Before we get into the intersection of mental illness and polyamory I want to take a look at a few facts about mental illness. This post is primarily written for the poly partners of people dealing with mental illness, but will be generally useful to anyone interested in the basics of mental illness.
What is Mental Illness?
Mental illness is defined by the Mayo Clinic as:
…disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.
If only it were that simple.
Mental disorder, the term used by the Diagnostic and Statistical Manual of Psychiatry and Psychology V (DSM-V), is a very broad category which has a bunch of very different issues lumped together. Everything from psychosis to major depressive disorder to autism can fall under the mental disorder umbrella. Basically, everything within the DSM is considered a mental disorder.
Within mental disorders are several very vague and ill-defined categories of which mental illness is one. Some sources use mental disorder and mental illness interchangeably, some have stopped using mental illness entirely, some separate mental illness from other categories of mental disorders, and some overlap mental illness with other categories of mental disorders.
This blog series will cover the following categories from the DSM-V:
- Schizophrenia spectrum and other psychotic disorders
- Bipolar and related disorders
- Depressive disorders
- Anxiety disorders
- Obsessive-compulsive and related disorders
- Trauma- and stressor-related disorders
- Dissociative disorders (formerly known as multiple personality and related disorders)
- Personality disorders (possibly)
After discussion, with other poly-folk who have experience with mental disorders, I will be covering developmental disorders (such as autism and ADD) in a separate series. A suggestion was made to include personality disorders with developmental disorders rather than with the mental illnesses covered here. I’m still debating the pros and cons of that division, and will update this section later.
Mental illness is usually diagnosed (when it is diagnosed at all) using either the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Statistical Classification of Diseases and Related Health Problems (ICD). I am more familiar with the DSM, so will largely be referencing that criteria. (Apologies to my international readers—I realize the DSM is largely a US system, but I feel it is better to stick with the system I know.)
Okay, but What is Mental Illness?
The dry facts of how mental illness is defined and the different disorders we’ll be covering don’t really help in understanding what mental illness is, do they?
Part of the problem is science doesn’t really understand what mental illness is either. The best I can give you is what one psych teacher told me once ten years ago.
Mental illness is a normal mental function that has grown to such an extreme it becomes life disrupting.
This same teacher asked the class a series of questions, all of them straight out of the “Do you have OCD?” playbook. Questions like:
- Who counts their steps?
- Who gets stressed if their underwear doesn’t match their outfit?
- Who can’t leave the house until they’ve turned the lock twice?
- Who avoids stepping on cracks in the sidewalk?
By the time he asked ten questions, everyone in that class had their hand up. And he told us to look around and gave us a minute to recognize that it wasn’t just any one of us, it was all of us. Then he explained: it’s normal. Just like feeling depressed sometimes is normal. And feeling manic sometimes. Like feeling anxious, or being self-absorbed or being a little bit paranoid.
If you haven’t had that occasional moment of walking home late at night and feeling like someone is following you, then you are the first person I’ve met who can say so. The difference between that feeling and what is commonly called paranoid schizophrenia is when you get home, the itch between your shoulder blades goes away and you can laugh it off. Schizophrenia takes that normal mental quirk and blows it completely out of proportion.
Take this with a grain of salt, but as I said it is the best explanation I’ve ever come across.
Mental illness is what happens when a normal mental process metastisizes. Tweet this!
How Common is Mental Illness
Exact numbers of people with mental illness are nearly impossible to nail down, in part because so many people with mental illness are not receiving the care or support they need, either due to lack of resources or stigma against mental health care. And of course in part because (see above) how mental illness is defined varies so widely, and what constitutes a mental illness (as opposed to a developmental disorder, a mental disorder, a personality disorder…) varies just as much.
The US National Mental Health Institute estimates that 18.6% of US adults suffer from some form of mental illness. The UK Mental Health Foundation estimates 1 in 4 people, or 25%, will experience some kind of mental health problem over the course of a year. Canada’s Mental Health Institute puts their estimate at 20% of Canadians experiencing mental illness during their lifetime. The World Health Organization doesn’t have easily accessible statistics on mental illness in adults, but says 20% of children and adolescents have “mental disorders or problems.”
