Defining Mental Disorders

By Swami Dr Snehananda Jyoti on 28-10-2010

What is mental
health? What is mental illness? What is normality? What is abnormality? What
are normal and abnormal behaviors? These are questions that are not settled;
they lend to debates and heated discussions in academic circles. Theoretical
formulations related to the etiology (origin) of diseases depend on the various
schools of psychology one follows or advocates. Etiology and epidemiology
(spread and control of diseases in a given society) go hand in hand. Variables
such as culture, social class, evolving societal norms, mores, habits, and
customs also figure much in the determination of mental disorders. What is normal
in one culture may not be so in another culture. For instance, burping or
belching especially after a meal may be a sign of contentment or satisfaction
and may be acceptable or tolerated in one culture; but the same behavior may be
considered to be rude and socially unacceptable especially in western
countries. Similarly, washing one’s mouth or gargling with clearing one’s nasal
and throat cavities with all the accompanying unappetitive, obnoxious noises in
the public that is not uncommon after a meal in Kerala societies may be rightly
confined only to toilet rooms in other cultures.  The trend or evolving normative behaviors may
be patterned on the most influential persons in society, be they entertainers,
sports heroes, singers, writers, politicians, beauty queens, wealthy, and the
powerful. What is normal at one period of history may be abnormal at another
period. For instance, certain terms used to address certain castes in earlier
years in Kerala (India) would be considered to be offensive at the present
time. The same is true of certain jokes or sayings. For instance, one of the
carpenters in our construction setting used a proverb that is connected with
another caste and is offensive was used to indicate his uncertainty on the
following day. His conversation unwittingly happened to be in the presence of
that other caste lady.  I had to
personally intervene to diffuse the crisis and tell the offending party not to
use such offensive, stereotypical sayings that could demean a whole section of
a society. Again, before the civil rights era in the 1960’s in the United
States of America, the black race would be generally called Negroes; now the
term negrowould be considered tobe
offensive; they would like to be called African Americans. Normality quite often
is useful only as a statistical concept in research that can describe or
quantify a certain characteristic or variable in a given population.

           In
some primitive societies persons with psychotic disorders (major mental
problems) would be considered to possess certain unusual or divine powers or
abilities. And as such they could be treated with special deference.
Homosexuality that was considered a mental disorder in an earlier era (in
DSM–II: Diagnostic and Statistical Manual of Mental Disorders–II) is no longer
considered to be so (in DSM-IV). With rapid progress in affluence and
westernization eating disorders, for example, characterized by severe
disturbance in eating behavior are raising their ugly heads in India. More
specifically, Anorexia Nervosa and Bulimia Nervosa, the two most common eating
disorders (diseases), more commonly seen in women, related to maintaining a
minimum body weight in one case and preventing weight gain through binge eating
and compensatory methods such as vomiting and purging in the other seen in the
west have started manifesting themselves in the affluent sections of India.
Indian culture in general, for instance, is more tolerant of mental disorders
than the USA culture. Ingestion of psychotomimetic (inducing psychotic behavior
and personality) drugs can also alter one’s mind and generate psychotic
symptoms while under the influence of those substances.   A psychotic (someone who is out of touch
with reality) person creating nuisance in public might be more likely picked up
and committed to a mental hospital in the USA than in India. What does all this
mean? Understanding and diagnosing mental disorders are very complex and
multi-dimensional. A certain amount of arbitrariness and tentativeness is
inevitable. A provisional diagnosis before all the data are in, especially in
difficult cases, makes good sense.  Many
disorders may share similar symptoms. So focus may have to be on syndromes
(clusters of symptoms). Many variables need to be taken into account before
understanding, classifying, and diagnosing mental disorders. In my next article
I plan to deal with some important models of psychopathology (the study/science
of mental disorders).

About The Author

Swami Dr Snehananda Jyoti

Dr. John K Thekkedam (Swami Snehananda Jyoti) spent most of his life as a clinical psychologist in USA. He began his public life as a Jesuit priest. Quite attracted in distinct philosophies, he left the society and founded 'East West Awakening'.