What is a Mental Illness Anyway?

If I asked this question to a random passer-by in any city in the western world I would probably get a mix of different answers but possibly with an overall  consensus that might be something like: “a disease of the mind”, a “problem with the brain” or a “non-physical illness”.

Thinking of a mental illness as just a disease of the mind or brain though means that it would have to include things such as brain tumours, strokes, or Alzheimers disease, each of which is not considered to be a mental illness by the medical professionals.

So let’s have a look at what these “professionals” say:

Wikipedia, that bastion of collective knowledge gives the definition as:

“A mental illness is a condition that impacts a person’s thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Each person will have different experiences, even people with the same diagnosis.”

The Mayo Clinic gives it as:

“Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.”

These are really just as vague as the answers I hypothetically received from my hypothetical passers-by.

I mean having a common cold can affect my mood and my behaviour but is certainly not considered a mental illness.

My point here, albeit made a little bluntly, is that the idea of a mental illness is really just a loose fitting label given to problems that affect the mood, thinking, or behaviour of a person, but which cannot be characterised as anything else. In other words it cannot be tested through a physical process, as once it can it then becomes a physical problem.

This leads us to the realisation then, that there are no physical tests for mental illnesses at all (by definition) and therefore all diagnoses can only be made on anecdotal evidence and observations alone.

I think Dr Thomas Szasz, professor Emeritus of psychiatry at new York Medical school put it interestingly when he said:

“There is no blood or other biological test to ascertain the presence or absence of a mental illness, as there is for most bodily diseases. If such a test were developed…then the condition would cease to be a mental illness and would be classified, instead, as a symptom of a bodily disease.”

So when we get down to the nuts and bolts of it all, the only real difference between physical and mental illnesses is that there is no way to test for a mental illness.

It is true that no blood test, scan, genetic markers, or chemical imbalance has ever been found for what we describe as mental illnesses and that is why they are still considered to be mental illnesses. But does that mean there isn’t one out there somewhere?

I mean, only 100 years ago we had no way to test for heart disease and relied on observations of the patient and the patient’s own description of the symptoms. Today of course we have a battery of tests we can do from an EKG, to cholesterol tests to the CT scans of blood vessels. Now we can very accurately diagnose and often even predict heart disease, but 100 years ago it was all a bit of a crap-shoot.

Who’s to say then that in 100 years time, we won’t have found tests that can diagnose or predict our mental illnesses. Does that mean they will stop being mental illnesses? Well it might well do. As soon as we discover a “physical” test, then the illness must be considered a symptom of a physical problem, even if it manifests itself in the mind or mood.

If there is a blood test for schizophrenia, or a CT scan for depression, then these things must become symptoms of physical illnesses just like brain tumours or heart disease. But will this ever be possible?

Does this mean, then, that all mental illnesses are just physical illnesses that have yet to be tested or diagnosed properly? I don’t think it is that straight forward, and I will try and explain why.

First of all, most mental illnesses are based on a sliding scale of degree, and only made absolute by arbitrary guidelines fashioned by groups of psychiatrists, unlike the much more cut and dried approach of physical illness. For example, with physical ailments like cancer, you either have it or you don’t. Sure you can have a small tumour or a big tumour, but if a tumour is present then you are considered to have cancer. With mental illnesses, however, it’s never as clear cut as that. Just take anxiety for example. Anxiety is present in everyone, we all have it, and it plays a vital role in our survival and growth. Some people have more anxiety than others, and some people have so much anxiety that it impacts their daily lives and they cross the line that deems they have a mental illness. Would a physical difference noted in the brain be able to differentiate between normal anxiety and too much anxiety?

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  1. I would like to learn more about “ Generalized Anxiety Disorder “. I think this was a wonderful article, and so very true!

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