It Is Called Footnotes Because We Are All Getting Stomped to Death

August 11, 2025

“If our union is destined to turn into separation; if it is destined to be pathologically misread and abbreviated, then so be it if we can only embrace each other under the footnotes of DSM-5 and ICD-11.”

This is my rough translation of a Tumblr-style post I have come across lately. I absolutely hate it, but I hate it only because it sounds a bit cute and even a bit charming, which I am sure other people will agree. It inspires a few questions, although posited countless times and answered in countless ways, that need to be answered in this exact context. How are diagnoses and relationships connected? Why do we think about mental struggles in terms of diagnoses? How is it romantic that we are in the footnotes?

There is a terrifying yet promising amount of discussion about mental struggles. However, the bulk of the discourse in mainstream media hinges on diagnoses. Is this disorder real? Are people faking that disorder? Is this disorder overdiagnosed? Do doctors know what they are doing when they treat that disorder?

This discussion is useful; it is certainly important that we classify people into increasingly neat little boxes and decide if they deserve human rights based on the neat little boxes. However, it is concerning how much the validity of a certain feeling or getting a certain treatment (both in the social and medical sense) hinges on the validity of a diagnosis. People are increasingly paranoid about not being able to tell if an emotion is genuine that they pass the ball to a medical profession that sees the person for thirty minutes every two weeks, then the ball gets passed to a piece of paper with questions on it, so on and so forth. Much like how I do not have to explain the utility of psychiatry, I do not have to talk beyond making the point that psychiatry currently features some pretty funny stuff, either. So let’s get to the point. How does it all relate to relationships?

Diagnoses are when the conversation stops. Like all explanations, we would like to not explain why we are sad, angry, or anxious up to a certain point. A diagnosis is a proxy to a non-answer through science; you can stop asking about why when I say it is a chemical imbalance, or it is a developmental disorder, or science just does not know yet. Diagnoses help people identify other people who are also annoyed by having to explain themselves to no end, and more broadly, oppressed in roughly the same way. But at the same time, the label of a diagnosis provides a means to a fantasy, where the illusion hinges on the mythical, unifying, hidden cause. In relationships, a shared fantasy is a good fantasy.

A fantasy backed by science is a convenient fantasy. We would like to think that everyone has different experiences, and therefore different struggles. But all this becomes very inconvenient when we want to find a way out of this, especially some quick, proven, and commercialized way. By relegating the burden of proof on science, we are free to treat mental struggles more like natural disasters or accidents than we are forced to think, when free will is assumed without access to free choice. Does this sound dangerous? Yes, a popular fantasy is also a dangerous fantasy. The fantasy itself might not be harmful by itself, but popular fantasies often enter policy-making before good explanations of the fantasy does.

It is called footnotes because we are all getting stomped to death. Everyone subject to a label must endorse, implicitly or explicitly, a position on the accuracy of the label. Some argue that a label is the first step towards awareness; others argue that any generalization will backfire and jeopardize people’s trust on others being able to make decisions for their own. But what we are often forced to do is to accept a label on a condition. Do people think that it is romantic to be in the footnotes because they can finally have labels, or because it is brave to enjoy (or suffer from) relationships despite they are getting stomped to death?

In most cases, it is a little bit of both. Psychiatry is a special science for confidently generating so much utility and so much suffering despite the unignorable uncertainties in its findings. Would you take a pill if nobody is sure about how it works?

I would. Not because I do not care about how it works, but because if it does work, all this question of why and how becomes irrelevant. What if it does not? Well, I am already in the footnotes, anyway.

This is a short-short article in a series of short-short opinion pieces. Ideas are of my own except when they are not.