It happens again and again. Every time I see or hear it, a small piece of my hope for humanity shrivels up and withers away into nothingness. A politician tweets about the correlation between mental illness and school shootings. A frustrated relative fumes, “You can’t have it both ways. You either have a mental illness and can’t function, or you have to be responsible all the time.” Another celebrity opens up about a recent mental health struggle and receives a tremendous outpouring of public support. Or an acquaintance consoles me with the words, “Everyone struggles with their mental health sometime in their lives. It’s tough, but everyone goes through something.”

These are just a few examples of the many misconceptions and disparities I encounter daily in my struggle with mental illness. Depending on who I ask, “mentally ill” may be a fitting way to describe the latest school shooter, or someone’s quirky friend who is “so OCD” because her desk always must be kept a certain way. Indeed, talking about mental health or mental illness might be a taboo concept for one person, but it can feel like an overused cliché to another. So, the question is: what really is mental illness, and how can it be defined? What does it truly mean to be “mentally ill?”

The formal definition of a mental disorder has evolved somewhat over the years, due to ongoing developments in our knowledge of psychological and pathological processes. However, the current academic consensus, as stated in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), defines mental illness as “a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning” (1). Note that the precise pathology of the illness is not specified; this is because mental disorders are of uncertain origin and classified based on symptoms. The definition continues with three other important criteria: a mental disorder causes significant distress or disability, it is not merely a socially or culturally acceptable response to a stressor or loss, and it is not synonymous with socially deviant behavior unless it results from a dysfunction in the individual.

In other words, mental illnesses are terrible diseases that deserve to be taken seriously. Not every mental health struggle or stressor is comparable to a severe or chronic mental illness. When I hear young people say things like “I have so much anxiety” or “I’m literally having a panic attack right now” because they procrastinated or forgot to study for a test, or post on social media “I’m so depressed” because they broke up with their fourth girlfriend this year, it is striking to me how unaware they are of the true gravity of the subjects they are discussing. Likewise, when people tell me to “suck it up like everyone else” or to “just get over it,” it is clear they have never experienced the level of torture and hopelessness I feel day in and day out.

Just as important to understand is that mental illness does not equal socially deviant behavior. Yet this is exactly the stereotype we see presented repeatedly in the media. Where did the serial killer in that movie escape from before he went on a killing spree? It was an insane asylum. What do they say could have prevented that high school shooting? The police should have caught the shooter early and institutionalized him. After all, he was a loner with depression. Do you know that erratic, narcissistic leader that everyone’s afraid of? He must be mentally ill. What other explanation could there possibly be for such despicable behavior?

In reality, violent or hateful intentions are not symptoms of any diagnosable mental illness. We have another, more fitting word to describe such people: evil. More importantly, most of the millions of people living with mental illness, and certainly all I have met, are loving, intrinsically valuable, and often exceptionally bright and talented members of society.

Sometimes I even read claims that people who hold certain beliefs, especially unprovable religious beliefs or a sexual orientation that differs from the norm, are afflicted with delusions or other mental illness. Does this mean that everybody who believes strongly in something or feels a certain way is mentally ill? Of course not. We live in an uncertain world in which it is impossible to definitively prove or disprove anything that is not blatantly obvious to be absolute truth based on our limited human logic. Moreover, these feelings and beliefs do not satisfy what in my opinion is the most important criterion for something to be considered a mental disorder: it must cause some form of distress or disability in the afflicted person.

A person’s mental illness was never asked for and never desired; it just happened. For the same reason that no one asks for a broken leg or a cancer diagnosis, no one wants to be have a mental illness. A mental illness diagnosis is a lifelong sentence to be a prisoner of your own mind. Recovery is possible, treatment is available, symptoms are abatable, but mental illness never fully goes away. Many people claim that people who are suffering are just not trying hard enough, faking or exaggerating their symptoms, looking for attention, or otherwise at fault for their condition. When the illness affects their functional ability, others view the sufferer as equivalent in social relevance to an invalid or a child. I have experienced some of this prejudice firsthand. Sometimes it seems as if people are only willing to accept the fact that mental illness will always have some impact on my functioning if I remain completely disabled, permanently dependent, and eternally hopeless for the rest of my life. If I say that I believe things will get better, then not even my most tenacious efforts to achieve recovery are considered enough. Yet nothing could be further from the truth.

