Mental illness is not “madness“.
By Dr. Chua Sook Ning
It is not just being misunderstood.
Mental illness causes distress and impairs someone’s functioning in important areas of his/her life. Perhaps there are a blessed few who are able to use their illnesses to achieve great heights but most people suffering from a mental illness are ordinary, hard working and decent who are struggling to function in their everyday lives.
Majority of the mental illnesses listed in the DSM-5 (The classification and diagnostic tool for mental illnesses) has this criterion:
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The individual cannot function to their optimal level. If you give them a magic wish, they would wish that they were not ill.
To not feel sad and worthless all the time.
To not be worry about every single thing all the time.
To not hear voices telling them someone thinks they are crazy.
To not have wash their hands for 2 hours until their skin cracks from the dryness.
It is not just a single occurrence like “Eric Cantona, who in a moment of madness, was immortalised for his kung-fu kick on a stupid fan” but symptoms over a period of time.
Take for example, an ordinary guy named John. John woke up in the morning like usual. He felt pretty good – he went for an early morning run, he wolfed down his favourite breakfast and headed off to work looking sharp. Unfortunately the day took a turn for the worse when he was yelled at by his boss for not meeting his KPI for the month. He felt embarrassed, ashamed and guilty for his poor performance. He felt like he was being judged by his entire team. He could not concentrate on his work and decided to take the rest of the day off. He went back home, changed into his pajamas and spent the rest of the day in bed. Not even his favourite TV show could cheer him up. The next day however, he felt better. He thought about what had gone wrong, what he could improve on and felt quite optimistic that he would be able to meet his KPI this month. He went to work, talked to his boss about his strategies and reasoned that he didn’t do very well this month, but it doesn’t mean he is a failure. He had dinner with his colleagues and laughed off his embarrassment. He did not feel down for the rest of the month.
Is John depressed?
John is not clinically depressed even though he felt down, felt guilty and ashamed, loss of pleasure, showed signs of fatigue, and had low concentration for a day.
Despite showing signs of depression, he does not meet the diagnostic criteria for depression because the symptoms were not present consecutively for a 2 week period. It is not merely feeling down for a day, but there is a criterion of time that must be met as well.
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Psychologists and psychiatrists are not on a mission to label the whole human race as suffering from a mental health illness. We take our jobs seriously as mental health professionals. We take the suffering of our clients seriously. It is inaccurate and irresponsible to suggest that mental illness is fashionable and trendy as it dismisses the real suffering of individuals with a mental illness. There is nothing fashionable about feeling suicidal. Neither is it just attributable to a moment of madness. One would not call an individual suffering from cancer as “mad”, neither should we dismiss individuals suffering from mental illness with such derision.