The
human psyche, fortunately and necessarily, is oriented toward
self-preservation. If not, our species never
would have survived. Since we are the
most physically dependent and the most social animal, our survival has demanded
that we relate adaptively to those within our “tribe.” Accordingly, humans developed extraordinary
skill in understanding themselves and those around them. Moreover, the two skills have been
inextricably related—we understand ourselves by contrasting our behavior with
that of our contemporaries and vice versa.
Almost
every day we observe someone doing something that we consider “crazy.” Those crazy behaviors could include anything,
from running away from home to never leaving the house. Given our penchant for “social comparison,”
we often imagine that we never could behave so maladaptively. And, because of our “fundamental attribution
error” predilection, we ascribe other people’s oddities to their enduring personalities
while excusing ours as due to transient, external influences. Moreover, to justify our perceptions about
our odd neighbor, we can search through scores of mental illnesses enumerated
in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) to find
one that seems just right.
Our
weird neighbor is the exception of course.
There’s never anything strange about us.
After all, mental illness is rare.
Isn’t it?
The
conventional view had been that mental illness was uncommon. However, over the last decade several
studies suggested otherwise. For
instance, the National Institute of Mental Health reported that 18 percent of
American adults suffered from mental illness in 2014 (www.nimh.nih.gov), and Kessler
et al. (2005) suggested that about 50 percent of us will evidence a diagnosable
mental illness during our lifetime.
If
you think those statistics are ominous, consider the even more startling
conclusions reached by Jonathan D. Schaefer and his colleagues (2015) who believed
that previous reports most commonly employed three data collection methods that produced spurious low results.
First, national registries, they said, included mostly or exclusively
persons who received treatment in psychiatric facilities, missing those treated
in other settings or those not treated at all.
Second, retrospective studies primarily were limited to persons
diagnosed with Axis I mental illnesses (e.g., Schizophrenia) and, therefore,
missed Axis II and other serious problems (e.g., Psychopathic
personality). The final inadequate data collection method employed prospective
cohort studies. Although prospective
cohort studies (that follow persons of similar age over time) often are
considered excellent, the problem for Schaefer was that the ones he uncovered
also assessed only Axis I. Despite
that limitation, however, the prospective research did disclose a mental
illness rate ranging from 61 to 85 percent, significantly higher than the other
methods.
To
remedy the perceived research inadequacies, the Schaefer group examined data
from the Dunedin (New Zealand) cohort, a group that had been studied
meticulously from their births until middle-age. The entire cohort was scrutinized – not just
those with diagnosed mental illness - and all diagnoses – not just Axis I -
were considered. Given that
comprehensive, all-inclusive criterion, an astounding 83 percent of the study’s
subjects suffered a diagnosable mental condition sometime during their lives. Also surprising was that those who did escape
all mental illness were not especially intelligent, physically healthy, or from
a financially privileged family. Rather,
the emotionally sound 17 percent tended to be ones who had managed to maintain high-quality
interpersonal relationships, to be more satisfied with their lives, and to have achieved greater educational and occupational success.
Before
you conclude that we are doomed because almost everyone is going out of their minds, recall that Schaefer employed a very broad definition of mental illness. There are so many mental diagnostic categories
that virtually any imaginable problem can be labeled. Moreover, the study did not adequately report the severity or diagnostic distribution of the illnesses that were found. There is a world of difference between an “Adjustment
disorder with depressed mood” and “Schizophrenia, Paranoid Type.” The Dunedin study can, in fact, be of comfort
to you. If emotional problems are so
ubiquitous, then many, virtually by definition, are everyday problems of living. So, when anxious, depressed or otherwise
afflicted, remember that you probably are no more deviant than the weird
neighbor mentioned earlier. Do not let
your emotions overwhelm you. Keep moving
forward, and as I implied in the subtitle of my Don’t Rest in Peace book, do your best to maintain an
activity-oriented, physically and mentally integrated lifestyle.
References:
Kessler,
R., et al. (2005) Lifetime prevalence
and age-of-onset distributions of DSM–IV disorders in the National Comorbidity
Survey Replication. Archives of General
Psychiatry, 62, 593– 602. http://dx.doi.org/10.1001/ archpsyc.62.6.593
Schaefer,
J., et al. (2016) Enduring mental health:
Prevalence and prediction. Journal of Abnormal
Psychology, Dec, No Pagination Specified. http://dx.doi.org/10.1037/abn0000232
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