I read a blog post today that discussed the idea of being depressed as a ‘norm’; that it isn’t something to be fought against, to be sidelined or dismissed, but rather something to be cherished, almost to be proud of. That it can, for some, be a normal state of being.
I deeply empathized with the writer, because I frequently feel the same; as someone with a diagnosed mental disorder (bipolar type II), I know what it’s like to live day after day, endlessly, with something most people consider to be a problem, a disease—a cripple. Yet for me, I don’t always think of it that way; I don’t think of it as something necessarily wrong with me. It’s just … how I am.
It becomes very difficult to diagnose and treat mental illnesses when this is taken into account, because often it becomes an issue of perspective; to an outsider there’s something wrong, while for the sufferer all is well. There is a distinct difference between mental disorders and other types of illnesses in this regard. Few people, I think, would consider cancer a ‘normal’ part of existence; even fewer would leave a cut or wound untreated simply because it is how it is.
But disease and trauma to the body is somehow different than the same thing applied to the mind. I say ‘somehow’, because it isn’t strictly clear what the distinction is, where the line is drawn. After all, even my own disorder, bipolar, is the result of specific chemical activity in my brain influencing my thoughts and behaviors. Without that activity—or with different activity—I wouldn’t be considered to have an illness at all.
This is why mental illnesses are so difficult to diagnose and treat; the patients themselves may think there’s nothing wrong. Unlike a wound, a tumor or infectious disease, there aren’t always visible symptoms of a mental disorder. You can’t look at someone and say they suffer from depression the same way you would with, say, measles.
Observable behavior is the primary standard for diagnosing most mental illnesses. A psychologist or therapist can physically look for signs of abnormal behavior—in my case, it would be a sluggishness in movement, an admission of finding no joy in day-to-day activities, and at its worst, self-harm. These are things that can be seen by others.
Yet what makes those things abnormal? Where is the control sample, the person for whom everything is absolutely, perfectly normal? What is normal, mentally? Human behavior is a deeply complex subject, enough that there are entire fields of science dedicated to studying it, and while physically inflicting wounds on oneself would probably fall pretty far outside the ‘normal’ spectrum of behaviors, does walking slowly? Does not smiling? What about believing in one’s own worthlessness? Is that any more harmful than believing in a deity for which there is no evidence? Belief is a matter of neuronal connections, and the belief that it’s not worth staying alive can be just as strong as the belief that the sky is blue.
And of course, all of this really boils down a simple assumption: that everyone wants to be alive, and everyone wants to be happy in life. It’s often argued that mental illnesses should be treated when they begin to affect a person’s ability to function in society, but what does that say for overly-positive people, or people with psychopathic disorders? Many of them function just fine in society, yet are far from ‘normal’.
I don’t think there’s necessarily a simple answer to this dilemma; mental disorders will always be difficult to diagnose, and difficult to treat, primarily because the sufferer may not want to be treated at all. They might not think there’s anything wrong.
And, at the end of the day, what if there isn’t anything wrong? What if it’s the rest of the world that is unbalanced? And, of course, what’s so great about ‘normal’ anyway?