An explanation you often hear on why there’s a stigma around mental illness is that we are afraid of people with mental health issues and hence we try to distance ourselves. We perceive them as unpredictable and dangerous or as if they lack a sense of morals. This is not true. There is no causal relationship between mental illness and violent crimes. People with mental illness are not more likely to commit crimes than the general population. About 25 % of the population will sometime during their lifetime be affected by mental illness. …and 25% of the population are not criminal. Actually people with mental health issues are far more likely to suffer as victims of violent crime.
There are a lot of myths and misunderstandings surrounding mental illness which all serve to perpetuate the stigma. I an attempt to clarify and address some of these myths I’ll try to give you a comprehensive overview of mental illness and the different psychiatric diagnoses. Mental illness is a complex and diverse scientific field including, psychiatry, psychology and social sciences which all need to come together in order to form a representative view of the field.
For the sake of clarity I’ve divided all (not exactly all) major mental illnesses into four different groups. Issues arising in childhood/adolescence, affective and mood related issues, personality issues and psychosis related issues. I have chosen to not address issues of addiction in this post all though they are represented in diagnostic manuals.
Issues arising in childhood/adolescence
Here we find all developmental disorders such as ADHD, ASD, PDD, Tourettes and Aspergers. Since the introduction of DSM-5 Aspergers are no longer a diagnosis on its own but is subsumed under the wider diagnosis Autism Spectrum Disorder (ASD). There are two very important things to know about this group.
1, These children and adolescents are not sick, they have a set of characteristics that makes it difficult for them to adapt to societal norms and requirements. They have a hard time getting through school and forming valuable social connections resulting in a high risk of ending up in crime and addiction.
2, People with Autism or Aspergers do not lack empathic ability. They have a hard time interpreting and expressing body language and mimicry resulting in mistaking the the lack of expressing empathy through body language for lack of the general ability.
Affective and mood related issues
In this group we find issues related to depression and anxiety such as major depression, generalized anxiety disorder, OCD, fobias, anorexia and bulimia and bipolar disorder but also stress and trauma related disorders such as PTSD and stress related depression. These diagnoses all have an emotional component plus they also tend to effect basic behavior such as sleeping, eating, sex and fight or flight responses.
In this group Bipolar, being repeatedly featured in pop culture, seem to be surrounded by most myths. Bipolar disorder is characterized by extreme changes in mood, energy and sleep. On one end of the spectrum you have manic or hypomanic periods characterized by high energy, little or no sleep and reckless behavior and on the other end you have a depressed state with very low energy, lots of sleep, depressed mood and extreme guilt. The time and frequency of the episodes can vary and in between episodes people can be virtually free of symptoms. A lot of people manage to live full and happy lives with the disorder.
Personality related issues
Personality disorders are characterized by a pattern of behaviors and cognitions that markedly deviates from the norm within the persons’ socio cultural context. The diagnosis personality disorder imply that there is something off about you as a person. Something rooted in your nature that is defect or harmful. That, however, is not the case. You are not born with a personality disorder, it is something that you develop. The exact etiology is not known but it’s an interaction between genes and psycho social stress factors such as physical abuse, sexual abuse, parental (primary caregiver) neglect, maltreatment, traumas etc. Of course growing up under such extreme circumstances highly impacts how you interact with other people and how you relate to and interpret events around you. When these behaviors become clinical they have a pervasive and harmful effect on personal and interpersonal functioning. Personality disorders are viewed as a chronic disorder. I would say that this is a rather harsh statement especially when you take the whole spectrum in to account.
Psychosis related issues
A psychosis is an episode in which you lose your grip on reality. The person has entered their own world, a world which is most often very scary and threatening to that person. A person in such a state can definitely be violent and aggressive but tend to be of a far greater danger to themselves than to others.
Schizophrenia is the most common mental illness related to psychosis. About 50% of those who suffer through a psychosis will at a later point in life be diagnosed with Schizophrenia. Schizophrenia is a serious mental illness characterized by incoherent or illogical thoughts, bizarre behavior and speech, and delusions or hallucinations, such as hearing voices.
There are two important things to know about schizophrenia.
1, A person diagnosed with schizophrenia is not more dangerous and do not have a higher tendency towards violent crime than the average person.
2, Schizophrenia have nothing to do with a split personality or multiple personalities.
Almost all mental illness are characterized as disorders or contain multiple symptoms of which you do not have to display them all in order to fulfill the diagnosis. This of course creates a variation within the diagnosis and people who seem to have very different issues can have the same diagnosis. Symptoms and behaviors that are part of a psychiatric diagnosis tend to occur normally. They become clinical when they occur in a more extreme fashion or in an extended period of time and then become functionally impairing. It is completely normal to be sad or to be hyperactive, we only classify these things as clinical when they cause suffering or harm a persons’ development and/or functioning.
25 % of us will at some point in life suffer from mental illness.
Mental illness affects all of us but we tend to not know that because we don’t talk about it. Therefor when you or someone close to you is affected it’ll probably be a while before you realize it. A lot of us don’t know how to recognize it or how to deal with it when it happens. This is my first article in a series that will aim to spread knowledge on early signs of mental illness and on how to live and take care of your mental health. Please share what you learn and your own experience of mental illness in order to raise the awareness and fight the stigma around mental illness.
DSM-5, American Psychological Association
Recognizing the signs of schizophrenia, Shirley M. Glynn, PhD, Karen Kangas, EdD, and Susan Pickett, PhD, American Psychological Association
The Collaborative Longitudinal Personality Disorders Study: development, aims, design, and sample characteristics. Gunderson JG1, Shea MT, Skodol AE, McGlashan TH, Morey LC, Stout RL, Zanarini MC, Grilo CM, Oldham JM, Keller MB. J Pers Disord. 2000 Winter;14(4):300-15.
How often and how consistently do symptoms directly precede criminal behavior among offenders with mental illness?, 2014. J.,K., Peterson, J., Skeem, P., Kennealy, B., Bray, and A., Zvonkovic. Law and Human behavior, 38,439-449.
Where personality goes awry: A multifaceted research approach is providing more clues to the origins of personality disorders. Charlotte Huff. The monitor, APA, March 2004, Vol 35, No. 3
Myths and Realities about Bipolar Disorder, APA, 2012