That is entirely a function of how widely do you define “mental illness”. You set the bounds of normality narrowly and you get that mental illness is common, you set them far out and mental illness becomes a rarity.
Mayoclinic defines mental illness as such: “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.” This seems to be the standard definition.
The statistic of 1 in 5 that I used seems to pretty much only refer to diagnosed people with specific, named disorders. I don’t think it was including “I feel sad sometimes” as a mental illness. And considering it was only used statistics based on diagnostics, it seems pretty clear to me that a LOT of people got left out. Many people can’t get help. This also only covered the U.S.A., and statistics could vary widely in other areas of the world and based on methods.
If you like, we can taboo the “mental illness” phrase and instead use something like “badly defined and illogically based thinking patterns.” That would cover the schizophrenic fantasy/reality disconnect, anxiety, depression, etc. Then it becomes pretty clear that “badly defined and illogically based thinking patterns” are really common and often not as specific as biases. I don’t think anyone would claim mental illness is rare. According to the American Foundation for Suicide Prevention, 12.6 people out of 100,000 successfully committed suicide in 2013. That means over 41,000 people died, in one year, in the U.S. alone, not counting the suicides ruled as accidents or disappearances. The AFSP says it’s not easy to get a good number for suicide attempts, but they believe based on self-harm caused hospitalizations that it easily exceeds 600,000 people a year. And that’s just the people who want to die. Eating disorders are gaining attention as one of the more common kinds. Addictive disorders are so common almost everyone knows one or more people struggling. Depression, the same. There’s a trend among students where anxiety and stress are causing serious issues.
Also, there’s a difference between commonality and normality. Urine fetishes, for instance, are considered abnormal and uncommon. BDSM would be considered normal but uncommon (though 50 Shades of Grey seems to be making it a more common thing.) The urge to eat is normal and common. Mental illness, I would say, are considered common but abnormal.
Honestly, I can’t think of a single definition of mental illness that would say it’s uncommon. I may be misinterpreting your meaning, but it kind of seems like you’re focusing on semantics when the problem here is that common diseased thinking patterns are killing, sickening, and limiting lives.
Mayoclinic defines mental illness as such: “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.” This seems to be the standard definition.
Actually, I think the “standard” definition is provided by the current DSM. The Mayo Clinic definition is way too vague and general to be of any use.
If you like, we can taboo the “mental illness” phrase and instead use something like “badly defined and illogically based thinking patterns.” … Then it becomes pretty clear that “badly defined and illogically based thinking patterns” are really common and often not as specific as biases.
Sure, but then you are defining stupid people as mentally ill. Are you willing to do that for everyone with, say, the IQ under 85?
Honestly, I can’t think of a single definition of mental illness that would say it’s uncommon.
Go back a hundred years, for example. Under the definitions used then, was mental illness common?
common diseased thinking patterns.
“Diseased thinking patterns” is a dangerous concept. In the Soviet Union disliking communism was a diseased thinking pattern and people were actually put into mental hospitals for that. Not long ago being attracted to people of the same sex was considered to be a diseased thinking (and feeling, and behavioral) pattern, to be treated as a mental disorder. If I want to lose weight, is that a diseased thinking pattern and who will judge that? If I feel dissatisfied with life, is that a diseased thinking pattern and what kind of a pill will I be prescribed?
Vague, yes, but I disagree that it’s useless. It at least is an extremely basic overview that someone can build on.
Hmm. I wouldn’t call stupidity mental illness- low IQ doesn’t necessarily mean they’re an illogical person. it can mean they’re slow, or challenged, etc. A person can be “stupid” and not, say, think the moon is made of cheese. Limitations on your complexity of thought doesn’t necessarily mean the thoughts you have are wrong.
No, 100 years ago, a woman getting mad at her husband was a sign of mental illness. Mental illness was considered very common. People were put in asylums for anything from homosexuality to being too smart, or being transhumanist, or atheist.
I can see how the concept is dangerous, but only if misused. Cars are dangerous if misused. We use them daily. The idea isn’t to toss pills at anyone unhappy or who happens to have different beliefs, the point is that some patterns are harmful and some people would like help with that. I think deciding for others what is harmful is, itself, harmful- if a person enjoys their hallucinations, and the hallucinations don’t cause them to do harm, then honestly, we should leave them alone. If a person likes murder, we shouldn’t. If you want to lose weight, you should get nutrition and exercise advice. It becomes a diseased thinking pattern if you think you still need to lose weight when you have a body fat index of 5%, or if you think no one will ever care about you if you weigh above 125. If you feel dissatisfied with life, the question is why. If you have everything going perfectly in your life and you’re still constantly sad, that’s a sign of a problem, and you should probably see a doctor. You might be prescribed therapy rather than a pill.
