Ever since I was a little kid, I have felt the pain of the world quite deeply (how’s that for a pretentious opening sentence?!). I don’t recall being an unhappy child—not by any means!—but I do quite distinctly remember being drawn toward more existential themes of pain and loss and identity and belonging, even as a relatively young person. Often the manifestation of these tendencies coincided with being dumped by a girlfriend (in grade 7-8!) or failing a test (mathematics and I are still sworn enemies) or some other utterly ordinary perceived injustice in the life of a kid. But I also remember wondering about and being saddened by some fairly big questions. Why do so many people suffer? Why do I have a mom and a dad who love and care for me while others do not? Why was I born in Canada and not Ethiopia? How does God expect us to live with joy and happiness when we see pain all around us and while we know that death is coming? If God is good and powerful, why does he allow so much horrific pain in his world?
All this is to say, I suppose, that from my earliest memories I have lived with the knowledge that life is a mixed bag and that all of our human stories will inevitably include pain. There is a kind of inherent sadness built into the system, it has always seemed to me, and this ought to be reflected in how we think and live in the world. I always marveled at those around me, whether inside or outside the church, who could so easily come to peace with the world as it is. “That’s just the way things are… Gotta make the best of it… God knows best… Focus on the good…” Etc., etc. But why are things like this? I would often say, to God or far less frequently, to a real unfortunate human being who happened to be in the vicinity. How can God expect us to celebrate the good with all of this badness skulking around in the shadows?
None of this is, of course, in any way unique to me. But I have been thinking about these themes in light of an article I read last night called “Mind Games” by Kwame McKenzie from this month’s issue of The Walrus. The article deals with the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the “bible” psychiatrists use to diagnose mental illness. The overarching question raised by the article is, to what extent are we over-diagnosing mental illness? According to the article, a recent survey indicates that fully 26% of the American population would have some sort of mental disorder according to DSM-5. What is the apparently ever-shrinking “normal” that these 26% don’t fit in? Who defines it? And, beyond that, larger questions loom: Are we turning unhappiness itself into a mental illness? What does this say about us as a society?
This paragraph from McKenzie’s article stood out:
The increase in the number of DSM diagnoses may reflect a larger shift in society’s expectations. Out of the 400 medical students at my lecture, only one considered it reasonable to expect psychiatrists to return patients to a state of normal unhappiness. Everyone else thought we should strive for more. This suggests that the psychiatrists and psychologists who created the manual, as well as the North American society they serve, now expect to achieve something other than normal unhappiness. It also raises questions: If unhappiness causes distress and people do not want to be unhappy, does this make unhappiness an illness?
I’m hardly the first person to think along these lines, but I wonder how many of history’s truly great minds would have been diagnosed with a mental disorder? Dostoevsky, Tolstoy, Kierkegaard, Luther, Julian of Norwich, John the Baptist, any of the biblical prophets (to remain only under the broad Christian tent)… the list could get very long, very quickly. We could even include Jesus for that matter. Each of these people were, in their own way, profoundly in touch with the shadow side of human existence. They could never have done what they did and had the influence they had without this capacity to hurt, to feel deeply, to grieve, lament, weep, rage. These were not “happy,” “well-adjusted,” “normal” citizens. They were wild and shrill voices from the deep, dark places of life—voices that needed, and still need, to be heard.
There is something about the way the world is that ought to make us unhappy, I think. Aside from the pain that we witness in our world, the pain we experience personally, and the pain we inflict on others, there is something deeper yet. Most of the writers of DSM-5 obviously would not accept a anything like a Christian understanding of human beings, but according to a Christian anthropology, there something fundamentally wrong with us. We are not as we ought to be, as we were made to be. We are restless, rebellious, narcissistic, and hedonistic (among other things). We are incredibly resourceful when it comes to denying death, ignoring pain, and pretending things are other than they are in our world and in our lives. We do not adjust well to reality. We are forever trying to turn ourselves or our world into something they are not and cannot be.
But we are never successful at this endeavour for very long. And then, when our misguided expectations go unmet, when things come crashing down, or even when we begin to see life as it really is, we are unhappy. So we go to a doctor, get a diagnosis—an official-sounding name for our “condition”—and we pop a few pills, trying to feel happy again, trying trick our brains into telling us that everything is fine. Normal. Happy. Well-adjusted.
Perhaps part of what it means to live truly in God’s world is to recognize that sometimes, unhappiness is normal. Sometimes, indeed, it is far more abnormal to be happy.