In Anglo countries so far we’re hitting right around 1 in 5 people experience mental health problems at some point in their lives, and WHOs numbers seem to back that up. It is important to note that each of these studies used different criteria for determining what would be included, with the WHO study covering “mental disorders or problems” while the US or Canadian studies use “mental illness” (and how they define “mental illness” is unclear). The UK studies description includes the very vague “mental health problems.” Never mind the difference between “this year” and “in their lifetime.” It would take a professional statistician to evaluate these studies and see how they actually line up, but for our purposes 1 in 5 isn’t a bad approximation.
However, these numbers have to be considered low. A significant proportion of mental illness is either undiagnosed or untreated. A combination of stigma against mental illness and lack of available resources have left many people around the world struggling to deal with mental illness alone, often not knowing what they are struggling against. Some estimates put the lifetime prevalence of mental illness (percent of people who will experience mental illness during their lifetime) as high as 85%. My own experience definitely runs towards the high end of the estimates. It is rare for me to get to know a person well enough for them to open up about their mental health and not learn about one or more mental illnesses they have experienced throughout their lifetimes.
How is Mental Illness Treated?
Treatment for mental illness varies widely depending on where in the world you are, the disorder in question, and how severe the illness is.
Common treatments in Western medicine include:
- “Talk therapy”
- Cognitive behavioral therapy (CBT)
- the nicely vague “counseling”
- and others
Traditional Chinese Medicine(TCM) (and other Asian medical models) use:
- Other traditional treatments
I have heard of (unverified) treatments in some parts of Africa where the entire family is always treated together, “prescriptions” for time spent out of doors, dancing and singing, herbs, and other approaches. (Source: an old psych teacher who spent time with international treatment teams)
I am sure that other cultures have developed their own approach to treatment of mental illness, and I invite others to share their experiences in the comments.
The important (and scary) thing to realize is that treating mental illness is a numbers game. Western treatments have around a 50% success rate. Studies I have seen on TCM have similar numbers. Imagine going to a doctor and getting an antibiotic, “We think this will work, but we don’t really know. We just have to try it and see. If it doesn’t work, we’ll try something else. Sooner or later we’ll get it right.”
I think the most common response in the US and Europe would be “WTF? I didn’t volunteer to take part in a medical experiment, I want treatment!”
But this is what people with mental illness deal with every time they see a doctor. Stabbing in the dark, trying different treatments and hoping that this time, this one will actually work.
Mental Illness Is Out of Our Control
This is the most important this for poly partners to understand: we cannot just “get over” mental illness.
There is no magic wand, not positive thinking, no “Secret” to dealing with mental illness. In some cases, mental illness can be healed or cured, with a lot of time and/or a lot of work. In other cases, it can only be managed. And no matter what the case, someone with mental illness no more “decides” to get better or “push themselves through” than a diabetic can decide to not have diabetes.
Out of Control Doesn’t Mean Hopeless
The fact that we cannot control our mental illness does not mean that we cannot learn to manage it. Like a Type I diabetic taking insulin shots, we can do many things, some that are part of “accepted” treatments and some just the tricks and tips we have learned ourselves and pass on to each other. Finding the right system to manage mental illness takes time, patience, and a strong support system. It isn’t as easy as finding the right insulin dose (which ain’t all that easy either!), but it completely and totally possible. So hang in there, there is a light at the end of the tunnel (and it ain’t a train).
There is a Huge (Invisible) Community
Finding a depression support group is a royal bitch in a lot of places, finding people to talk with about depression is dead easy. Just open up about having depression, and sooner than you would believe possible, you’ll hear from someone “Yeah, I have depression too,” or “My sister had that,” “My husband is on (name your med of choice).”
We swap coping tips over the lunch table, share experiences on the back porch, and even support each other at the Chamber of Commerce, “I’ve been there too. It sucks. You can get through it.”
Having mental illness is like entering into this secret club. You think you are completely alone until you start talking about it, and then you learn that everyone around you is a member too, you just had to learn the secret handshake.
If you are learning to cope with mental illness, your own or a loved one’s, you can benefit a lot by tapping into this community.
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The DSM-5 has eliminated subtypes of schizophrenia. Someone who was previously diagnosed as “paranoid schizophrenic” would now be diagnosed as “schizophrenic” with delusional paranoia as one of the symptoms.