How Normal is Abnormal?

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Just how common are mental health problems? According to researchers following more than a thousand New Zealanders for 35 years, they’re extremely common. By age 38, they say, 83% have had a diagnosable mental health condition at some point in their lives; in most cases, a mild depression, anxiety, or substance use disorder.

Also, they found that mental health was not associated with wealth, physical health or intelligence. They discovered certain temperamental aspects from childhood such as being more social, less emotionally reactive, and having higher levels of self-control can predict enduring mental health. It helps, as well, to not have family members with psychiatric conditions.

The research comes out of the ongoing Dunedin Multidisciplinary Health & Development Study which has followed volunteers since they were 3 years old. Every few years the folks at Dunedin meet with the subjects and their loved ones to ask them a million questions about their health, mental health, and development. Conclusions are limited by the fact that there are only a thousand, they are only New Zealanders, and they are a single age cohort that’s now approaching forty.

Does this mean that 83% of millennial New Zealanders are stark raving mad? Not by a long shot. Nor does it mean that all of our stigmas and assumptions of psychopathology are ill founded. I think it would be nice to say that, but I don’t think we can.

The problem is not with the study, but with the way people are likely to interpret the study. The problem, you see, is that our definition of mental illness has changed over the years. It used to be, a scant fifty years ago, that if you were officially mentally ill, it meant that you couldn’t take care of yourself, you lost your freedom, and you were committed to a horrible mental institution for, sometimes, decades. That’s how our grandparents experienced mental illness; so when your meemaw can’t understand why you see a shrink, that’s what she’s thinking. Under those conditions and with that outcome, you, too, might avoid admitting you had a problem. You’d stay away from shrinks and deal with things yourself.

Today, mental illness does not mean that. Effective unintrusive care is relatively accessible. If you can stay out of jail, you can continue to be with your family and have a productive, if not totally satisfying life, despite a mental illness. There are some things that we no longer label as a mental illness: homosexuality, for one; but others we do: tobacco use disorder comes to mind. But the biggest change is that we now include milder versions of the old standbys: depression, anxiety, bipolar, and the addictions; so that you don’t have to lose all your ability to function to receive a diagnosis.

This, I think is a good thing. Younger people don’t have to be afraid to admit they’re having some problems, compared to their grandparents’ generation, so they can get help sooner and not have to suffer so much. But, it’s a confusing thing when terminology no longer means what it used to mean.

So, it’s still normal to be normal; but normal can mean you have a few things that are a little off.

Click here to read the research.