This is where the obligatory caveat goes. I am, of course, aware that the diagnosis and treatment of mental disorders can be a profound source of healing and hope for many people and that there is heavy and tragic human cost associated with untreated mental illness. I do not wish to discount this in any way. I am simply wondering here about the scope of “mental illness” the nature of “normal” and about how we ought to think and live in a world containing such a bewildering amount and variety of both goodness and evil.
Wow, well written! It’s been several months now since I completed my thesis on madness, so it was good to be drawn back into these kinds of reflections. In a relatively recent conference Dallas Willard apparently said that we have yet to produce a truly Christian psychology. On the one hand, as you say, sadness is not always (or even usually) pathology. On the other, true joy is not simply the product of therapy and pharmaceuticals.
Thanks, Mark. Not surprisingly, I agree with you (and Willard) re: the nature of sadness and joy and how we (often mistakenly) undersand and avoid/pursue these things.
(I read yesterday that Willard has been diagnosed with cancer. Very sad to hear this… and hoping for successful treatment options for him.)
hadn’t heard that about Willard – scary.
This is very good Ryan. I guess I think this because I agree with it and have been thinking about it a lot lately. Sometimes when I feel “down” or depressed for a length of time (and I think there are usually good reasons i.e. I watched the news, seemingly endless evil in the world, too much work, tax season, a disturbing story from our kids) I start to worry if I am officially “depressed”. Should I see my doctor? I can’t shake this darkness. Is there something wrong with me… Strange how the pendulum swings from feeling guilty and ignoring mental health issues, which is very dangerous, to now possibly over prescribing to keep us in state of Nothingness.
Will definitely read this post again and keep processing it.
Thank you for the Strong caveat at the end. Very important.
Yes, the pendulum tends to swing hard, doesn’t it? I wish I had some compelling criteria to determine the difference between depression/mental disorders and “normal unhappiness.” Alas, I do not. I do, however, feel very uneasy about the way we are medicalizing sadness or any other behaviour, disposition, feeling that doesn’t fit with some predetermined norm. Kids won’t sit still? Give them Ritalin. Feeling blue? Have some Xanax. Sex life isn’t what you’d hoped? We have pills for that, too.
I don’t dispute that there are cases where each of these drugs (and others) are profoundly good and necessary (well, maybe not the last one… :)). But I do wonder what it says about what we expect, how we think we should feel, and who gets to define the boundaries of normal behaviour/experience? I think our current tendencies say a lot about how we understand “salvation” and who we expect to save us. Our horizons have radically shrunk when compared to earlier ages. We want a pleasant, comfortable life free from distress/sadness/pain. There may or may not be an afterlife to hope for, but we’ll settle for that. And doctors/scientists are our new priests that we look to for salvation. They are the ones with the chemical miracles that we require. That probably sounds a bit more blunt and un-nuanced than I might like, but I think there is some truth in there…
“Our horizons have radically shrunk when compared to earlier ages. We want a pleasant, comfortable life free from distress/sadness/pain.”
Have they? Or have we, as you say, turned to a new source of salvation? Maybe the earlier ages lacked the immediate fix.. so they were required to turn to the long game. Just some thoughts.
There may be some truth in what you say, Tyler, but I don’t think it tells enough of the story. I don’t think people hoped for eternity only because their lives were “nasty, brutish, and short.” I think it’s part of how we’re wired.
This is probably a bit too simplistic, but if it were true that we have left behind the “long game” because we have figured out how to fix the “short game” and that preoccupation with eternity was simply a way of compensating for our inability to secure comfort and happiness in the present, I would expect people to be much happier today than they seem to be. Instead, we see skyrocketing mental health problems, depression, anxiety, you name it. Our new salvation doesn’t seem to be working as well as we might have hoped.
I fully agree Ryan! By no means did I intend to imply that this “shorter term pleasure” was remotely more efficient and effective. If we are wired to hope for eternity it could very well be because we are wired that way. However, this could be this way through either biology or creation. That part doesn’t really matter to me in regards to this. I think we are unable to comprehend our own death. How could the concious do this after all? Even when we ponder our own concious we have made the thinking-thing. Therefore the thinking-thing can never be categorized so how could it ever truly ponder its own death? The hope for eternity is just the limits of the conciousness.
With all that said, life can be “nasty, brutish, and short.” This is always a matter of perspective though. Life goes on and life changes rapidly. The long game is what matters as Aristotle seems to correctly point out. Only at the end of a life do you know if it is a good one. The sad reality is for many they might not be able to see it was a good one.
This brings me back closer to the initial arguments: “But I do wonder what it says about what we expect, how we think we should feel, and who gets to define the boundaries of normal behaviour/experience?” This is a good question and has no easy answer. This is why I have great concern for answers given like the one below. Disorders are one the rise and the jury is still out on whether it is caused by better ability to diagnosis, environmental conditions or ? – the list goes on. What do we achieve by attempting to normalize everything? More similarity in realities? Sameness? These are tough questions and sometimes scary ones. Especially when we try to fit them into the realm of ethics (in either of our world views).