There are many things that mental illness is not, but really only one thing that it is. Mental illness is not a death sentence; it does get better. Mental illness does not make someone obsessed with shooting people with guns or prone to violent, erratic behavior. The only lives it ruins are those of the sufferers themselves, and the lives of those who truly care about them. Mental illness is not a joke, not a meme, not a trend, and not a quirk. Mental illness is neither a figment of one’s imagination nor a product of their own doing. Mental illness does not equal everyday stress, common fears, different beliefs, or uncommon feelings. Mental illness does not mean a temporary mental health struggle, but it certainly does not translate to crazy psychopath either. Mental illness does not always mean delusional or psychotic, but when it does, it rarely means dangerous and never means despicable.

Mental illness is unimaginable pain and incomprehensible suffering. Mental illness is a name given to a unique set of symptoms afflicting a human being. Mental illness is serious, and if left untreated, mental illness can be deadly. Mental illness is uncontrollable, but mental illness is always manageable. Mental illness is worth respecting, and mental illness is worth defining.

 

  1. Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5). American
    Psychiatric Association, 2013.
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13 thoughts on “Define “Mental Illness”

  • June 14, 2018 at 10:23 am
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    I read your article and was very insightful. I know about mental ilness because my daughter suffer of atypical depression and my brother had (he is dead now) sciizophrenia. He was 4 when he felt on a cliff and was in a coma for six month. His personality change and for then on he suffer all his life. My mother refuse treatment for him and he wasn’t dangerous to any one but sometime he will beat my younger brother. Anyhow He was put in antipsychotic medidications and he was able to function. I love him dearly and I wish he has treatment early. I have learn a lot about mental conditions but you put it in a clear way that everybody could understand. Thanks.

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    • June 14, 2018 at 4:50 pm
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      You’re welcome, and thank you! I’m so sorry to hear about your brother.

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  • June 14, 2018 at 12:58 pm
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    I tried to find you on twitter to thank you for your article. The more years that pass the more I understand that no one who does not experience mental illness can possibly understand what it is or the depth of the pain. You obviously do. The more that is written accurately, by people who live it and can articulate it, hopefully the more people will understand and be able to help themselves and their loved ones. May we all find healing.

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    • June 14, 2018 at 4:44 pm
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      Thank you so much! I totally agree. Unfortunately I’m not on Twitter, but you can follow my page on Facebook and Instagram.

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  • June 14, 2018 at 3:25 pm
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    Your account of what mental illness is and isn’t is so well described. Thank you!

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    • June 14, 2018 at 4:46 pm
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      Thank you!

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  • June 15, 2018 at 12:09 am
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    Your blog post is exceptional and truly spoke to me. We are parents of a 30-year old man who has faced the challenges of OCD, depression, and anxiety since he was 8 years old. We have tried to help him along the way with years of therapy of all types, IOP clinics, special schools, and scores of therapists and sessions with many religious leaders. He has a “way” of making many really bright people believe that he has no problems, which is far from the truth. He recently told a very astute psychologist of 50 years that he has no time for therapy, after he agreed for this counselor to administer the MMPI test, which showed nothing really new. He is defiant, fairly non-reliant, and non-compliant. He does religiously take prozac, and finished college, and has a part time job, has an apartment that no one can enter b/c it is so full of junk, etc. He often cannot find bills and other important documents. He desperately wants to get married and believes that his “issues” will be erased with marriage. He does have a few friends who show stability in their personal lives. We have straightened up the apartment many times, but this never stays orderly. He is moving in 3 months and has made no plans for dismantling the contents of the apt. or finding a new residence. What advice can you offer well meaning and concerned and loving parents who have had a history of being too doting but who are changing, but have a son who seems not to have any interest in seeking the help he needs to live a happier and more stable life?

