Is there any person who doesn’t have a mental health disorder these days? In my local bookstore I whimsically picked up a book on adult ADD, because I’ve always thought (like many, many other mental health disorders) that I exhibited some of the symptoms even though I’ve never been to see a mental health professional, and thus never been diagnosed with anything.
In one of the early chapters the author started explaining that there’s no one personality “type” who has ADD because it can manifest itself in different ways, and then went on to describe the “types”. There were something like 30 of them, ranging from everything from “manipulators” to “codependents” to “low self-esteem” to “apparently high self-esteem but not really” to “control freaks” and those with “learned helplessness” etc. Basically any type of person I’ve ever met was described in there.
And that’s just ADD, of course there are many more diagnoses and the DSM adds more brand-spankin’-new disorders with every edition. Everyone I meet these days either claims to be bipolar, or OCD, or addicted to something, and it almost feels like it’s trendy to be one of these things. Now I understand that to be considered official or “clinical” the symptoms are supposed to be “severe” and “persistent”, but that’s a subjective quality and I have a hard time perceiving where the line is. And based on some stories I’ve heard of people’s experiences with mental health professionals, even some “professionals” seem to have the same problem. Don’t get me wrong, I have seen/read about certain examples of people that are clearly affected by these types of things to a very severe degree where they can barely function in society and they are the “textbook cases”. But so many people are not that obvious.
My intention isn’t to attack the mental health industry. I want to believe this stuff is all backed by real, hard science. But I’m in a biological psychology class that focuses on the structures and physical anatomy of the brain and I’m realizing how little we really know about it with any degree of certainty.
So what I’m wondering is, first of all, what is a “normal” person supposed to even be like by the standards of modern mental health criteria? And in your estimation, what is the quackery quotient of the mental health industry?
Some of it may be, but there’s evidence of plenty of pseudo science.
I recall an article on ADD in schoolchildren from several years ago that I found alarming. It had nothing to say about any objective, repeatable crtieria for diagnosing this condition. Instead, it stated that a child is a candidate for an ADD diagnosis when he exhibits “any 5 of the following 12 behaviors” which included such things as fidgeting in class, talking out of turn, etc. - things that nearly every kid does occasionally. It noted that teaches are encouraged to be on the lookout for these symptoms, but that “some training” might be needed before a teacher’s diagnoses were reliable.
My reaction was that while there no doubt is such a thing as ADD, this article’s author met reasonably strict standards for scientifically ignorance of the subject. And that if diagnoses of ADD are based on this, many of them are likely to be wrong.
In my humble, non-professional opinion, if you’re functional in three areas without taking medication, then you are “normal”.
You can support yourself financially.
You have a social life and strong interpersonal relationships.
You can withstand everyday stress without falling to pieces (suicidal ideation, violent rages, hysterical crying, panic attacks, etc.)
A person who meets the above may have quirks and “issues”. They might not necessarily be the easiest person to love, live with, or work with. And medication may improve some of their flaws. But they are functionally normal and should view themselves as such.
It’s just like if I had arthritis. If I still can take my daily walks and the aches and pains only occassionally keep me from exerting myself, then while I can acknowledge I have a problem, I probably wouldn’t say I’m arthritic (which conjures up images of grave severity). And I probably wouldn’t mention it very often.
I was recently diagnosed with a psychiatric disorder. I’ve only told one person about it (regretfully) and I don’t plan on telling anyone else unless they ask me about it directly. Although I’ve fully accepted the diagnosis and I’m learning how to cope with it through therapy, I don’t plan on having my identity crystalize around it. No t-shirts or bumper stickers or ribbon pins for me! I don’t participate on message boards focused on the disorder (there aren’t that many of them), because the posters at those places are overly devoted to their “condition” and being “special”. I guess I don’t want to be seen as abnormal or someone who wants to be abnormal. Nor do I want people to accuse me of having been labeled inappropriately, as if they know me better than I know myself. I just don’t care that much to argue about it, even if I have accepted that it’s an accurate diagnosis.
