Sunday, April 27, 2008

Opening the nutcase

I am crazy. I have decided to come out of the closet about this. Now, I realize "crazy" is not a diagnosis, but it's more descriptive and, in my mind, probably a damn sight more accurate than what comes out of that holy grail of books, the DSM IV. For those of you not familiar with this book, its full name is "Diagnostic and Statistical Manual of Mental Disorders" and it is written and published by the American Psychiatric Association.

This is the book that psychiatrists use to pigeonhole people so that they don't have to spend time seeing them as individuals. It also supplies the code number so that doctors can bill insurance companies properly. This may be the most important aspect of the book.

Until 1980, the DSM considered homosexuality a psychiatric illness. There has been continuing controversy over the term "neurosis" for decades. This book, which is revised periodically (hence the IV, which is now in a newer, revised edition), is considered the scientific reference manual for psychiatric disorders. With the exception of schizophrenia, every diagnosis in this book is conceptual and open to debate.

Yet, in spite of this, anyone who has ever seen a professional for a mental health reason has been labeled with a so-called objective scientific diagnosis that is gleaned from this manual. These diagnoses can be tricky, and some of them are very sticky, for once you have one, it's almost impossible to rid oneself of these "diseases". You will be forever treated not like an individual, but by a label.

I sincerely doubt there's any person in this society who couldn't be tarred and feathered with at least one mental health diagnosis. If you function well in society, you will not receive a diagnosis. This doesn't mean you don't have one. You may have narcissistic personality disorder (and most likely do) if you're an actor, but this serves a person well in this particular job. The same set of character traits will impede you greatly if you live in a small town and work in a job with no possibility of recognition or achievement.

Sociopaths make excellent businessmen, for they care not a whit about others, and so they can make decisions based solely on the bottom line without any guilt. Again, put that person in a small town and see how well they do.

I didn't know where this post was leading, but I see a thread that intrigues me greatly and I've never thought of before. There is a higher significance of mental health problems in rural areas. I have always attributed this to poverty, but now I think there's much more to it. Many personality disorders are very useful (and perhaps essential) in high paced, competitive fields, which are found, generally speaking, in high population, urban areas. In areas where there are no outlets for competition and conformity is prized over originality, many people languish. In addition, lack of diversity and outlets for creativity. . .well, it's an environment ripe for simple depression at the very least.

I'll stop here. There's too much to chew on and I could babble forever. But I've started the conversation (and the rant) that I need. It's healthy to come out of the closet. I never knew what it meant exactly, but there's an AA slogan "You're only as sick as your secrets" that I like. It resonates with me even though I don't know how to explain it. Anyone care to enlighten me?

Richard Dadd (1817-1886 ) spent 9 years (while "insane") painting his "The Fairy Feller's Master Stroke". I found his name on this webpage: Famous Crazy Folks - Almost no one was glad to be their friend until they became famous.

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