The Madness They Named for Us: How Psychiatry Pathologized the Feminine

Beneath the white coats and credentials echoes something far older than science:
the ancient story that women are simply too much.
They feel too deeply, speak too boldly, shatter too easily.
Their ways are unusual, attuned to nature, sensing what others cannot.
They do not fit neatly.
They are called witches—
something to be feared,
something to be controlled,
something we don’t understand and therefore seek to name, to box, to bind.
Contained.
Not because they are dangerous,
but because they are powerful in ways the world has forgotten how to hold.

And so, for centuries, the feminine has been framed as frailty.
Her emotions transformed into disorders,
her grief into illness,
her righteous rage into symptoms.
They once called it hysteria—a womb gone wild, a mind unhinged by its femininity.
Now, they give it new names:
depression, anxiety, borderline, ADHD.
Neatly labeled. Clinically coded.
Still echoing the same ancient fear of feminine fire.

And the naming—and the shaming—has continued.
From witches to hysterics,
from unclean to unstable,
from too sensitive to mentally ill.
Each generation finds new language to contain her,
new categories to explain her away.

Behind all the naming lies the DSM—the Diagnostic and Statistical Manual of Mental Disorders—the Bible of Psychiatry. Now it is the DSM 5-TR having gone through eight iterations since 1952 with diagnostic categories now nearing 541, although the distinct number is somewhat debated. This book decides what is "sane" and what is "sick," what warrants a label and a prescription. And for decades, its gatekeepers have been mostly men. Their worldviews etched into diagnostic criteria, their assumptions quietly inscribed into what becomes truth. Yet, one might ask who’s truth is in favor, or out of favor, as diagnoses change with the winds. As Paula Caplan argued in They Say You're Crazy, diagnoses are often based on consensus, not science—voted into existence or removed through committee decisions that can reflect bias, social pressure, or ideology. What was considered a mental disorder in one era may be viewed as entirely normal—or even discriminatory—in another.

So when we ask what counts as madness, we also have to ask: who’s doing the counting?

As psychologist Paula Caplan writes:

"The process of creating psychiatric diagnoses is not scientific but political. Diagnoses are based on voting, not science. The powerful decide whose pain is real and whose is not.”
(They Say You’re Crazy, 1995)

And who bears the burden of these truths? Women.

Women are twice as likely to be prescribed antidepressants, handed bottles of silence for their sorrow. Not because they are more broken—but because the world asks them to carry more and complain less. Commercials show them wrapped in cardigans and shadows, eyes downcast, smiling once the pill works its magic. “Feel better,” they whisper. “Don’t feel too much.” As if her pain were a personal glitch, not a symptom of a society that erodes her spirit and calls it disorder.

Jonathan Metzl traced this trend in his study of antidepressants and identity, noting:

“Psychiatric diagnoses such as depression and anxiety became cultural shorthand for white, middle-class women’s distress, recoded as biological imbalance.”
(Prozac on the Couch, 2003)

The pharmaceutical industry has long known how to speak to women’s insecurities—offering serenity in a capsule, hope in a script. From Valium in the ‘50s to Prozac in the ‘90s, the message hasn’t changed: you’re too much, let us fix you. These drugs didn’t just treat—they prescribed roles: calm wife, quiet mother, pleasant worker. They dulled the scream that wanted to rise.

But what if her sadness is sacred? What if her rage is righteous?

Joanna Ussher asks us to reconsider the lens entirely:

“Women’s madness is a sane response to an insane world, a form of resistance, not pathology.”
(The Madness of Women, 2011)

Women are not unstable for responding to injustice. They are not ill for feeling deeply in a world that wants them numb. The question is not only what is disordered, but rather:
Who has the power to define the terms—
and who is silenced beneath them?

There is nothing mad about a woman who refuses to be broken by the weight of a world that pathologizes her soul. You are not broken or sick. Do not let them tell you otherwise.