I rarely get sick.
I say this while superstitiously touching my wooden desk to try and avoid putting the mockers on myself. Thankfully, I have a fairly robust immune system and, after years or working in hospital paediatrics and general practice, and having been sneezed at or coughed on multiple times a day, I have been exposed to just about every variation of the cold virus and influenza possible.
Even for those of us with an immune system as solid as a prize bull, we still get sick every now and then. We all get upper respiratory viruses so commonly that we just consider it a normal part of life. Most people will take some paracetamol or ibuprofen and keep going. Some people will go to their GP, and while a most will (… should …) come away some simple reassurance, occasionally some will need a prescription medication for a nastier bacterial infection. An even smaller percentage will need admission to hospital because of a much more severe infection.
I read an interesting blog this week on Psychology Today by Dr David Rettew. Its provocative title was, “Is Mental Illness the Rule Rather Than the Exception?”
The blog discussed the study being carried on in Dunedin which has been following a cohort of a thousand people for the last thirty-five years. This particular study looked for common factors that were shared by those people who had never been affected by a certifiable psychiatric disorder. What was interesting was that only seventeen percent of the people in that cohort had NOT been affected by a mental illness at some point in that thirty-five-year time frame.
Now for the average Australian, there are some obvious kiwi jokes going begging here (like, I’d be depressed too if I had to live in New Zealand, or how can someone tell if a sheep is really depressed or not, etc. etc.). All jokes aside, seventeen percent of people not affected … that’s a remarkable figure. In researching my latest book (soon to be released …) I had come across the figure of fifty percent of people had a lifetime prevalence of any mental illness. That’s one in every two, and chances are that if you weren’t the person affected, you would know someone who was affected, but the Dunedin figures are even higher. If you can accurately extrapolate them, four out of every five people will be affected by mental illness at some point in their lives.
The inevitable response from modern psychiatry’s critics is entirely predictable – there will be claims that the DSM5 is simply making diseases out of normal human life experiences, that our humanity is being pathologised and over-medicated for the benefit of big Pharma.
But as Rettew points out in a separate blog post, something may be such a common occurrence as to be considered part of the normal human experience but it can still be a pathology. The common cold is so common that it’s a normal part of life, but it’s still a disease.
Whether four out of every five people will be affected by mental illness or one out of two, whatever the number, the idea that most of our population will be afflicted with a mental illness at some point in their lives isn’t necessarily a negative thing. As Rettew also discusses, we don’t arbitrarily change the definitions of physical illnesses to match how many people we think should suffer from them, and neither should we arbitrarily change the diagnostic boundaries of mental illness so less people appear mentally unwell.
We need to accept that, at times, people will be functionally impaired to varying degrees because of mental illness just like people will be functionally impaired by physical illness. We need to treat mental illness with the same respect as we would physical illness.
In the same way that not all physical illnesses require medication, neither do all mental illnesses. By and large, most mental illnesses that people suffer from will be short lived and self-limiting, the psychiatric equivalent of having a cold. Some people will need treatment for their mental illness, but usually this takes the form of structured behavioural therapy like ACT or CBT. Occasionally, people will need to take a medication and very occasionally, some people will need to be hospitalised because of their mental illness.
For too long, mental illness has been viewed from an extreme perspective – mental illness is uncommon and severe. The nuances of mental illness have been lost or ignored in the white noise of ignorance and sanctimony. The lack of subtlety and understanding has failed us as a community. When treated early, mental illness has a much better prognosis, but the stigma, fear and misunderstanding perpetuated by the all-or-nothing approach has left a lot of people without treatment and therefore with worse outcomes overall.
If people were to realise that most of us will be touched by mental illness at some point, then perhaps there would be more understanding and less judgement, something that would lead to less suffering because of mental illness.
That would only be a good thing.
If you think you might be affected by mental illness or if you would like to know more, see your local GP, family physician or psychologist. On line information can be found at many reputable sites including Beyond Blue – https://www.beyondblue.org.au