Past and current debates about applying medical diagnoses to psychological difference in society are examined. Beginning with a brief historical overview from antiquity to 'anti-psychiatry' and a summary of recent debates, the article then offers two case studies of common diagnoses ('depression' and 'schizophrenia'). The main challenge for social science is no longer about what is wrong with psychiatric diagnosis (that is now well rehearsed) but how to account for how and why it has survived. In answering this question about survival, inter-disciplinary work could attend to the pre-empirical positions of mental health researchers; the ways in which mental disorders are similar and different to physical disorders; and the interest work of different social groups defending or attacking psychiatric diagnoses in varying contexts.