I think most people decide for themselves if they like their thinking patterns. I don’t like mine. I’m seeking help. A person might be friends with the voices in their heads. A person might be tired of them telling him to kill himself. A transgender person may be miserable with their body-mind disjointedness and want therapy and/or a treatment plan to become what they want to be.
I may be misinterpreting your meaning, but it kind of seems like you’re focusing on semantics when the problem here is that common diseased thinking patterns are killing, sickening, and limiting lives.
You are on LW. Clear thinking is valued here and that involves debating how to talk about issues. Semantics matter.
Yes, and that definition leads to a field that’s not productive at solving the problem.
Plenty of criticism surfaced in the wake of the DSM-5 which currently contains the official definitions for mental illnesses.
I’m aware. I do study psychology, although my personal passion is microbiology. The question Lumifer raised was if mental illness is really that common. It’s pretty hard to find any evidence saying it’s uncommon, and a LOT of evidence saying it’s common. I’m curious- from your comments here, you seem to have a differing point of view than I do. Could you explain what you think mental illness is, and your related opinions? I think that would lead to a more productive discussion.
I’m not sure that the term “mental illness” is pretty useful if your goal is to do change work. Part of the societal role of the term is to distinguish mental phenomena where it’s legal to take drugs to solve them from mental phenomena where it isn’t. To decide what insurance will pay for and where it won’t pay. Those concerns dictate how wide or narrow we have our net as to what constitutes “mental illness”.
If we talk about anxiety I’m not sure that “mental illness” is a good framing. Every healthy human being sometimes has anxiety. There might be some brain damage that prevents certain people from having anxiety, but it’s part of normal human functioning.
That means it’s useful to learn how to deal with anxiety in a productive fashion. There are a bunch of emotional management skills that are useful for everyone.
I know little about schizophrenia but my general impression is that it’s something that’s qualitatively very different from a phobia.
Anxiety transcends a normal thing and enters mental illness when it becomes pervasive and unreasonable. My anxiety about having used a wrong word in a conversation I had last year is unreasonable. My constant feeling of dread is unreasonable because I’m not constantly in a situation that should inspire dread. Mental illness is really hard to define properly- there always seems to be something left out, or something that’s implied to be illness when it isn’t.
Honestly, I feel like the discussion has been derailed a bit- we’re focusing on defining a very vague thing that we don’t understand yet. I can’t offer answers at to how we should define mental illness because that’s a question that would take years to answer. And it seems like one of those questions no one will ever agree on, either. As a utilitarian, I think mental illness is a thinking pattern that causes unhappiness or harm over a period of time, or that blocks someone from being able to view the world realistically. Someone else might have a different set of values that has an entirely different set of “bad thinking patterns.”
But people ARE suffering, we know that there ARE diseased thinking patterns, and we know that people want help. Maybe “mental illness” is a bad frame, but at the moment, do we really have another to work with? I don’t think so, which is why I think that this is an important question. All of the answers we’re getting are mysterious, and thus not answers.
Yes, I want to do change work, and I think that it’s impossible to do anything if we refuse to start helping because we don’t have a good frame yet. Sometimes you have to explore a problem for a while to even start to figure it out. We have an extremely flawed and basic understanding, and saying, “well, what can we do then?” is like throwing out a hypothesis because of one inconclusive experiment.
Anxiety transcends a normal thing and enters mental illness when it becomes pervasive and unreasonable.
If the thought of asking out a woman for a date raises anxiety in me I don’t care at all whether or not that’s “reasonable” or “normal”. It’s a trigger that I don’t want to have regardless of whether it’s classified as a mental illness.
Maybe “mental illness” is a bad frame, but at the moment, do we really have another to work with?
Yes. I have multiple different one’s.
In Danis Bois perceptive pedagogy an answer might be: “You have problems with anxiety and worry about what you said last year because you constantly feel that you have to prove that you exist. If you would have a strong feeling of existence, your issues with anxiety would simply clear.”
In NLP it might be: “There are a bunch of situation where you are ineffective triggers that produce unproductive emotions. Let’s do the Fast Phobia Cure on all of them and get done with the problem.”
Lefkoe Method would say: “You might have 40 limiting beliefs that produce that problem like “I’m not lovable”, let’s go and clear those beliefs by spending 30 minutes on each of them with the Lefkoe Method.”
I haven’t been at a CFAR workshop so I don’t know their exact answer, but part of it seems to be: “Let’s get clear about how our emotional desires differ from our intellectual one’s and train comfort zone extension.”
