Maybe a lot of both.
Let’s take the ever-increasing “diagnostic criteria” for ADD/ADHD/autism “spectrum” and other such squishy “disorders”
It’s a complex issue, and the desire among p-sychs and drug companies to have insurance billables make sales compounds the problem, especially for those for whom ADHD (and those with real autism) who actually do suffer from real world consequences of real conditions are just as much harmed by excessive diagnosis and treatment of others as are those others who should NOT be tagged with “disability” labels and drugged out of their minds–especially children.
Some real people with real problems do exist, but I am in no way convinced that it is the dire mental health issue it is presented as.
If viewed in the most positive light possible, most of the DSM “diagnostic criteria” that has spawned these expanded classes of “disorders” has simply been efforts by (often high-functioning) “Norms” to explain away behavior by “Odds” who simply do not fit their view of societal norms. . . because Odds frequently do not adhere to societal norms. when those oddities do not cause direct harm to the Odds in question, or to those around them, save perhaps in the secondary effect of bigoted Norms who refuse to allow Odds to be themselves, these (often high-functioning) Norms feel behooved to label the Odds as. . . odd, but in pejorative, and actually harmful terms.
Where’s the love for diversity of viewpoint, eh? *heh*
(BTW, had current standards and practices existed at the time, I too very likely would have been diagnosed as “having” a “disorder” that would then be treated by quacks. My current–and lifetime–signs say I fulfill diagnostic criteria in the DSM-IV for a certain so-called “autism spectrum disorder,” but since I long ago learned how to feign normalcy when I want to, it isn’t so much a disorder–causing physical or social harm to me or others as a REAL disorder does–as an occasional inconvenience, primarily when I attempt to explain some complex subject to a “Norm” who can’t–or simply won’t–grasp my frame of reference easily.)