Focusing in on mental illness

459px-DepressionThe notion of a mental disorder, or illness, is an essentially normative notion. It is dependent on the availability of some metric of normalcy, or orderliness. Whether a given mental tendency is a disorder or not depends on whether or not, and in what ways, it deviates from what is considered normal, or orderly. But, what are the norms that determine this metric?

This question is highly controversial, and its importance transcends far beyond the walls of academia. Few such seemingly terminological issues have such a tremendous impact on the day to day lives of so many millions of individuals across the world. For example, until quite recently (1973!!), homosexuality was considered a mental disorder by the American Psychiatric Association. Its status as a disorder gave legitimacy to subject individuals ‘afflicted’ with this ‘disorder’ to psychiatric treatment, often leading to detrimental effects (not to mention the pervasive social and legal discrimination they faced). Characterizing a given tendency as a disorder has the potential to bring about terrible harms and injustices. However, there are also cases in which pursuing various corrective measures seems crucial. Certain tendencies, such as schizophrenia, can be so disruptive to an individual’s life that treatment seems necessary. Labeling such a tendency as a ‘disorder’ potentially brings with it various societal and legal commitments to provide support that can substantially alter the lives of suffering individuals for the better. It is clear, then, that much hangs on how we come to characterize a mental tendency as a disorder.

In a recent article in Scientific American, authors Paul W. Andrews and J. Anderson Thomson, Jr. argue that depression should not be thought of as a disorder. Rather, it is an evolutionary adaptation that bestows various cognitive advantages alongside its familiar drawbacks. Among these advantages are an enhanced ability for analytical thought, for breaking up problems into more manageable components, and a greater capacity for solving social dilemmas.

While acknowledging these benefits is important, it is questionable whether the fact (if it is one) that depression is an adapted trait, should have any bearing on whether or not it is to be thought of as a disorder. If our criterion for mental health is an individual’s happiness, or reported well being, for example, it is unlikely that the depressed individual will serve as our poster child for metal order. Similarly, if our criterion is an individual’s capacity to contribute to, and enjoy the benefits of, his or her social environment, depression, again, seems to be a disorder. Finally, suppose we discovered that Parkinson’s disease was an evolutionary adaptation that also bestowed on individuals that had it an immunity to certain poisons prevalent in our ancestor’s environment (surely, an advantage). Would that supposed fact have any bearing on whether or not Parkinson’s should be considered a degenerative disorder? What reason might we have to establish our criteria for mental health, and for mental disorderliness, on such considerations from evolutionary psychology?

Given the substantial impact that a proper characterization of mental disorders has on the lives of so many individuals, much more care is needed in addressing it.

Related articles:

£1.99 - small Morality and Psychology
By Chrisoula Andreou, University of Utah
(Vol. 1, December 2006)
Philosophy Compass

Health and Disease
Dominic Murphy
A Companion to the Philosophy of Biology

Psychiatry and Mental Illness
George W. Brown
The Blackwell Dictionary of Modern Social Thought

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