Tuesday, June 07, 2005

Psychiatry and its Discontents

According to a series of studies, the prevalence of mental health problems has been vastly underestimated. When it hits too close to home, the topic of mental illness inspires its usual mix of dread (as evidenced by the headline writer at the NY Times: "Most will be mentally ill at some point, study says"), and denial. The latter is reflected in this quote by Dr. Paul McHugh, whom I have long admired and often agree with (I'd like to think the Times writer has taken him out of context):

"Fifty percent of Americans mentally impaired - are you kidding me?" ... "Pretty soon," he said, "we'll have a syndrome for short, fat Irish guys with a Boston accent, and I'll be mentally ill."

On the other hand, I think that the studies' lead author, Dr. Ronald Kessler, puts the matter into perspective:

"If I told you that 99 percent of Americans have had a physical illness, you wouldn't blink an eye," he said in an interview. "The fact is that there is a very wide range included here, with the equivalent of many psychiatric hangnails. We don't want to demonize those, but we don't want to trivialize them, either, because we know in many cases they lead to serious problems later on."

Even the illness metaphor itself can be very misleading, since some mental suffering is a condition of our living in civilization (as Freud said, the goal of psychoanalysis is the transformation of "hysterical misery into common unhappiness"). Analagous to the role of genes in our lives, which I posted on previously, it seems difficult for many in today's society to accept that psychological problems are part of the fabric of life, an essential part of our humanity. Some are fleeting, some are enduring; some are ennobling, others, crippling. Not all problems deserve the attention of mental health professionals, but all of us could probably benefit at one time or another from guided introspection with the help of a caring and knowledgeable other.

Still, the fact that everyone gets the flu doesn't mean that everyone will get Ebola; the fact that some die of Ebola does not mean that I am doomed if my temperature goes above 100. And while I don't enjoy hangnails, broken bones, or the flu, I wouldn't trade them for an android body. Why do so many want to believe that they have an android's mind?