Mental illnesses are real. But the construct of “mental illness” isn’t. There is no such thing as an “illness” that is completely psychological in nature, ie. only “caused by thoughts and behaviours”.
What are called mental illnesses belongs into three broad categories instead:
Biological Illnesses
Many “mental” illnesses are genuine biological illnesses that have been shunned from fields such as neurology and stigmatised by calling them mental.
Ie. Schizophrenia (part genetic, several brain changes), Bipolar (genetic, HPA axis dysregulation + structural signs), Major depressive disorders etc. I’d like to remind that many genuine illnesses that dont even affect the brain were called mental illnesses before we fully figured the pathology out. From peptic ulcer to lupus.
difficult living conditions manifesting through changes in behaviour
ie. Some cases of anxiety disorder (maybe its normal to be anxious in the case you’re living, ie. stressful 9-5 with lots of responsibilities), reactive depression (it isn’t a mental illness to be depressed when your spouse dies, its completely normal)
Normal behaviours that society chooses to brand as deviant
ie. Gender dysphoria is not a mental illness, it is NORMAL, Same thing as homosexuality was called a mental illness in the past
Talk therapy also helps cancer patients and people with biological chronic illness. So does exercise. Doesn’t mean these are mental illnesses.
The distress though isn’t the brunt of the condition. If you were of the opposite gender that people see you as you would be stressed too. Same tactic was used in the past to brand being gay as a mental illness. In my country’s textbook the definition also included “severe distress”
You still misunderstand, a significant number of people who are trans never experience gender dysphoria. Experiencing distress is the brunt of gender dysphoria, without distress, there is no diagnosis, you’re just trans.
Almost universally in the DSM, diagnoses are qualified by “clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
Helps them with what? Anxiety? Depression? There are a lot of different people out there, and just how only a subset of people who experience a trauma develop PTSD, only a subset of people with a chronic illness will experience clinically significant emotional distress and meet criteria for a certain psych diagnosis because of it.