I once ran across a picture of the actor Russel Brand. Across the picture was a quote, presumably said by him, that read, “My personality just does not work without fame. Without fame, this haircut looks like mental illness.” To be sure, Brand is a skilled actor and comedian who also happens to be diagnosed with bipolar disorder and attention-deficit/hyperactivity disorder (ADHD). It’s unlikely that his statement was cutting or derogatory or ignorant.
Still, while not upset by it, I pondered the statement. What does it even mean? It’s humorous. Although while laughter is good, and it’s healthy to not take oneself too seriously, is this comment really that funny? Or is it just vague enough to perpetuate the equally vague and hurtful stereotype that mental illness is synonymous with “crazy?”
His hair looks like mental illness. Okay. Is it crazy? Hmm. What are the other stereotypes of mental illness? People with mental illness are violent? Lazy? Weak? Attention-seeking? Making it up? Guess what. Mental illness is not any of these things. Nor is it something, unlike a hair style, that people choose to have. It’s not something that can be willed away or just “gotten over.”
So if it’s not these things, then what, exactly, is mental illness? The truth is that the term “mental illness” is far too broad, far too vague, to have any single meaning. This has implications both good and bad. The good is that it renders all of the above stereotypes absolutely meaningless for the myriad individual disorders and, especially, for the unique human beings that experience them. The bad, though, is that because there are so many different types of mental illness and because there are a great number of individual differences within each one, “mental illness” is a very difficult concept to fully understand as a general category.
“Mental Illness” is a very vague term indeed. It’s best to seek to understand what each disorder is individually. Schizophrenia, for example, is very different from bipolar disorder, and Bipolar Disorder, while it includes depression, is different from Major Depressive Disorder. The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) includes clinical disorders and personality disorders. Further, many of the disorders don’t occur alone but are co-morbid with others. And overarching all of this is the fact that people are unique individuals. Just as all physical traits are manifested differently in people (not all blue eyes are the same shade of blue; not all musicians express themselves with the same instrument or the same musical style; not all cancer patients have the same illness and outcome), mental traits are different, too. Schizophrenia, for example, or post-traumatic-stress-disorder, or various anxiety disorders, or paranoid personality disorder doesn’t look or feel the same in every individual who experiences the given disorder.
So, again, I ask: What is mental illness? What does the term even mean? Despite such extensive differences in both the disorders themselves and in the people who experience them, there are general characteristics that help us define mental illness as a broad concept. Mental illness encompasses the following:
- Mental illness in general impacts the way people think, the way they interpret life/environment/others/self, and the way they feel. As a result, it can impact the way they behave.
- It’s a pattern of thoughts, behavior, and/or feelings that is present in someone’s life. It’s a way of thinking or doing that is pervasive. Someone once came to me concerned that she had Obsessive-Compulsive Disorder because each night she checks several times that all doors are locked. A single quirk (or even a few) is not the same thing as having mental illness. Which leads to the next point…
- The pattern is disruptive to the person’s life. Whatever the patterns are (and again I emphasize that they are unique to each disorder and each individual), they cause significant disruption. A need to check the doors every night may become an annoying bad habit to the person, but it doesn’t take a significant amount of time away from his or her day, nor does it impede functionality. Which segues into…
- Mental illness impacts the person’s ability to function in life and thus brings with it the risk (but not the guarantee) of disability in one or more areas of living. For example, for reasons unique to each disorder and each individual, it can be (sometimes, but not always) difficult or impossible to hold a steady job. Because of different ways of interpreting life, thinking about those interpretations, feeling certain ways because of them, or acting upon them, relationships with others can be very taxing. Yet positive relationships are essential for everyone’s well-being, and people with mental illness are no exception. That maintaining healthy relationships is difficult is tragic.
- With the risk of disability comes the risk of loss of freedom. Sometimes people need to be hospitalized or supervised. And if they are unemployed, even if they live on their own, their lifestyle is limited. With difficult relationships can come a restricted social life and a crushing sense of isolation and loneliness.
- Because of all of the above, mental illness causes significant distress. People suffering from mental illness often report confusion, frustration, and despair.
When professionals use the DSM-5 to diagnose, they use it to classify disorders. They do not use it to categorize people. This is a very important idea to understand. “Mental illness” can be defined and described, but it is the illness, not the sufferer, that is being discussed. Individuals aren’t defined by their illness (or their hair).