In 1992, psychologist Richard Bentall published a paper in the Journal of medical ethics titled “A Proposal to Classify Happiness as a Psychiatric Disorder”. At first glance, the idea of classifying happiness as a mental disorder seems laughable. But consider the DSM (Diagnostic and Statistical Manual of Mental Disorders) definition:

A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognitionemotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. 

Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5

…and the beginning of the proposal…

It is proposed that happiness be classified as psychiatric disorder and be included in the future editions of the major diagnostic manuals under the name Major Affective Disorder: Pleasant Type. In a review of relevant literature. it is shown that happiness is statistically abnormal, consists of a discrete cluster of symptoms, is associated with a range of cognitive abnormalities and probably reflects the abnormal functioning of the central nervous system.

Richard P. Bentall, Journal of Medical Ethics, Vol. 18, Issue 2, 94-98 (Jun/1992)

…and it becomes much easier to see how this proposition could be taken seriously.

If major affective disorder, pleasant type were to be considered a psychiatric disorder, it would make complete sense why some people are capable of feeling more joy than others, an idea as old as the Stoic philosophers and the hypothesis behind the classic 1978 study, Lottery winners and accident victims: Is happiness relative?

We all know people who are inherently happy most of the time. The majority of these people are far from monk-like in their dedication to training their minds, so it stands to reason that – just like common mental disorders – the cognitive processes responsible for their happiness have psychological and/or biological roots for which they’re not responsible.

Of course, one key aspect of mental illness we can’t ignore is its ability to cause distress or dysfunction in the person suffering and those around them. While this might not be as apparent in pleasant types as it is in, say, a schizophrenic, anyone who’s gone through a period of prosperity or spent a significant portion of time around unreasonably optimistic people will attest that it’s true.

Among other things, Bentall’s proposal points out that people suffering from the heights of happiness have been shown to…

  • Gain weight (commonly seen in recently married couples).
  • Consume excessive amounts of alcohol.
  • Act irrationally.
  • Behave in a manner discordant with their life goals.
  • Have difficulty with mundane, but essential tasks.
  • Force their condition on unhappy people.
  • Misremember negative events.
  • Believe that others share their unrealistic opinions about themselves.
  • Show a lack of evenhandedness when comparing themselves to others.
  • Overestimate their control of events and/or perceive random events as subject to their will.

The type of delusional thinking represented in the last point has been termed Magical Thinking and is a symptom of certain mental health conditions, such as Obsessive Compulsive Disorder.

My Week of Magical Thinking, by Ruben Bolling

Interestingly, depressed people often see the world through a much clearer lens than the rose-tinted glasses worn by pleasant types. Because they do not suffer from the biases shown in happy people, they exhibit more accurate judgment around unforeseen events than people with a positive inclination.

Dr. Bentall notes that, while current research has been focused on depressive realism

…it is the unrealism of happy people that is more noteworthy and surely clear evidence that such people should be regarded as psychiatrically disordered.

Richard P. Bentall, Journal of Medical Ethics, Vol. 18, Issue 2, 94-98 (Jun/1992)

All of the symptoms of happiness become even more disconcerting when you realize that they could convey an biological disadvantage for pleasant types, which might explain why people seem more miserable than ever. Still, if survival of the fittest does indeed favor those that are a little more fucked, then maybe we should seriously consider the happiness clinics and anti-happiness medications proposed by Dr. Bentall as a cure for pleasant types.

I realize this message borders on sacrilege in a country where the aspirational nature of happiness has been deemed so fundamental to being a human that the pursuit of it is one of our three inalienable rights. This was not lost on the British psychologist either and he addresses the possible objections to the proposal early in the paper.

One possible objection to this proposal remains—that happiness is not negatively valued.

Richard P. Bentall, Journal of Medical Ethics, Vol. 18, Issue 2, 94-98 (Jun/1992)

And with that we get to the heart of the matter. Namely, that it’s impossible to talk about mental health without having a discussion on values. So far it’s been a pretty unsophisticated discussion…

  • Happiness = good (positively valued)
  • Depression = bad (negatively valued)
  • Anxiety = bad (negatively valued)
  • Anger = bad (negatively valued)

Because of this, the cognitive distortions that lead us up the ladder to happiness are far less researched and discussed than the errors in thinking associated with negatively valued conditions. We know what it’s like to feel happy but are unsure of how to get there or why we should want to. This has led people to be surprisingly poor predictors of what will make them happy in the future. Psychologist Dan Gilbert wrote an entire book on this topic titled Stumbling on Happiness.

Dan Gilbert: The Surprising Science of Happiness

While on tour promoting the book, Gilbert was asked the one-trillion dollar question…

Interviewer: How do I find happiness?

Dan Gilbert: People have been writing books that promise to answer that question for roughly two thousand years, and the result has been a lot of unhappy people and a lot of dead trees. 

Author Q & A w/ Dan Gilbert

And it’s not just the books we have to contend with anymore, but the endless stream of #insprationaladvice that litters our news feed.

Terrible advice to give unpleasant types.

Well-meaning platitudes like the above may generate a lot of likes, but they do nothing for the people who really need to internalize the message. Anyone who’s suffered from a mental illness knows that telling someone in the grips of despair or anxiety to “keep calm and carry on” is as effective as telling their cheerful companions to “start stressin’ and feel depression.” Shit don’t work.

In fact, research has shown an inverse relationship between how much someone values happiness and how happy they become. Put another way…

The more you try to be happy, the sadder you become.

This is the ultimate double-edged sword for the “unpleasant” types of the world, many of whom are literally dying to feel better. The numbers are staggering…

  • Approximately 1 in 5 adults in the U.S. (46.6 million) experiences mental illness in a given year.
  • 6.9% of adults in the U.S.—16 million—had at least one major depressive episode in the past year.
  • Only 41% of adults in the U.S. with a mental health condition received mental health services in the past year.
  • Serious mental illness costs America $193.2 billion in lost earnings per year.
  • Suicide is the 10th leading cause of death in the U.S., and the 2nd leading cause of death for people aged 10–34.


And if you think that’s terrible, things are even worse for young people. Between 2009 and 2017, rates of depression more than doubled among 13 to 17-year-olds and suicide is now the 2nd leading cause of death for people aged 10 to 34. The rise is most apparent in young girls, who have been inordinately affected by this increase. While a causal link has yet to be proven, many experts theorize that the rise in social media use and cyberbullying has played a significant role.

The silver lining to all of this is that it’s no longer taboo to discuss mental health issues in the open. This alone is often enough to ease some of the suffering of those affected as most of these conditions feed on isolation.

Most of us weren’t lucky enough to be stricken with major affective disorder, pleasant type. But just because happiness doesn’t come easily to us, doesn’t mean it’s unattainable. The longest-running study on happiness has been collecting data for over 80 years on the things that make for a good life. And what did those tens of thousands of pages worth of data say?

The clearest message is this: good relationships keep us happier and healthier. Period.

Dr. Robert Waldinger

Cultivating these relationships if you don’t have them will be hard. But take it from Teddy Roosevelt, a president known to have suffered from periods of hypomania and depression.

“Nothing in the world is worth having or worth doing unless it means effort, pain, difficulty… I have never in my life envied a human being who led an easy life. I have envied a great many people who led difficult lives and led them well.”

Theodore Roosevelt