What Everyone Gets Wrong About Mental Illness

Think Tank #72

I want to talk today about psychological diagnoses.

Particularly, I want to talk about the diagnoses that we slap on children who do not fit nicely within the American school system.

Attention Deficit Hyperactivity Disorder. Oppositional Defiant Disorder. Major Depressive Disorder. Generalized Anxiety Disorder. Autism, in some cases.

All these things are are labels of different ‘types’ of behavior. They are classified as ‘mental illness,’ but they are not really illnesses, because these ‘diseases’ are defined entirely by their symptoms.

It’s an endless loop. A kid can’t sit still? He calls out in class? He talks a lot? He has trouble focusing on his homework? Well, that’s because he has ADHD. How do we know he has ADHD? Well, he can’t sit still, he calls out in class, he talks a lot, and he has trouble focusing on his homework.

There is a semantic counterargument to this. Pathogens cause illnesses. Pathogens are not the illnesses. Similarly, some mysterious force causes depression and anxiety and ADHD (in the same way that a pathogen causes physical disease), and thus the presentation of symptoms is the illness.

There’s only one difference. Pathogens and cancers and autoimmune disorders are real. Mental illness does not have any of these things.

This is where I’m going to piss a lot of people off, but I stand by my statement. We don’t give people chemotherapy because they are presenting with symptoms of cancer. We find the cancer before we even dream of administering the potentially harmful treatment.

So why are we prescribing amphetamines and other potentially-harmful drugs to children when they present with ‘symptoms’ (i.e. behaviors) of a potentially made-up disease?

Well, it all comes down to the fact that we don’t really like people that are different.

Who decided that sitting in one seat in school for several hours every day is something that young, energetic children are supposed to be doing? It’s what we make them do, for sure, and there are reasons for this, but it doesn’t mean that the child is deficient because he/she cannot adhere to this. In a different context (a nomadic lifestyle, for example) the athletic kid who doesn’t like to sit in his seat would be an asset to the group. It’s all relative.

Even Autism! Yeah, I know, it gets a little dicey when we get to the extreme end of the Autism Spectrum, but what about a mildly autistic kid who is remarkably intelligent, but just doesn’t really ‘get’ social situations, and can’t bring himself to focus on things that he’s not interested in.

Is this kid ‘diseased’ because he can’t complete his English Language Arts homework? Why should he have to conform to the ‘normal’ standard, just because it’s what everyone else is doing?

What about if he wasn’t smart (and thus didn’t show any characteristics that could be ‘of value’ to the average person). Would that change your answer to the above question?

Since it’s all subjective, who decides?

Also, why are savants lumped in with the nonverbal, violent autism? We made all these labels up! Perhaps it’s time to update them a little bit.

Why don’t we? Could it be because then it would betray how flimsy the whole concept is?

The traits that are considered ‘normal’ in human societies vary widely. However, not being able to fit in to what’s ‘normal’ has universally been scorned.

What’s new is conceptualizing it as a ‘disease.’ Perhaps it might be more constructive (for the people presenting with these ‘symptoms’) to view it as a deficiency in skills. After all, that is essentially what they are.

Autism Spectrum Disorder can be conceptualized as an (often extreme) inability to understand social situations.

Generalized Anxiety Disorder can be conceptualized as a deficiency in one’s ability to cope with everyday life.

Oppositional Defiant Disorder is often a reaction to trauma, and can be conceptualized as a deficiency in the skill of restraint and emotional regulation.

Kids with ADHD need to hone the skill of focusing on things that they’re not interested in.

Isn’t that so much less defeating? These things aren’t ‘illnesses’ that are imposed on a person for life. They’re skills that they can work on (if they choose to) in order to better function in the society in which they were born.

Sure, some people probably can never learn to sit still. That still doesn’t make them ‘diseased.’ Is that really so different from the person that, no matter how hard they try, can never run a five-minute mile, or lift three hundred pounds? People are just different.

Of course, this outlook doesn’t sell a lot of drugs.