Do you have a mental disorder? If you answered “no” with little thought, you may need to reconsider. According to information on the National Institute of Mental Health web site, a 1993 study estimated that over 20 percent of Americans 18 and over “suffer from a diagnosable mental disorder in a given year” (emphasis mine). In the same paragraph this fact was given, it was stated that “many people suffer from more than one mental disorder at a time”.
How did “mental disorders” come to be so common? Since the first Diagnostic and Statistical Manual was published in 1952, what has been considered a “mental disorder” has ballooned. Here are some things that are currently considered “mental disorders”:
- You could have a “substance-related disorder” if you use too much marijuana, alcohol, nicotine, caffeine, or a number of other substances—including many prescription medications.
- Get too much sleep? Not enough sleep? Have nightmares or sleep apnea? They’re all psychological disorders.
- Don’t desire sex much? That’s hypoactive sexual desire disorder. Don’t get aroused easily? That’s a disorder too, as is not having orgasms.
- Are you shy? Don’t like being in crowds? You could have a social phobia.
- Here’s today’s trendy diagnosis for being a nerd: Asperger syndrome.
- And we don’t want to forget the children, who can get diagnosed as having: a “feeding disorder of infancy or childhood” (essentially being a picky eater); attention deficit disorder and attention deficit hyperactivity disorder; stuttering; and something called “selective mutism”—where a child who’s capable of speaking will not do so in certain situations, usually school.
The short answer—and a telling explanation in its own right—for why diagnostic categories and “disorders” have increased is insurance coverage. Insurers are more likely to pay claims for things that are diagnosable—hence, lots of things are now “diagnosable”. And while this is scary enough for the bureaucratic nightmares it implies, there are other—and to me, much more important—considerations.
Although I’m a psychologist, I’m not a clinical psychologist; I’m far from an expert in this area. My interest is very personal. I’m someone who many individuals have felt comfortable talking with about these, and other personal matters. It also happens that, according to the list above as well as certain psychological tests, I could be considered as having several “mental disorders”.
I put that term in quotation marks because, as the examples above suggest, the concept has become so stretched as to lose its meaning for me (and others, including some experts). Making so many things “mental disorders” encourages individuals to consider themselves victims—somehow unworthy of appreciation, or unable to achieve goals, or inferior in some other way. It also encourages dependencies—upon the largesse of the state for support; upon the diagnostic label as an excuse for failure or a copout from even trying; and upon that victim status as a tidy means of summing up what an individual is.
For me, the worst aspect of this “psychological medicalization” is the influence it can have on an individual who isn't “disordered” or ill in any way. Let me use myself as an example.
From some of my earliest memories, I can recall realizing that I was quite different from others in my family—and that they didn’t appreciate my differentness. I was a dreamer, endlessly inquisitive, and a tomboy. When I was in college, as a psychology major I had the opportunity to take various psychological tests for educational (rather than diagnostic) purposes. According to one widely used test, I scored “deviant” (meaning outside the statistical norms) for introversion, and “borderline deviant” for masculinity. A retake of the revised version of that test just a few years ago gave essentially the same result, but added the possibility of “problems with authority and authority figures”—no doubt picking up on my individualist-anarchist principles. From the list above, I could have: caffeine substance-related disorder; sleep disorder; social phobia; and if I were a child today I would be very likely be diagnosed with “selective mutism”.
That’s seven disorders, without even breaking a sweat.
Despite all those possible “disorders” I am a highly functioning, responsible adult living a fairly contented life. I have never let them influence my actions, in large part because by the time I was in college and took the first test that labeled me as “deviant”, I knew that I was different—and I knew that was a good thing. Even so, it was a difficult struggle for me to come to terms with being different. There are many others who never do, and who lack the understanding of “mental disorders” to know how meaningless that term can be.
Many individuals close to me have confided (or demonstrated) their own differentness. Some, like me, have come to value them, while simultaneously realizing the challenges they may bring. Others seem troubled by them and seek to hide, deny, or “fix” them in some way. That, to me, is the real tragedy of the bloating of “mental disorders”.
Some of the most creative individuals in our history are those who’ve danced at the edge of normality. They include Vincent van Gogh, Georgia O’Keeffe, Edvard Munch, Mozart, Syd Barrett, Cole Porter, Kurt Cobain, Ernest Hemingway, Edgar Allan Poe, T.S. Eliot, and Emily Dickinson. Will today’s culture produce a powerfully haunting writer like Mark Vonnegut, or are we doomed to white-bread entertainment because those who dance at that edge feel so marginalized they don’t dare draw attention to themselves? With today’s children being forced into social situations (as a treatment for Asperger syndrome) or forcibly drugged so they stay in their seats at school, dare I even hope for a better future? It’s very hard to do so.
Several individuals I know who are “different like me” already self-censor in various ways, or have expressed concerns about his or her “disorder” (often self-diagnosed based on popular reports, rather than tests or mental health consultations—not that those are necessarily more accurate). Parents confide fears about their children’s futures while trying to force them into stultifying, safe categories.
Every time I see something like that happen, I cringe. The wonderful individuality that makes humanity so rich and fascinating shrinks a bit more. Because of a fear of being marginalized simply for being different—a fear that is sadly justified—an individual’s potential is limited. The world is dimmed for a loss, the scope of which we will never know. That’s infinitely more tragic than trying and failing.
Don’t let your unique light be needlessly sacrificed to the cult of conformity—to those who would marginalize some of the best things within us.