“Our new salvation doesn’t seem to be working as well as we might have hoped.” Our old didn’t seem to have helped either. Maybe though, it is because there is nothing to save.
Can you say more about this, Tyler? I’m not sure I understand why consciousness in and of itself ought to preclude an acceptance of death.
Well, I suppose that depends on who you ask. Many people would say that their convictions about the nature of God, life, and the life to come are enormously significant. Of course, claims about a life beyond this one are unverifiable. But even if we acknowledge that many people are too heavenly minded to be any earthly good, as the saying goes, there are countless examples of those for whom the hope of eternity was the animating force behind an incredible amount of good done in this life.
where I get befuddeled is grappling with the differences between mental health illness and a personality disorder. The mental health professional can give meds for those diagnosed with a mental health. As I understand it, persons with a personality disorder are treated via behavioural modication.
Get this, there is a disorder labeled: oppositional difiant disorder – true disorder.
(the venacular for this is simply asshole – but then we all suffer from a bit of this don’t we).
Yes, the waters are certainly pretty murky aren’t they, Larry? I don’t know how to sort through all the differences, but I can’t believe that constantly adding more disorders is going to help things—especially ridiculous ones like the one you mentioned! Sheesh.
Ryan, I actually quite believe there are people dealing with oppositional defiant disorder. I’ve dealt with them. I am not sure how all the technical jargon or testing works. But it is quite real.
I think the disorders likely cluster together. Such as narcism and oppositional defiant. At an extreme edge we have psycopaths.
I think it is helpful to think of scales or range. People test out and can be placed on a grid.
We all score on this stuff.its a matter of degrees.
I wouldn’t right this off.
To be clear, I’m not writing anything off as far as the realities these labels describe. I’m simply wondering about the way we talk about these things and about what, if anything, is gained by defaulting to the language of “disorders” and “conditions” and “scores,” etc.
What need is this language feeding? Does it give us permission to think of ourselves primarily as victims (of biology, our genes, etc) as opposed to responsible agents accountable for our actions? I realize there is no one size fits all answer here, and that the factors that contribute to each individual case are enormously complex, but nonetheless, the trend toward medicalizing so much of human behavior makes me uneasy.
For the most part,I look at unhappiness as simply a symptom of a much larger internal/spiritual issue,but no one really wants to hear this kind of talk. I believe that unhappiness is meant to drive us back to our Creator from which we’ve drifted. Unhappiness eventually leads us into dispondancy and depression if the God issue is not delt with. The chemical imbalances that occur in the brain during prolonged unhappiness and depression ARE REAL,they are caused by the mind in conflict with itself. A trillion dollar a year(and growing) worldwide secular Industry revolves around treating the symptoms of our spiritual maladies since the Church became impotent in these matters.
P.S. I highly reccommend the acclaimed Documentary “Escape Fire” to you all
” I believe that unhappiness is meant to drive us back to our Creator from which we’ve drifted. Unhappiness eventually leads us into dispondancy and depression if the God issue is not delt with”
That’s a fairly slippery slope to walk on there.
Yeah,I know. But that has been MY experiencein Life. Maybe im guilty of over-generalization here. In AA we are taught that our Alcoholism is but a symptom of a larger spiritual problem.I think this truism may apply to many of the other Human conditions we suffer from.
Thanks for the recommendation, Mike.
I agree that our alienation from God is at the root of many instances of mental illness, depression, etc, even if it is operating on an unseen, unacknowledged level. I appreciate your referring to your experience at AA. I have heard this from others as well. It is important to get first things first.
As Tyler says, though, the slope is a slippery one. Are all people who have “dealt with the God issue” models of mental health and tranquility? I don’t think so. As I mentioned in the main post, some of the people we often associate with unique spiritual insight and vitality would probably have been diagnosed with a mental disorder today. I truly wish things were as simple as “get right with God and everything will improve,” but things are inevitably more complex than I might prefer :).
You guys have totally misunderstood my initial comment. I was speaking of the prevalent condition of unhappiness in/with one’s life, NOT “mental Illness” which is a clinically diagnosed condition.I’ve befriended enough homeless schizophrenics on the streets of Lexington to know the difference. It would be ludracris to expect that anyone with a mental disorder to recover by “finding God” or ‘asking Jesus into their heart’.
Sorry for misunderstanding, Mike. And thank you for clarifying.
