I have lived for years with someone who was deeply depressed. That dark privilege that forces you to see up close how an illness devours the one you love, forever inoculates you against the trivialization of mental suffering. For that reason alone I dare to write what follows.
We need more psychology professionals, more research, more resources. Mental health is the great silent crisis of our time. And, precisely because it is, we must have the courage, threading as finely as necessary, to confront the excessive medicalization that leads to the pathologization of life itself.
The psychiatrist Guillermo Lahera, head of psychiatry at the Príncipe de Asturias Hospital, describes it in his book The words of the beautiful beast: a brief manual of psychiatry with a soul with lacerating precision: young people who arrive at the emergency room with self-harm after failing in mathematics, a fight with their mother, a love breakup; simple frustrations of everyday life. “I can’t take it anymore, I want to die.”
Sadness, anger, disappointment, bitterness or desolation are not symptoms, they are the emotions that weave our lives. Converting everyday discomfort into a clinical disorder does not alleviate human suffering, but rather collapses mental health systems and leaves those who truly need it without care. Living hurts: at what point have we stopped being conscious?
The data is eloquent. In Catalonia, sick leave due to psychiatric causes has grown by 70% in five years. The recently created PADRIS-PRESTO cohort, which analyzes more than 1.4 million people between 2010 and 2019, reveals prescription patterns that its own authors—led by Hospital Clínic and AquAS—urge to review, to ensure that they respond to real clinical indications and not to care overflow.
Because therein lies the crux of the problem: primary care does not have time. And when there is no time, the easiest thing is to extend a recipe. Antidepressants end up being the only language available in a ten-minute consultation. There is no bad faith, there is a broken system due to overexposure.
A worker who suffers indignation or anger over her poor working conditions needs a union or legal consultation, not an anti-anxiety medication. A person with difficulties making ends meet needs social protection and decent employment. Someone who suffers an emotional breakup needs friendship, time and affection. In the past, few people consulted specialists because their boyfriend or girlfriend had left them. Now, professionals point out that it is common for people to go to primary care because they have broken up with their partner. The reduced tolerance to misfortune cannot be resolved with psychotropic drugs designed for serious illnesses. Psychiatric drugs are useful tools, but used as an anesthesia for ordinary discomfort, they become the problem they pretend to solve.
We cannot avoid pain, it accompanies our lives. Learning to sustain that pain without self-destructing is a human skill that requires learning, not pathological treatment. Confusing the two is actually abandonment disguised as care.
Sara Berbel Sánchez, doctor in Social Psychology and strategic advisor
