What is a diagnosis of ‘mental illness?’
The quick and essentially correct answer, is the meeting of criteria for an illness is the DSM V. In addition, mental health professionals can make ‘educated guesses’ based on firsthand experience with a client.
We have murky statistics that indicate what percentage of the American public are afflicted with this and that but many people, including myself, believe the percentages are not only shots in the dark, but probably low, at least for some conditions.
And the tricky part is some conditions are co-morbid, that is, a given person has more than one diagnosis. And some are mis-diagnosed – how many people with Borderline Personality Disorder were originally diagnosed with bipolar 2? A lot.
Then there is another category that I believe will forever be unknowable: those who exhibit traits of various mental illnesses but will never seek help for them. I’m not just talking about narcissists and others who believe they are ‘just fine,’ but a whole group of people who are suffering under various conditions, none of which, in their mind, rise to the level they would feel warrant getting help.
This also includes those who suspect they have a problem but for reasons of stigma, will keep it secret, fearing employment or relationship issues.
I thought about this while reading an article that recently appeared in the Stanford Graduate School of Business: “The Workplace Is Killing People and Nobody Cares.” Jeffrey Pfeffer, a professor of organizational behavior at Stanford Graduate School of Business, recently wrote a book, Dying for a Paycheck, published by HarperBusiness and released on March 20. Also: here on Amazon.
The gist is simple: the book ‘maps a range of ills in the modern workplace — from the disappearance of good health insurance to the psychological effects of long hours and work-family conflict — and how these are killing people.’
How is this happening? Pfeffer: “. . . there is a tremendous amount of epidemiological literature that suggests that diabetes, cardiovascular disease and metabolic syndrome — and many health-relevant individual behaviors such as overeating and underexercising and drug and alcohol abuse — come from stress. And third, there is a large amount of data that suggests the biggest source of stress is the workplace.”
The problem illustrated by Pfeffer: “And we are influenced by what we see our peers doing. I’ve had people say to me: ‘I look around and all my colleagues are working themselves to death. What makes me think I’m so special that I don’t have to?’ We have come to normalize the unacceptable. It’s hideous.”
The solution? There isn’t one. Again, from Pfeffer’s interview, when asked if people would turn against a system the way they forced companies to stop polluting the environment: “I cannot see that happening with respect to the workplace in the current political environment and the push for deregulation. And, for reasons I’ve already alluded to, I think people don’t necessarily see, recognize, or appreciate what’s going on in the workplace. To the extent that they do, they think it’s inevitable — everyone has to be working long hours and be miserable.”
Pfeffer believes that, maybe, lawsuits may force businesses’ hand for compelling people to work themselves to death, but as a former teacher of mine was fond of saying: figure the odds.
The workplace is now the fifth leading cause of death in America.
There are those with diagnosed mental conditions that cannot handle the stress of the modern workplace and some of them are fortunate enough to get disability before they die or kill themselves. Others, driven by fear of landing up in the street, develop the conditions that result from stress (such as Generalized Anxiety Disorder) but keep it to themselves as they march on the workplace treadmill of misery.
Of course, it doesn’t have to be this way as evidenced by several European countries that mandate a humane work-life balance. Of course, here that would be seen as socialism and a threat to profits. The system, rapacious and predatory, looking for ever more profit, eats people up and spits them out – both management and rank and file.
To be an American, it’s apparently our lot in life.
What strikes me as interesting is that the person in the cubicle next to you may have a bona fide mental illness that is slowly destroying their family, their peace of mind and perhaps their will to live and you will never know it until it is too late. So many suicides are greeted with genuine surprise: ‘we had no idea; so and so seemed so happy. They had everything (material) going for them.’
Everything except the one thing money can’t buy – peace of mind and spirit.
I do believe in many cases people send up signal flares of distress that are overlooked because, well, a LOT of people are sending up these same flares: calling in sick often, substance abuse, taking work home — that they don’t seem like problems.
I believe that not just the workplace, but the whole set of cultural values we toil under: rampant consumerism and the envy manufactured by advertising that goes with it, a win at all costs mentality where Little League fathers get into fistfights at games, the worship of youth and body image, and so on and so on, also degrade us. Little by little, these factors of our culture chip away at whatever strong self-image we may have inherited from decent parenting.
Throw in the stigma against admitting one needs help and you have a recipe for a society in deep trouble. Basically, we have everything we could ever want dangled in front of us, but we pay a very steep price to play with our toys.
My takeaway from this: not government, business, nor the mental health industry will save us. What I have come to realize is the extent to which we are really on our own (rugged individualism anyone?). The only triage we can perform is on ourselves and for each other. Much of what the mental health industry calls ‘self-care’ is impossible for people on the treadmill. If you’re lucky, you might spend a week at the beach counting every day before you have to go back ‘there,’ or worse: working on vacation. The thing that we have to do is value ourselves enough to separate as much as we can, from the rat race. That might mean living a more modest lifestyle, it could mean a lot of things.
But the last and most important thing we must do is break the mold of strong, silent individualism and reach out to help each other however we can, for only we will be able to save each other. This, of course, means stepping out of a comfort zone prison that has been created for us and find a way to talk to those we suspect need. . . a friend — something as simple as having a friend can make a world of difference to a struggling person.
I hate cheap, corny ‘solutions’ that commonly are offered at the end of essays like this. There are some issues that are truly insoluble. But on a micro level we can ameliorate the symptoms with each other – a bottom up approach.
I’ll close with a quote from one of the organizers of Woodstock (the original one) who looked over the vast throng of people in the rain and said into his microphone “if we’re going to get through this, you’re going to have to remember that the people sitting next to you are your brothers and sisters.”
As the man sang:
Carries saints and sinners
Carries losers and winners
Carries whores and gamblers
Carries lost souls
I said this train…
Dreams will not be thwarted
Faith will be rewarded
Hear the steel wheels singin’
Bells of freedom ringin’
(Bruce Springsteen, Land of Hope and Dreams)