That’s no complete list.
But when we go back to how to discuss the issue on LW, framing the issue as being around anxiety is likely more productive than framing it as being about mental illnesses in general.
Interesting, I haven’t heard of most of these. When I get the chance I’ll have to do some research.
Anxiety CAN be a good response. The fear-response that anxiety basically is can be a good “oh crap, I’m in a bad situation here.” Getting nervous when asking someone out is uncomfortable and kinda useless. Getting nervous walking down a street at night when someone seems to be following you is normal, and helps you respond properly. The pervasiveness is a major part. If the anxiety is infringing on your life in a lot of useless ways, you probably have an anxiety problem. If a minor problem causes extreme fear, like an unbearable fear of close spaces, you might have a problem- almost everyone has to get in an elevator at some point, and having a panic attack because of it would be inconvenient and unpleasant.
Perhaps tackling specific problems at a time would be more effective. But considering the sheer number of kinds of problems here, I’m not sure. If I wanted to write a sequence on “general mental illness” (sorry, I’m going to continue using that phrase because it’s not confusing and it’s a good, simple term that doesn’t require a lot of terms and you all know what I mean), and wrote, say, one article per mental illness… Well, I could say goodbye to ever getting anything else done. The research alone would take a lifetime, just on what we know now. Writing something worth having on LessWrong is a pretty big endeavor.
Once again, the problem is the sheer complexity of the problem. If we only tackled the really common ones (depression, anxiety, bipolar disorder, etc.) we might be able to do some good work, though.
The question Lumifer raised was if mental illness is really that common.
Not quite. I pointed out that mental illness can be defined in different ways (DSM was not brought back on stone tablets from Mount Sinai) and these different ways will give different answers about the prevalence of mental illness.
I should hope not, that would make me seriously question a good deal about history and biblicism. That’s very true, but narrowing the problem too much causes the same kinds of problems as opening it to everyone. If you give everyone with upcoming life changes a Xanax, you’re not letting them learn how to cope. If you refuse to help someone unless their illness is ruining their life, you’re letting a lot of people live seriously suboptimal lives. We don’t have a good entry barrier for determining if someone is mentally ill or not. We simply don’t know enough to make one.
Do you think that such an “entry point” could be discovered once and for all, an unchanging truth like a constant in physics, or do you think that the answer will always depend on who’s asking?
That is entirely a function of how widely do you define “mental illness”. You set the bounds of normality narrowly and you get that mental illness is common, you set them far out and mental illness becomes a rarity.
Mayoclinic defines mental illness as such: “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.” This seems to be the standard definition.
The statistic of 1 in 5 that I used seems to pretty much only refer to diagnosed people with specific, named disorders. I don’t think it was including “I feel sad sometimes” as a mental illness. And considering it was only used statistics based on diagnostics, it seems pretty clear to me that a LOT of people got left out. Many people can’t get help. This also only covered the U.S.A., and statistics could vary widely in other areas of the world and based on methods.
If you like, we can taboo the “mental illness” phrase and instead use something like “badly defined and illogically based thinking patterns.” That would cover the schizophrenic fantasy/reality disconnect, anxiety, depression, etc. Then it becomes pretty clear that “badly defined and illogically based thinking patterns” are really common and often not as specific as biases. I don’t think anyone would claim mental illness is rare. According to the American Foundation for Suicide Prevention, 12.6 people out of 100,000 successfully committed suicide in 2013. That means over 41,000 people died, in one year, in the U.S. alone, not counting the suicides ruled as accidents or disappearances. The AFSP says it’s not easy to get a good number for suicide attempts, but they believe based on self-harm caused hospitalizations that it easily exceeds 600,000 people a year. And that’s just the people who want to die. Eating disorders are gaining attention as one of the more common kinds. Addictive disorders are so common almost everyone knows one or more people struggling. Depression, the same. There’s a trend among students where anxiety and stress are causing serious issues.
Also, there’s a difference between commonality and normality. Urine fetishes, for instance, are considered abnormal and uncommon. BDSM would be considered normal but uncommon (though 50 Shades of Grey seems to be making it a more common thing.) The urge to eat is normal and common. Mental illness, I would say, are considered common but abnormal.
Honestly, I can’t think of a single definition of mental illness that would say it’s uncommon. I may be misinterpreting your meaning, but it kind of seems like you’re focusing on semantics when the problem here is that common diseased thinking patterns are killing, sickening, and limiting lives.
Actually, I think the “standard” definition is provided by the current DSM. The Mayo Clinic definition is way too vague and general to be of any use.
