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.
- Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5). American
Psychiatric Association, 2013.