Realists about mental disorder have been hasty about dismissing social explanations of how mental disorder is constituted. However, many social ontologies are realist ontologies. In order to create a meaningful distinction between realism and social metaphysics about mental disorder, I propose that realism about mental disorder is best understood as Individual Trait Realism (ITR) about them. For ITR, mental disorders exist in virtue of traits. I defend the view that ITR is compatible with social metaphysics, arguing that, in asking whether constituents in the social sphere figure the metaphysics of psychopathology, we are asking questions on three different strata of explanation: the strata of demarcation, instantiation, and individual traits. Distinguishing between these strata allows for nuanced realism that need not reject the social constitution of mental disorder.