Sure, but then you are defining stupid people as mentally ill. Are you willing to do that for everyone with, say, the IQ under 85?
Go back a hundred years, for example. Under the definitions used then, was mental illness common?
“Diseased thinking patterns” is a dangerous concept. In the Soviet Union disliking communism was a diseased thinking pattern and people were actually put into mental hospitals for that. Not long ago being attracted to people of the same sex was considered to be a diseased thinking (and feeling, and behavioral) pattern, to be treated as a mental disorder. If I want to lose weight, is that a diseased thinking pattern and who will judge that? If I feel dissatisfied with life, is that a diseased thinking pattern and what kind of a pill will I be prescribed?
Vague, yes, but I disagree that it’s useless. It at least is an extremely basic overview that someone can build on.
Hmm. I wouldn’t call stupidity mental illness- low IQ doesn’t necessarily mean they’re an illogical person. it can mean they’re slow, or challenged, etc. A person can be “stupid” and not, say, think the moon is made of cheese. Limitations on your complexity of thought doesn’t necessarily mean the thoughts you have are wrong.
No, 100 years ago, a woman getting mad at her husband was a sign of mental illness. Mental illness was considered very common. People were put in asylums for anything from homosexuality to being too smart, or being transhumanist, or atheist.
I can see how the concept is dangerous, but only if misused. Cars are dangerous if misused. We use them daily. The idea isn’t to toss pills at anyone unhappy or who happens to have different beliefs, the point is that some patterns are harmful and some people would like help with that. I think deciding for others what is harmful is, itself, harmful- if a person enjoys their hallucinations, and the hallucinations don’t cause them to do harm, then honestly, we should leave them alone. If a person likes murder, we shouldn’t. If you want to lose weight, you should get nutrition and exercise advice. It becomes a diseased thinking pattern if you think you still need to lose weight when you have a body fat index of 5%, or if you think no one will ever care about you if you weigh above 125. If you feel dissatisfied with life, the question is why. If you have everything going perfectly in your life and you’re still constantly sad, that’s a sign of a problem, and you should probably see a doctor. You might be prescribed therapy rather than a pill.
I think most people decide for themselves if they like their thinking patterns. I don’t like mine. I’m seeking help. A person might be friends with the voices in their heads. A person might be tired of them telling him to kill himself. A transgender person may be miserable with their body-mind disjointedness and want therapy and/or a treatment plan to become what they want to be.
You are on LW. Clear thinking is valued here and that involves debating how to talk about issues. Semantics matter.
Semantics matter to the extent that everyone is on the same page. Mental illness is pretty clearly defined.
Yes, and that definition leads to a field that’s not productive at solving the problem. Plenty of criticism surfaced in the wake of the DSM-5 which currently contains the official definitions for mental illnesses.
I’m aware. I do study psychology, although my personal passion is microbiology. The question Lumifer raised was if mental illness is really that common. It’s pretty hard to find any evidence saying it’s uncommon, and a LOT of evidence saying it’s common. I’m curious- from your comments here, you seem to have a differing point of view than I do. Could you explain what you think mental illness is, and your related opinions? I think that would lead to a more productive discussion.
I’m not sure that the term “mental illness” is pretty useful if your goal is to do change work. Part of the societal role of the term is to distinguish mental phenomena where it’s legal to take drugs to solve them from mental phenomena where it isn’t. To decide what insurance will pay for and where it won’t pay. Those concerns dictate how wide or narrow we have our net as to what constitutes “mental illness”.
If we talk about anxiety I’m not sure that “mental illness” is a good framing. Every healthy human being sometimes has anxiety. There might be some brain damage that prevents certain people from having anxiety, but it’s part of normal human functioning.
That means it’s useful to learn how to deal with anxiety in a productive fashion. There are a bunch of emotional management skills that are useful for everyone.
I know little about schizophrenia but my general impression is that it’s something that’s qualitatively very different from a phobia.
Anxiety transcends a normal thing and enters mental illness when it becomes pervasive and unreasonable. My anxiety about having used a wrong word in a conversation I had last year is unreasonable. My constant feeling of dread is unreasonable because I’m not constantly in a situation that should inspire dread. Mental illness is really hard to define properly- there always seems to be something left out, or something that’s implied to be illness when it isn’t.
Honestly, I feel like the discussion has been derailed a bit- we’re focusing on defining a very vague thing that we don’t understand yet. I can’t offer answers at to how we should define mental illness because that’s a question that would take years to answer. And it seems like one of those questions no one will ever agree on, either. As a utilitarian, I think mental illness is a thinking pattern that causes unhappiness or harm over a period of time, or that blocks someone from being able to view the world realistically. Someone else might have a different set of values that has an entirely different set of “bad thinking patterns.”
