The Minefield of Defining Mental Disorders

The Minefield of Defining Mental Disorders
Classification of mental disorders is highly complex, even for the so-called experts and clinicians in the field. It involves checking thoughts and behavior against all sorts of criteria and there is still often a lot of debate and divergence within the ranks around what constitutes a scientific and objective definition /diagnosis against what could be regarded as a value judgment based on what is considered “normal”. In practice reaching a diagnosis is not so straightforward and is based on a combination of clinical experience and expertise, knowledge, established “objective” criteria as well as other feedback from detailed assessments, questions and observations within the individual context of the patient.

Although there has been an attempt to “standardize” the classification of mental disorders based on establishing set criteria (notably by the American Psychiatric Association and the World Health Organization), that is by and large used worldwide by professionals; in application and practice there is still a lot of variation in the way mental disorders are ultimately assessed, defined, diagnosed and treated. Every clinician brings to the table a different understanding and experience, and their “interpretation” of the criteria does differ from one to the next.

Given the complexity of defining mental illness, it is very hazardous for the lay person without any clinical training or in-depth medical knowledge to even attempt to diagnose and classify another person’s behavior and symptoms, let alone their own. The easy access on the internet nowadays to so much medical information can be helpful, but at the same time can also be a hindrance and become a cause for much anxiety, as one can end up easily putting a whole lot of medical diagnoses and labels onto oneself, which there may be no basis for. Diagnosing a mental health disorder is best left to a suitably qualified professional, so that the right help can be given.

I don’t know what the phenomenon is called, but the “pliability” and suggestibility of the human mind is quite unusual. It is common to hear medical students undergoing their training to imagine themselves to be afflicted by every pathology while studying them, and for some to even develop pseudo-symptoms, so hardly surprising that the rest of us can end up imagining the worst by reading about symptoms. And we all know how easily the lines can get blurred and how difficult it can be to see clearly and objectively when we feel worried and anxious.

The most important thing is to always acknowledge the suffering that is taking place, which is very real, and to reach out for help in the first instance, by simply letting someone you trust know how you are feeling. There are likely to be times when many of us will all undergo difficulties that produce a whole host of mental and emotional symptoms, some of which could potentially be classified within a rubric of some mental disorder. But there are many criteria for defining mental disorders, and each situation needs to be looked at very carefully and individually, before conclusions can be drawn. A diagnosis cannot be arrived at simply by reading up on a list of symptoms and criteria. Defining mental disorders is a highly complex and complicated process, based on lots of factors.

There is additional fear and anxiety around the possibility of having a mental disorder, no doubt because of the stigma that is still associated around mental illness, but attitudes are changing. It is difficult to reach out to other people when we feel “locked in” by certain thoughts and feelings, especially if we are ourselves disturbed or embarrassed by them, but regardless of the symptoms and how bad they feel, the first step is to reach out and talk to someone else.

Ultimately it doesn’t really matter whether you speak to your partner or a supportive colleague at work, the main thing is to not to be left alone with it, to allow some new “space” into the situation, and also to break the “taboo” of keeping it secret, that can wreak its own havoc on anxiety levels. Talking to someone is a very powerful act that will immediately release the internal pressure and give you a sense of greater mastery on the situation. It really cannot be stressed enough just how important this is.

Of course, it would be sensible to give the person you decide to speak with a little forewarning that there’s something you need to talk about, so that you can both set aside some quality time and space in which to do that, without being interrupted. Being face to face can also be very helpful and add to a sense of physical support and presence. If you live on your own and are limited in moving around, try finding a local telephone helpline or support service to contact, as a first point of support. There may be information in your local phone directory, or talk with your doctor.

If the symptoms or concerns you have are enough to keep you awake thinking about them or are occupying your mental space more than usual, take the small step of talking it out loud to someone who will listen. In this age of self-help, we’ve all to some extent become brainwashed into thinking that we need to be able to figure most of it out by ourselves, forgetting that we are human beings who are first and foremost social “animals” who are interdependent on one another. We all need support and help and communicating with one another is a necessary part of that. Talking to appropriate people about our concerns is important to staying well, can reduce anxiety and also bring us one step closer to finding a solution that will alleviate our suffering much quicker.

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