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The Mad, Mad World

Psychiatry is making people crazy

It’s a mad, mad world. Literally. The National Institute of Mental Health (NIMH), a part of the Department of Health and Human Services, estimates that in a given year, 26.2 percent of Americans 18 and older suffer from a mental illness. That’s one in four of all of us. In the words of Rita Mae Brown, “Think of your three best friends. If they’re okay, then it’s you.”

Even if you’re fortunate enough to have a crazy friend, you aren’t in the clear. The World Health Organization (WHO) estimates that in the United States, the likelihood that a person will develop some mental disorder during his lifetime is 48.6 percent. Although this data may go a long way towards explaining political phenomena in the United States, it is nonetheless not very reassuring that one-half of Americans are at some time certifiably bonkers—especially given our liberal gun laws. The problem isn’t just that we are crazy now; it’s that we are progressively getting crazier. The WHO predicts that by 2020 mental health disorders will become the second most common disease in the world, just behind heart disease. The basic consensus: if you aren’t crazy now, just wait—you will be.

Why is everyone going crazy? Is it something in the water, the crushing weight of soulless international imperialistic consumer capitalism, or perhaps those accursed trans-fats? Christiopher Lane, the author of “Shyness: How Normal Behavior Became a Sickness” has a different suggestion. Lane argues that psychiatrists have been systematically narrowing the acceptable range of human behavior by increasing the number of diseases afflicting the human mind. To illustrate his point, Lane explores the expansion of the Diagnostic and Statistical Manual of Mental Disorders (DSM)—the handbook listing the types of mental disorders and their criteria. In 1994, the fourth edition of the DSM appeared with 400 more pages than the previous edition.

Lane specifically focuses on “social phobia,” which he personally believes is in reality nothing more than shyness. Criterion D for Social Phobia in the DSM is “the social or performance situation is avoided, although it is sometimes endured with dread.” If you experience dread in performance situations and “a marked and persistent fear of social or performance situations in which embarrassment may occur” (Criterion A), then you may have Social Phobia, just like an estimated three to 13 percent of the general population.

Other jewels present in the DSM are Opposition Defiant Disorder (a “recurrent pattern of negativistic, defiant, disobedient, and hostile behavior towards authority”), Caffeine Intoxication (characterized by “restlessness, nervousness, excitement, flushed face, insomnia, and gastrointestinal disturbance” after drinking two to three cups of coffee), and Dependent Personality Disorder (an excessive clinginess which could involve “a difficulty making everyday decisions without an excessive amount of advice and reassurance from others,” a “difficulty in expressing disagreement” and a tendency of “volunteering for unpleasant tasks”). The consensus is that if an individual is shy, clingy, distrustful of authority, or enjoys coffee too much, then he is chemically imbalanced and needs professional attention. My personal advice is to start planning interventions for all your friends.

At the heart of the mental illness craze is the question of what constitutes a normal, healthy mind. As scientific knowledge expands its understanding of genomics and the chemical make-up of the brain, there is a temptation to declare what should be considered a model specimen of Homo sapiens. However, the greatest contributor to human diversity is not large-scale cultural, environmental, or genetic diversity, but rather the basic differences that makes every brain unique. To load a person up on chemicals or therapies in order to iron out the aspects of his personality that don’t correspond to an arbitrary Platonic ideal of normality stands against the core values of Western civilization. The quirks and eccentricities of individuals give our world a richness that shouldn’t be stamped out in the name of normalcy.

Mental illnesses are serious illnesses. When individuals suffer from schizophrenia, bipolar disorder, chronic depression, or from one of the plethora of other chronic diseases, their pain is real, and they need real help. An overemphasis on mild forms of depression and anxiety ties up resources that should be used for major mental illnesses. Some people feel blue, and some people are suicidal. When medicine starts to forget the distinction between the two, everyone loses. Healthy people begin to wonder if they truly are healthy, while the genuinely ill are trivialized.

Steven T. Cupps ’09 is a biological anthropology and economics concentrator in Lowell House. His column appears on alternate Fridays.

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