October 8, 2020 PCI Centers
Overview
Most people struggle with anxiety, depression, panic, and/or trauma at some point in their life. Many people experience occasionally intense “highs” (ex. Anxiety), and, occasionally, intense “lows” (i.e., depression). It’s often difficult for people to know when their mental struggles are significant enough to seek out help. We hope to help clear some confusion up for you in this article.
The Debate
The debate about what exactly constitutes a “mental illness” is pretty intense in the academic and psychiatric literature, and has been raging since at least the 1970s. Some have argued that using diagnoses in the first place leads to increased stigma, which may lead more people to avoid getting help when they truly need it. Given that most conceptions of mental illness have been spear-headed by the American Psychiatric Association, a medical association, the notion of mental illness is typically “disease” oriented and therefore the connotation is that people with mental illness are “sick” in the same way that you have a broken leg or a cold. Now, in some ways, this means that people with mental illness should be treated no differently than someone with a standard “medical” problem, but we know that this doesn’t happen in real life, even with the passing of laws promoting parity.
This leaves us with the counter position, which is that people don’t really have a mental illness, but more like neurodiversity where the gifts and strengths of people that professionals diagnose are underexamined and the deficits are just culture-person mismatch problems. To an extent, this is true. People with mental illness are often seen in purely pathological terms, as if they’re broken watches, sometimes beyond repair. The issue is, people with mental illness are truly struggling and suffering despite whatever different culture or social system they are a part of. Life is generally challenging. Your bad luck genetically plus the way your environment shapes your mind in the first ~20 years of life can lead to all sorts of impairing mental conditions, regardless of culture. Mental illness exists all over the world, and people experience stigma, all over the world…both are true.
The Criteria
Generally speaking, since we want to treat people who truly are struggling but also not pathologize people who are just “a little different” or neurodiverse, we need to have some reasonable criteria for mental illness. So, as we mentioned earlier, the American Psychiatric Association publishes the Diagnostic and Statistical Manual for Mental Disorders, currently in the fifth edition (DSM-5, APA 2013). In this handbook of the various mental illnesses, their criteria, cultural conditions, areas for further study, and epidemiological data the authors list what constitutes a mental illness.
What it comes down to when we want to identify and treat people without stigmatizing “normal” (as in, happens reliably in typical situations) is a clear definition of what it means to have a mental illness. Generally, the following are indicative of what clinicians are trying to see when determining whether or not you/your loved one would benefit from treatment:
- A syndrome (a predictable pattern of symptoms, with common causes and known treatments).
- Clinically significant disturbance in cognition/emotion/behavior.
- This judgment can only be made during an assessment by a licensed clinician (i.e., psychologist or psychiatrist).
- Some type of impairment in social, occupational, or other areas of life.
- Does not include typical and/or culturally-sanctioned ways of responding to life stressors.
- Does not include abnormal cultural or societal beliefs.
- It’s okay to hate the government or want to live in a commune.
For example: a person who is involved in a really bad car accident is likely to experience some fears related to driving, sudden changes of lanes, hyperactive stress response, difficulty getting to/from places, and even some road rage. This may last a few days up to a few weeks. A person with Posttraumatic Stress Disorder (PTSD), on the other hand, would have these symptoms (and more) weeks and months after the accident and would still be experiencing them as often and/or at the same intensity as they did right after the accident, still causing impairment far far after the accident has occurred. It’s difficult to know if exactly what you’re experiencing is a “real” mental health condition, or if it’s a typical reaction to things. It’s honestly not your job to know the difference, and this is why we hope you seek out an evaluation if the mental or behavior issues you notice are causing you concern or are difficult to manage. If you have any questions about treatment please feel free to reach out to us anytime at 747-222-7464 or at https://www.pcicenters.com/