Ryan – I’m in full agreement with what I read the basic premise(s) of your post: a) we all can and should learn to live with an imperfect, less then blissful life (aka reality sucks so deal with it) HUGE AGREEMENT NO ARGUMENT; the medical profession and people can become over reliant on quick fixes, our modern western culture seems to have an ever expanding list is disorders/mental illnesses – what gives?. I appreciated the caveat you included at the end of your rant errr piece (I’m just joking about the rant comment :))
An anecdotal comment, some speculations and thoughts. Hopefully this will be helpful, Tyler appeared “greatly concerned” by my post (if he was commenting on what I wrote yesterday, he needs to explain more clearly just what he is concerned about) and I don’t think you are quite buying what I am selling.
Anecdotal: I’ve noticed people from non-western cultures coming into our western criminal system with undiagnosed issues. Perhaps: their families were ashamed of what they saw as weakness, they were unaware that mental health professionals could help via diagnoses. Whatever; they come into our western culture, create some havoc (sometimes a great deal of havoc) and hopefully find some help. Looking for reasons/labels isn’t all bad. See below..
Speculative: In times past life was more brutal. I’m wondering if people with profound mental illness were just locked up, people with the kind of personality defects I mentioned yesterday may have been treated quite summarily by the community or by whatever law ruled the land.
Thoughts: Ryan wrote: “I’m simply wondering about the way we talk about these things and about what, if anything, is gained by defaulting to the language of “disorders” and “conditions” and “scores,” etc. ….. What need is this language feeding? Does it give us permission to think of ourselves primarily as victims (of biology, our genes, etc) as opposed to responsible agents accountable for our actions?”
It seems to me that humans have the need to organize and categorize. So when the system (either mental health professionals, prison, legal) sees repetitive behaviour/issues hopefully the label helps in focusing resources/efforts. Does this mean those with the ‘labels’ become victims or are not responsible for their actions? I don’t see that played out on the ground except for those diagnosed “not criminally responsible.” Can diagnoses / labeling get out of hand? Absolutely! Not doing so is to operate blindly. For example: I think every pastor should read books about psychopathic behavior and become more familiar with personality disorders (it may help them survive board meetings :)). But if I remember correctly, I’ve been on this rant on your blog before, so I shall stop now.
I hope this makes some sense.
…”I think every pastor should read books about psychopathic behavior and become more familiar with personality disorders (it may help them survive board meetings” hahahaha, and some peculiar blog commenters 🙂 hahahahha
I was raised in a family with 4 sisters and a brother.. ALL of us siblings have developed psychological problems in varying degrees of one sort or another.My brother and I are Alcoholics and drug addicts,one sister is a hoarder,another is addicted to gambling among other things,one is unstable and suffers extreme bipolar mood swings and one displays clinical OCD/neurotic symptoms.We all have sought psychological counseling at one time or another in our lives. In my early twenties a psychiatrist diagnosed me with ‘Anxiety Neurosis’,years later a psychologist explained that I had PTSD otherwise known as ‘shell shock’ from growing up with an unpredictable cruel abusive Alcoholic father. I understand the vast difference between the general malaise of ‘unhappiness’ and clinical psychological disorders.People can be well adjusted psychologically and possess all the ”things” that we value and strive for in our culture and yet be unhappy and even depressed on a deeper soul level. I’ve also met many functional but psychologically ILL people who were never the less very happy. It’s all relative i suppose, but having a ‘Higher Power’,in my opinion,adds a dimension in our lives that is conducive to finding true ‘happiness’.
Wow, quite a story, Mike. Thank you for giving us a window into the multi-layered complexity of mental disorder, addiction, happiness, and general well-being.
I am very sorry for what you have gone through. I am also grateful for the wisdom and insight that have been among the fruits of what sounds like a long and winding road for you. I wish you much grace and peace as you work with the “Higher Power” to bring together the disparate strands of life into a future of shalom.
Yes, what you say certainly makes a lot of sense, Larry. I think we are mostly in agreement here. The labeling, diagnosing, and treatment of mental disorders is useful and necessary and can be a profound source of hope and healing (not to mention, in more dramatic cases, security for others!). It can also get out of hand and play into a culture of victimhood and an unwillingness to take responsibility.
In other words, like all tools, the understanding and treatment of mental illness must be used with skill and for the right reasons.
“if you want to be happier yourself then make other people happy and forget about being happy yourself.because as long as you are worried about being happy yourself,you will be unhappy,because you will measure how happy you are and you”ll not think it’s happy enough.You will want another ice cream cone, you”ll want another extra ‘thing’. But if you forget about how happy you are and just try to make another person happy,then without really trying you will be happy.” (Professor Robert Thurman-Columbia University paraphrasing the Dahli Lama)