The Economist’s special report this month is on mental illness. It’s well worth a read. As you’d expect it has some interesting stats, some lovely infographics, and is written engagingly by John Prideaux.
The report divides mental illnesses into those associated commonly associated with different life stages: it talks about Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disoder (ASD) in childhood, depression and psychosis in adulthood, and dementia in old age.
I was struck by how diagnosis-driven the report was, and it made me think a lot about the teaching sessions I’m involved in as part of my lecturing role, which are also often led by a diagnostic framework. It’s much easier to think about mental distress in terms of categories: it helps us think about the evidence base for treatment, it helps us have a shorthand for the types of experiences we are talking about, it helps us interpret statistics, but it leaves out a lot too. It couches everything in terms of the abnormal, the psychopathological, even if we caveat it with the usual consolations that these illnesses are on a spectrum.
The final paragraph of the report clocked the difficulties of this approach to some extent, although the medical framing remained:
“Many syndromes are now understood as points on a spectrum. Most people will have a touch of something at some point, and a large minority will get a longer-lasting illness. Over the course of their lives, nearly 30% of Americans are likely to suffer from clinical anxiety and 20% from a mood disorder such as depression.”
For me these last couple of lines struck the most helpful note though, particularly in the wake of debates this week on whether people with a diagnosis of mental illness should reveal it to their employer or not:
“Mental illness is less extraordinary and exotic than it is currently considered. Better treatment starts with acknowledging that.”
I agree. Better treatment of people in all sorts of ways could result from thinking about mental illness in “less extraordinary” terms. Not only psychiatric treatment, but our everyday treatment of each other, can only be improved by considering each and every one of us as holding the potential for profound sadness, overwhelming emotions of all other kinds, and bizarre internal worlds.