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    • June 19, 2018 at 7:38 pm
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      Thank you! I’m glad you found my article helpful. That’s a very difficult question. Although I don’t know that I’m really qualified to give that kind of advice, honestly, the most important part of recovery is the desire to get better. Second is the willingness to seek help. It sounds like your son might be in denial that he can’t handle things himself and needs help. It might actually be an aspect of his OCD. Either way, understanding and discussing the reason behind his reluctance is likely the best way forward. It might take time, but never give up hope that he will decide to seek help when he is ready. I hope that helps.

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    • June 19, 2018 at 8:14 pm
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      Hi I’m Daniel’s father. I can appreciate your perspective on feeling helpless in the situation. Daniel moved to live with me 3 years ago when we was released from in patient care.

      It has been a challenging 3 years and there have been many highs and lows through this time. The truth that I have discovered with Daniel’s help is that there is nothing I can do to make it better. He has made tremendous strides over the past 4-5 months. Actually now that I think about it, it. has been most noticeable since he first wrote this article.

      I’m no expert. In fact I’ve had nothing to do with Daniel’s improvement other than trying my best to give him the space to get better on his own. I hope that you can find strength in helping your son in a similar way.

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  • June 15, 2018 at 10:10 am
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    Wow, what a well written piece! I am the mom of a teenage daughter who suffers from extreme anxiety, panic disorder and agoraphobia. She just turned 15 and her anxiety was triggered by the death of her beloved horse two years ago. Although, as we look back now, we know she had anxiety when younger, it wasn’t until we had to put her horse down that it really became more than she could handle. We immediately sought help and she has been working with a therapist ever since. Unfortunately, her condition as continued to worsen. We went from being able to go to school, but having accomodations to not being able to leave the house, therefore missing her entire Freshman year of high school (she worked with a homebound tutor). Your writing really hit home for me, (and I will share it with her) when you talked about “school shooters, etc.”. My daughter said to me one day how she hates it when the media blames a school shooting on “mental health”. My daughter’s comment, “I have a mental illness, but I am not going to shoot anyone!”. Although we have a tremendous support system around us, even my mom doesn’t “get it”. “Doesn’t your daughter respect you enough to do what you tell her?”, she recently asked me. She doesn’t understand that my daughter is not being defiant when she won’t get in the truck to go somewhere, she CAN’T get in the truck, even to do the thing she loves the MOST in this world…showing her horse. It is such a difficult beast, this thing they call “anxiety” and society doesn’t make it an easier. I truly hope others read your piece, as I have shared it on FB. It is a slow process, but hopefully, education can only help…

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    • June 19, 2018 at 5:36 pm
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      Thank you so much! Certainly mental illness is difficult enough without having to fear judgment from other people. I hope things start to get better for your daughter. There might be CBT therapists who can come into your home available if you don’t have one already. I used to have a lot of difficultly leaving the house and going places because of anxiety and OCD, but I was able to get help in residential treatment at Rogers Hospital in Wisconsin. If you’re feeling like outpatient treatment isn’t enough, and your insurance will cover it, I would definitely look into the Adolescent Center anxiety program there. It sounds like it would be a major challenge for your daughter to actually get there, but in my experience it is definitely worth the struggle. The environment there is fairly open and far more understanding and supportive than most short-term inpatient hospitals are. Let me know if you would like some more information.

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  • June 15, 2018 at 3:11 pm
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    Thank you for your article. I really appreciate your clarity and your articulateness. I am someone who lives with mental illness, and am disabled by it. I have been interviewing new therapists, and you validated for me something I had been feeling. The last two therapists have both said some version of “everybody has problems and struggles.” That they were trying to be “helpful” by pointing out that everybody struggles with social interactions for instance. I did not find this “helpful” at all, but I wasn’t quite sure why. It was really validating for me to read: “Mental illness does not equal everyday stress and common fears…” (I think I paraphrased there a little.) I think now that it’s kind of a laziness on their part, an unwillingness to extend their empathy into my world. At any rate now I feel more validated that I was right to feel angry, sort of shut out, and not heard.

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    • June 19, 2018 at 7:13 pm
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      I’m sorry that those things were said to you by someone who should make you feel validated. Sometimes people find comfort in knowing that what they are experiencing is common, but it is definitely dismissive and certainly not helpful when people try to relate an actual severe mental disorder to a common experience. I hope you find a therapist that can empathize with you and give you the support you deserve.

      Reply

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