But people ARE suffering, we know that there ARE diseased thinking patterns, and we know that people want help. Maybe “mental illness” is a bad frame, but at the moment, do we really have another to work with? I don’t think so, which is why I think that this is an important question. All of the answers we’re getting are mysterious, and thus not answers.
Yes, I want to do change work, and I think that it’s impossible to do anything if we refuse to start helping because we don’t have a good frame yet. Sometimes you have to explore a problem for a while to even start to figure it out. We have an extremely flawed and basic understanding, and saying, “well, what can we do then?” is like throwing out a hypothesis because of one inconclusive experiment.
If the thought of asking out a woman for a date raises anxiety in me I don’t care at all whether or not that’s “reasonable” or “normal”. It’s a trigger that I don’t want to have regardless of whether it’s classified as a mental illness.
Yes. I have multiple different one’s.
In Danis Bois perceptive pedagogy an answer might be: “You have problems with anxiety and worry about what you said last year because you constantly feel that you have to prove that you exist. If you would have a strong feeling of existence, your issues with anxiety would simply clear.”
In NLP it might be: “There are a bunch of situation where you are ineffective triggers that produce unproductive emotions. Let’s do the Fast Phobia Cure on all of them and get done with the problem.”
Lefkoe Method would say: “You might have 40 limiting beliefs that produce that problem like “I’m not lovable”, let’s go and clear those beliefs by spending 30 minutes on each of them with the Lefkoe Method.”
I haven’t been at a CFAR workshop so I don’t know their exact answer, but part of it seems to be: “Let’s get clear about how our emotional desires differ from our intellectual one’s and train comfort zone extension.”
That’s no complete list.
But when we go back to how to discuss the issue on LW, framing the issue as being around anxiety is likely more productive than framing it as being about mental illnesses in general.
Interesting, I haven’t heard of most of these. When I get the chance I’ll have to do some research.
Anxiety CAN be a good response. The fear-response that anxiety basically is can be a good “oh crap, I’m in a bad situation here.” Getting nervous when asking someone out is uncomfortable and kinda useless. Getting nervous walking down a street at night when someone seems to be following you is normal, and helps you respond properly. The pervasiveness is a major part. If the anxiety is infringing on your life in a lot of useless ways, you probably have an anxiety problem. If a minor problem causes extreme fear, like an unbearable fear of close spaces, you might have a problem- almost everyone has to get in an elevator at some point, and having a panic attack because of it would be inconvenient and unpleasant.
Perhaps tackling specific problems at a time would be more effective. But considering the sheer number of kinds of problems here, I’m not sure. If I wanted to write a sequence on “general mental illness” (sorry, I’m going to continue using that phrase because it’s not confusing and it’s a good, simple term that doesn’t require a lot of terms and you all know what I mean), and wrote, say, one article per mental illness… Well, I could say goodbye to ever getting anything else done. The research alone would take a lifetime, just on what we know now. Writing something worth having on LessWrong is a pretty big endeavor.
Once again, the problem is the sheer complexity of the problem. If we only tackled the really common ones (depression, anxiety, bipolar disorder, etc.) we might be able to do some good work, though.
Not quite. I pointed out that mental illness can be defined in different ways (DSM was not brought back on stone tablets from Mount Sinai) and these different ways will give different answers about the prevalence of mental illness.
Oh, sorry. I misunderstood.
I should hope not, that would make me seriously question a good deal about history and biblicism. That’s very true, but narrowing the problem too much causes the same kinds of problems as opening it to everyone. If you give everyone with upcoming life changes a Xanax, you’re not letting them learn how to cope. If you refuse to help someone unless their illness is ruining their life, you’re letting a lot of people live seriously suboptimal lives. We don’t have a good entry barrier for determining if someone is mentally ill or not. We simply don’t know enough to make one.
Do you think that such an “entry point” could be discovered once and for all, an unchanging truth like a constant in physics, or do you think that the answer will always depend on who’s asking?
It’s possible we could. I certainly hope so. But it’s such a complex question that, at the least, we probably can’t have a simple universal answer.
I sometime do have some reservations against what happens in psychology departments, but I don’t think they are completely hopeless.
You could start a self help group with fellow psychology students. It would likely be a more productive road then seeking help on the internet.
There are various CBT techniques in the literature for dealing with anxiety that you can do as peer training.
You might even use the daily gratitude sharing exercise in such a group.