Written by Jurek Wötzel, Head Writer
The madman is a curious category. It works as the opposite of the ideal functioning person: everything that the functioning person is and does, the madman is not and does not. It is a concept that is essentially defined through what it is not, rather than what it is.
While medical literature did exist in premodern times, the scientific interest in mental illness explosively grew from the 1960s onwards. Modern forms of mental illness have been clustered under various terms nowadays. Depression, post-traumatic stress disorder, eating disorder, anxiety, psychosis, bipolarity, the list goes on. Categorization still largely relies on the statistical testing of patterns of lived experience. Both, reports of the inner feelings of patients and external observations of doctors, family members, and friends remain to be the main source for classification and diagnosis. While there have been some advances in uncovering physiological mechanisms lying at the heart of these mental illnesses there’s no consensus. There are researchers that believe serotonin imbalance causes depression, researchers who believe it is actually dopamine imbalance, and those who find the real reasons in genetics. Recently, a study found that our chances of becoming depressed in our lifetime is one in four – and if one of our parents had depression, it’s three in four.
The difficulties that we have with finding medical causes of mental illness may be overcome with time, but the dangers that come treating it a scientific problem will stay. One such issue sparked by the insufficient exploration of mental illness by medical researchers is that treatment often does not match the condition. Many times, chemical antidepressants prescribed by doctors bring little actual improvement and fight symptoms rather than causes. A meta-study by the NIHR Oxford Health Biomedical Research Centre showed that across the field, antidepressants relieve the symptoms by 50% after two months, but those who have experienced incidences of depression know it comes at a cost. Yes, you sleep better, and your mood is improved, but then you also get the side effects.
Another trending illness is ADHD. The UK National Health Service says symptoms of ADHD are essentially of two types: inattentiveness and hyperactivity/impulsiveness. A closer descriptions of symptoms lists ‘excessive talking’, ‘acting without thinking’ or ‘interrupting conversation’ as problematic behaviors.
Indeed, these problematic behaviors can cause distress for the patient. Repulsive reactions of peers in school or nursery, as well as problems in managing everyday life as an adult, are common issues related to ADHD. However, framing these behaviors as a disorder ignores the fact that the social organization necessarily produces misfits. Those who struggle to function within the established society are given a medical diagnosis and a medical treatment with the aim to make their personalities fit in. For ADHD, the medications often given, Adderall or Ritalin, are strong stimulants that can have long-term side effects such as heart-rhythm disorders, psychosis, and addiction. Headaches, dizziness, and anxiety belong to the more harmless side effects the patient may experience daily.
The most dubious of all classes of mental disorder are those of the personality disorders. Among them are for example the ‘antisocial personality disorder’ and the ‘obsessive-compulsive personality disorder’. The NHS says that expressions of anti-social personality disorder are “manipulative, deceitful and reckless, and won’t care for other people’s feelings”. They often have histories of repeatedly breaking the law. Obsessive-compulsive behavior means that a certain thought causes stress and anxiety, which is then relieved by repetitive actions that temporarily relieve this. While the antisocial personality disorder does not come with pharmaceutical treatment, OCD is treated with an antidepressant, an SSRI (Selective Serotonin Reuptake Inhibitors) which can cause insomnia, reduced sexual desire and has been found to double the risk of suicidal thoughts.
All these examples inherently have political relevance. We should ask ourselves to what extent mental illnesses are serious medical conditions of the individual or simply deviations from the norm – which could be totally fine to live with. Only our definition of what is normal produces the unnormal, which we for some reason cannot integrate in the workings of society. It is wrong to give strong drugs to children with the aim of making them behave like all the others, especially since many of the symptoms are based on social interaction in the first place. Even in cases when there’s no medical treatment as with the antisocial personality disorder, personality differences or non-conformism should not be treated as a medical condition, but accepted as a social phenomenon.
It is wrong to pretend as though the upsurge in depression is merely a result of increasing diagnosis rather than systematic causes that lie at the heart of the social order. In the past decade, depression has increased significantly among U.S. teens and it is estimated to become the world’s leading cause of illness by 2030. High-speed capitalism, the progressive up-breaking of stable social ties due to increasing job flexibility, and the constant fear of economic and social decline are just some of the societal developments linked to depressive disorders.
In general, I think there is a lot to be learned from investigating what is called mental illness. Often it can actually give us a hint at societal issues we would not have seen as issues otherwise. This can work in two ways. First, through addressing the question of whether something is an individual mental illness, or actually the symptom of a greater problem; and second, by questioning the extent to which the normalization of the individual is desirable. Repoliticizing mental illness instead of accepting it as a medical condition is crucial and it can be done by saving the debate from revolving around pure pharmaceutical expertise.