Rethinking “Normal”: Dr. Sami Timimi On Mental Health’s Big Questions

What if everything we thought we knew about mental health was due for a rethink? In his upcoming book Searching for Normal (out September 16 from Signal), UK child psychiatrist Dr. Sami Timimi challenges the rise of overdiagnosis and questions whether today’s “mental health industrial complex” is truly helping—or simply commodifying distress. Drawing on three decades as a clinician and researcher, Dr. Timimi invites us to reconsider what we call disorder, how we define illness, and why context matters as much as chemistry. We sat down with him to talk about ADHD, autism, and why it’s time to expand—not shrink—our definition of what it means to be human.

“The title of my book is deliberately ambiguous,” Dr. Timimi says. “I don’t like the word ‘normal’ because it assumes we know what that is. The truth is, all definitions of mental health are subjective. We create frameworks to make sense of behaviour, but they’re not objective facts like kidney disease or diabetes. You can’t put a thought under a microscope.”

For parents, that ambiguity can be unsettling—how do you tell the difference between a child in distress and a true clinical concern? Dr. Timimi’s advice: slow down. “We live in a culture obsessed with performance and diagnosis. Every stumble becomes a symptom. But often what we’re seeing in our kids are understandable responses to pressure, not pathology. Be patient. Don’t fear emotions. And above all, nurture the relationship with your child over trying to ‘fix’ their behaviour.”

One of the biggest risks, he says, is the rush to label. “In a word, the danger is disempowerment,” he explains. “Labels shape how children see themselves—sometimes for life. They internalize the idea that something inside them is disordered. And while awareness campaigns may have reduced stigma, they’ve also expanded the number of people identifying as ill. That’s not liberating; it’s limiting.”

Dr. Timimi describes the modern mental health system as an “industrial complex,” where diagnoses function less like medical categories and more like brands. “Parents should be sceptical of promises that the latest label or treatment will offer long-term improvement,” he cautions. “The evidence just isn’t there. In fact, naturalistic studies suggest outcomes are often worse for children who are diagnosed and treated compared to those who aren’t.”

The rapid rise in ADHD and autism diagnoses—especially among girls and women—illustrates this shift. “When I started practicing in the early ’90s, I hardly saw a single child diagnosed with ADHD,” he recalls. “Back then, it was considered rare and largely developmental. Now the definition has stretched to include more and more behaviours and populations. With concepts like ‘masking,’ we’ve opened the door to diagnosing people even without observable symptoms. These are conceptual expansions, not scientific discoveries.”

So how should parents approach neurodiversity without defaulting to labels or medication? Dr. Timimi is blunt: “By definition, we are all neurodiverse. Each of us has a unique set of genes and experiences. Yet after decades of research, there’s no consistent biological marker that separates so-called ‘neurodivergent’ from ‘neurotypical.’” He adds, “Medications may provide short-term relief in rare, extreme situations, but the evidence shows no long-term benefit. Too often, psychiatric drugs do more harm than good. Wherever possible, avoid giving them to children.”

Of course, parents don’t raise their kids in isolation—school plays a huge role. “Our schools reflect a performance-driven, competitive society,” he says. “That culture produces shame, anxiety, and fear of failure. Teachers often try their best, but the system is designed to make children prove their worth, not to simply be accepted and loved. Fortunately, in my experience, the most common dynamic I still see between parents and children is love. That remains the saving grace, even under enormous pressure.”

What Dr. Timimi advocates instead is a relational response. “Think of parenting as a dance,” he says. “Each relationship has its own rhythm: I do this, you respond like that, and we repeat. Too often parents try to control behaviour directly, which can escalate tension. It’s more powerful to change the dance—to focus on the joyful, ordinary parts of the relationship and strengthen those connections. Emotional flow matters more than behaviour management.”

Even in our screen-saturated world, he resists alarmism. “Every generation fears the latest technology—from the printing press to television to social media. The real issue isn’t screens themselves, but how little space children now have away from adult scrutiny. That said, constant access does bring risks: bullying that follows them home, exposure to harmful content, or the glamourizing of disorders online. I favour age limits on phone use, but I also recognize kids need private spaces to build their own culture.”

For parents whose children already have a diagnosis, Dr. Timimi stresses perspective. “Technically, psychiatric diagnoses don’t explain anything. They’re descriptions, not causes. Depression, for example, just means persistent low mood—it doesn’t point to a biological fault. Parents should hold diagnoses lightly. Children change. Your role isn’t to fix their distress but to be with them through it, so they learn they can endure and grow.”

And if there’s one thing he wants every parent to remember? “Don’t panic. Don’t try too hard to ‘fix’ your child. Let them cry, be there for them, and trust that life will keep moving forward. That patience and acceptance is what truly helps children thrive.” —Noa Nichol