What’s Normal Is When the Emotion Matches the Circumstance by William Weston Hedrick is a thought-provoking challenge to modern psychiatry. With its slightly mouthful of a title, it draws on decades of clinical experience to propose a different way of understanding emotions and mental illness. It’s a book that is accessible to everyone interested in psychology, though it is written in a slightly academic style, somewhat like a PhD thesis adapted into a book. Luckily I have a personal interest in this topic, and I ended up enjoying it a lot.
The book’s central argument is deceptively simple yet profound: psychiatry has failed to define what normal emotions are, making it nearly impossible to reliably diagnose when emotions become pathological. Hedrick proposes that an emotion is normal when its type and intensity match the circumstance and are proportional to it. From this foundation, he builds a comprehensive theory treating emotions as biologically based survival mechanisms, each tied to specific neurotransmitter systems and brain centers.
Hedrick introduces six primary emotions organized in opposing pairs. What makes the author’s approach particularly valuable is his insistence on distinguishing emotions that psychiatry routinely conflates. As he convincingly argues, sadness is the normal emotional response to loss and should be proportional to what was lost, not medicalized as depression. Depression, by contrast, is a distinct emotional state with different biological underpinnings and functions.
I learned quite a bit from this book, particularly about how much remains unknown about the brain and emotions, and also just some fun facts like the etymology of agoraphobia. One example that stood out was the discussion of research by Helen Mayberg at Emory University, who studied brain area Cg25 and its role in depression. PET scans showed this region to be highly active in depressed patients, and in cases of treatment-resistant depression, deep brain stimulation produced dramatic results. Several patients described it as if a switch had been turned off and their depression simply vanished. I thought that kind of thing was pseudo-science before.
I also found the comparison between human depression and animal hibernation especially interesting. Research showing the existence of a specific hibernation factor in animals, and the possibility of a similar mechanism in humans, fits convincingly with the book’s evolutionary model of emotions as survival systems rather than purely cognitive or psychological phenomena. The book’s treatment of bipolar disorder is equally provocative. Hedrick argues that mood swings in bipolar disorder result from the spontaneous instability of emotional centers.
Controversially, Hedrick argues that major unipolar depression is a malfunctioning depression center that spontaneously produces depression neurotransmitters independent of cognition. This means psychotherapy alone cannot “turn off” a biologically autonomous depression, a position that challenges the establishment view. The book also does an excellent job explaining why patients so often confuse emotions, noting that emotional neurotransmitters don’t come with labels.
Having studied Thomas Szasz briefly in a psychology class in college, I found Hedrick’s critique of modern psychiatry particularly relevant and engaging. Like Szasz, Hedrick recognizes that the DSM diagnoses mental illness through symptom checklists without adequately considering context, causes, or proportionality. Both thinkers oppose the medicalization of normal human suffering.
However (and I’m far from an expert, so I hope I’m conveying this all accurately), Hedrick diverges from Szasz by affirming that emotional illnesses are real, biologically based conditions that can malfunction like any other physiological system. He’s not anti-psychiatry; he’s advocating for better, more scientifically grounded psychiatry. I was pleased to see the explicit reference to Szasz’s work at the end, showing I wasn’t completely off-base.
My only minor complaint is the presentation: the font is quite small, and as I already said at times the book feels more like reading a thesis than a general-audience work. While this lends it a certain academic seriousness and the voice comes across as thoughtful and grounded in long clinical experience, it can make extended reading slightly demanding. I also found it a bit brief. I would have liked the author to develop some ideas further, particularly the practical clinical applications of his framework. That said, the book’s argument, and analogies like the memorable metaphor of mismatched gears to describe relationship breakdowns without blame, were refreshingly clear without being preachy.
Final verdict: A credible, well-argued challenge to psychiatric orthodoxy. Hedrick offers a coherent alternative to both the DSM’s approach, grounded in evolutionary biology and neuroscience. Despite its academic presentation and brevity, it’s an essential read for anyone interested in the intersection of the philosophy of mental health. For readers familiar with Thomas Szasz, Allan Horwitz, or critiques of psychiatric overdiagnosis.
You can get your copy of What’s Normal is When the Emotion Matches the Circumstance here!
