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Comment by showerst | Hacker News Reader

"Every year, one in every five children and one in every four adults has a diagnosable mental illness. A quarter of all mental illnesses are considered serious."

1/16 adults having a serious mental illness seemed awfully high to me, but I went and looked it up and that may actually be low-balling it: http://www.nimh.nih.gov/health/publications/the-numbers-coun...

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I don't really like the term 'mental illness', not so much because of the stigma attached to it, but because the term implies there is some 'normal' from which only a small subsection of the population deviates.

In reality, there is no 'normal'. There is no one person with perfect mental health; perfect clarity of thought, perception, of feeling and action. Everyone, to put things bluntly, is a little fucked up.

Thus, these figures don't really surprise me. As far as I'm concerned you can end up with any percentage of the population suffering from mental illness, it just depends where you set the thresholds.

There's a ridiculously vast difference between "a little fucked up" and serious mental illnesses such as schizophrenia, rapid cycling bipolar disorder or borderline personality disorder.

If you think serious mental illness isn't a real, debilitating reality, I encourage you to spend some time with somebody in a truly psychotic state and see how you feel afterwards. Then imagine living as that person.

There may be no absolute "normal", but there are most certainly people who live in a sad, terrible, frightening state of mental disturbance with no simple treatment.

> There may be no absolute "normal", but there are most certainly people who live in a sad, terrible, frightening state of mental disturbance with no simple treatment.

Agreed. There's a vast gulf between someone who is quirky on Tumblr and someone with a mental illness. It's simply not the same, not even close.

Don't get me wrong, I don't mean to belittle those with debilitating mental illnesses.

I simply don't like the view many seem to hold that mental illness is black and white; you have a mental illness or you don't.

This has long been my opinion.

I worked with kids at a YMCA in a wealthy area, I would say 50% of them were diagnosed ADHD. I think if it's 50%, then it's just normal. 50 years ago ADHD was normal--we hadn't set our bar there yet.

But there's a world of difference between ADHD and schizophrenia.

There's a significant difference between the casual DSM-reader's "everyone's got a diagnosis" and problems that lead to significant dysfunction. Even if you're only looking at the "entry level", there is a difference not only in magnitude but in kind between having the blues, or even having life-altering acute sadness, and being what a clinician would call depressed. Similarly, there's a huge difference between, say, believing in the lamed vavniks (that there are, at all times, 36 truly righteous people roaming the planet doing good — the idea being that you might be one of them, and breaking with that nature could have some nasty consequences in the hereafter) and believing that Murray next door is really the archangel Gabriel in human form. Or wondering if that cute barista is flirting with you and interpreting the name written on your cup as a love letter. We may all be a little fucked up, but only a little.

Then you don't like the world "illness" in general. The same holds for physiological health: none is completly bacteria-free, has perfect levels of vitamins, etc. However, we need to operate in our judgements with ideals (healthy; sane; circle and all other mathematical entities, etc.): reaching for them, although never succeeding; that's perfectly okay.

Oh, and we do have some quite good (attempts at) theories of what "sanity" is all about.

A mental illness is a mental abnormality that significantly impacts on your quality of life or the lives of those around you. That's the definition.

Well yes, my point is that you can draw the line in any number of places. Even if we were to agree upon your definition — and there are many different, conflicting definitions of 'mental illness' — what constitutes a significant impact on quality of life?

At some point you have to draw an arbitrary line, and even then it's frequently a guessing game working out on which side of the line someone actually lies.

My definition is from the DSM and while it is true that there's always edge cases, in practice the gray area is pretty small. Especially when we're talking about serious things like schizophrenia.

When you consider that (probably) most of the people who exhibit serious substance abuse problems are self-medicating, the numbers aren't difficult to digest. (I say this not as somebody with studies in hand, but as a person who's been clean and sober for more than a quarter-century, and who has significant experience dealing with other addicts and alcoholics. One can make pretty reliable predictions about underlying issues based entirely on the addict's "drug of choice".)

What underlying issues do you see with someone who takes psychedelics (shrooms, LSD, DMT, etc)?

It isn't about just trying them, it is about using them to medicate or escape other symptoms.

Hmmm let me try…

Psychedelics -> Social rejection

MDMA -> Problems with parents

Weed -> Infantilism

Alcohol -> low IQ

NOTE: they are not absolute (e.g IQ below average), but relative to what would make that particular individual comfortable given the life challenges he deals with at the time.

Alcohol abuse has actually been correlated with High IQ and is most commonly abused by this group because of the despair they see in the world due to their high IQ's. Essentially, because they tend to be more educated, and aware of global problems that makes them depressed.

The causality of that is highly suspect.

That sounds like an urban legend.

The high IQ is a bit of a miss—it covers the spectrum, although it is certainly true that there was a tendency for high-functioning people from relatively affluent backgrounds to find their way into a recovery setting years ago. Self-selection was certainly part of it, but we have to keep in mind that more effort would generally be put into "salvaging" somebody who had displayed a lot of promise once than someone who would be a lot easier to write off.

The despair, though, isn't far off: chronic depression, or dysthymia, is common among alcohlics.

I guess I hadn't considered that, although it makes sense that the people seeking treatment would skew the results.

There are a lot of mental illnesses (did I spelt this right?) which aren't noticeable and even untreated let you live a "normal" life (whatever a normal life is).

I'm diagnosed with ADHD myself. I'm not on medication or treatment and while my attention span is somewhat weak I learned to live with it and find ways to accomplish things. Working in a field I find interesting, even when everything seems to be interesting for me, helps.

I think that we need a new definition of "serious" if you can live a normal life without treatment. If someone has a "serious" tumor, the assumption is they are likely to die soon without treatment.

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