IMHO, most people who have genuine psychiatric disorders don’t talk about it all that much because it’s a private, potentially embarrassing issue. Like, if people at work found out about my diagnosis, I would totally freak out and look for an alternative job. It’s cool to be different…until, that is, you find out you really are different and that no pill or cheap therapy will fix you. With some exceptions, it’s the guy who is broadcasting to the world that he has the latest syndrome who probably doesn’t have it all that bad (or not at all).
Quite seriously, this attempt to medicalize everyone has gone far too far. There are seriously ill people, for sure, but there is also a lot of attention seeking. Look up Munchhausen’s syndrome.
I vote that normal be defined as slightly dumb and readily suggestible. Hallmarks to include loose-fitting sloppy-casual clothing, attendance at big-box feel-good megachurches, a taste for reality TV, and an inability to spell.
I would be sure to distinguish statements from the self-help section at your local Barnes & Noble from statements issuing from the actual science/discipline of psychology and psychiatry. Nobody goes to GNC and mistakes that snake oil salesmanship for state-of-the-art medicine; likewise, it would be an error to confuse the cold reading of the enterprising self-help author with the current state of mental health science.
Psychiatrists and psychologists generally don’t use the word normal. They use the word functional. For example, everybody has routines that make them feel more comfortable. Unless those routines interfere with everyday life or cause them stress or unhappiness, they don’t rise to the level of Obsessive Compulsive Disorder. Everybody has things that scare them, but unless those feelings get in the way of everyday living it isn’t an Anxiety Disorder.
So the average therapist knows that everybody is a little bit crazy, but doesn’t really care.
Do psychologists and psychiatrists ever turn away patients and tell them they’re… if not normal, that they don’t qualify for any currently-defined mental illness? Or would the simple fact that the patient is seeing one cause them to find the best-fitting disorder even if that person is actually “sane”?
The concept of “normal” doesn’t come into play when a mental health professional is diagnosing patients. If something (fear, sadness, obsessiveness, anger) is causing you distress, and if you can make the case that it’s impeding your life, then you will almost certainly be diagnosed with one mental illness or another and prescribed medication and/or therapy. After all, that’s why you went for help in the first place. It really doesn’t matter how many other people suffer from the same problems.
Until the villagers come with torches and pitchforks, no, it probably doesn’t.
Then again, virtual communities of the like-minded sometimes take on the aspects of villagers - and all too often the kind who would torch-and-pitchfork the surrounding countryside if they could.
All disability- even physical disability- has a cultural aspect. Roll this around in your head for a minute…
What is the difference between a person who is blind, and a person with bad eyes? In our society, it’d probably be reading. If a person can’t see well enough to read, they are disabled. In a farming society, that person may well be considered pretty much fine.
In America, it’s pretty common for people to be unable to walk a mile without exhausting themselves. In a society where you need to fetch water, this would be a major disability. I’d venture that most Americans are unable to squat easily. In a country with squat toilets, you’d be a cripple.
Mental illness is the same thing. It is defined by how well you can deal with society. And our society is now squeezing out some pretty interesting definitions.
“It is proposed that happiness be classified as a psychiatric disorder and be included in future editions of the major diagnostic manuals under the new name: major affective disorder, pleasant type. In a review of the relevant literature it is shown that happiness is statistically abnormal, consists of a discrete cluster of symptoms, is associated with a range of cognitive abnormalities, and probably reflects the abnormal functioning of the central nervous system. One possible objection to this proposal remains–that happiness is not negatively valued. However, this objection is dismissed as scientifically irrelevant.”
I do not recall any entry in the DSM-IV that did not include the paragraph or bullet point indicating that the symptoms had to lead to a serious impairment of function or a serious interference with one’s life. Having a collection of tics does not indicate a “mental disorder.” Demonstrating behaviors that impair one’s ability to function or survive indicates mental disorders and the psych corp is relatively good about making that distinction.
Diagnoses are not made by school teachers. This is not to say that there are no psychologists who are peddling pills, but a genuine diagnosis requires an actual statement by a trained physician or psychologist who has examined the patient in light of the DSM-IV–including the statement regarding impairment of function.