Yep.

Thrashing is a well known known issue that can occur with swap, but it can also happen from page cache or memory mapped files. Indeed not having swap enabled can make things worse, as private pages that haven't been used in a hours cannot be swapped out to keep the important files cached or memory mapped.

Realistically for measuring physical memory sufficiency, you care about memory/data of any type (even files) that will be used in use upcoming time period, and ensuring that a sufficient percentage of it can be held in physical memory to avoid thrashing.

This is hard! Technically impossible to know for the general case (halting problem), and all methods of trying to approximate it involves trade-offs.