the boundaries of normality are shrinking, resulting in more adolescents being labeled as mentally ill.
Pharmaceutical Influence
The pharmaceutical industry has also played a role in the medicalization of adolescence. Direct-to-consumer advertising and aggressive marketing to healthcare providers have increased awareness of psychiatric diagnoses, sometimes without sufficient emphasis on developmental context.
This has contributed to increased prescriptions of psychotropic medications for adolescents, even when symptoms are mild or developmentally appropriate (Hinshaw & Scheffler, 2014).
Cultural Shifts and Rising Pressures
Modern adolescents face heightened academic, social, and extracurricular pressures. At the same time, emotional distress is often less tolerated by schools and families and is less likely to be viewed as a normal part of development.
The rise of social media has further amplified adolescent stress, making everyday worries more visible and sometimes more intense. These cultural pressures may make normal developmental struggles appear more severe than in previous generations, increasing the likelihood of clinical intervention (Twenge et al., 2019).
Stigma Reduction and Awareness Campaigns
Efforts to reduce stigma around mental health have had many positive effects, including increased screening and access to treatment. However, greater awareness has also lowered the threshold for what is considered “abnormal.”
More adolescents are being diagnosed and treated for mental health conditions, which can risk labeling normal developmental experiences as pathology. Research suggests that even the concepts of anxiety and depression have shifted over time, making them more likely to be pathologized (Xiao et al., 2023).
Potential Risks
Pathologizing normal adolescent behavior can have unintended consequences, including unnecessary medication use, increased self-stigma, and a reduced sense of autonomy and resilience among teens (Horwitz, 2020).
Striking a Balance
Recognizing and treating genuine mental health concerns is essential. However, distinguishing between normal developmental struggles and clinical disorders remains critical. Experts recommend a nuanced, individualized approach that considers the context, duration, and severity of symptoms before diagnosing or intervening (Frances, 2013; Horwitz, 2020).
Therapists often return to two guiding questions:
- What thoughts, feelings, or behaviors are causing distress?
- How is that distress impacting daily functioning?
Not all distress reflects disorder—and not all discomfort requires a diagnosis.
Conclusion
While increased attention to adolescent mental health is a positive and necessary trend, it is equally important to avoid pathologizing normal development. Supporting resilience, coping skills, and emotional growth—rather than immediately assigning diagnostic labels—can help adolescents navigate this critical stage more effectively.
Therapists at Resolve Community Counseling Center in Scotch Plains, NJ provide developmentally informed teen counseling and adolescent therapy, helping families identify what is truly causing distress and develop effective strategies to reduce dysfunction in daily life.
By— Emily Parodi, MA, LPC, LMHC
Psy.D. Doctoral Candidate
References
— Frances, A. (2013). Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. HarperCollins.
— Hinshaw, S. P., & Scheffler, R. M. (2014). The ADHD Explosion: Myths, Medications, Money, and Today’s Push for Performance. Oxford University Press.
— Horwitz, A. V. (2020). Between normal and abnormal: Mental health diagnoses in the age of DSM-5. Social Research: An International Quarterly, 87(2), 303-329.
— Levin, J., & Bradshaw, M. (2024). Normal isn’t normal: On the medicalization of health. EXPLORE, 20(3), 417-423.
— Steinberg, L. (2014). Age of Opportunity: Lessons from the New Science of Adolescence. Houghton Mifflin Harcourt.
— Suhr, J. A., & Johnson, E. E. (2022). First do no harm: Ethical issues in pathologizing normal variations in behavior and functioning. Psychological Injury and Law, 15(3), 253-267.
— Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in adolescents and young adults: Evidence from U.S. national surveys, 2005-2017. Journal of Abnormal Psychology, 128(3), 185-199.
— Xiao, Y., Baes, N., Vylomova, E., & Haslam, N. (2023). Have the concepts of ‘anxiety’ and ‘depression’ been normalized or pathologized? A corpus study of historical semantic change. PLOS One, 18(6).
