Is mental illness real?

When people ask whether mental illness is real or not, my suspicion is that they really mean: does mental illness have a physical, material cause, in the same way as cancer or a broken leg? Can it be tested for, diagnosed and treated with the same certainty as a physical disease? Whatever the answer to that question, it should cast no doubts or aspersions on the very real suffering of people with mental health problems.

When we think of mental illness, we tend to think of categories such as schizophrenia, bipolar affective disorder, depression and anxiety. These categories cannot be verified with objective tests, in the way as, say, cancer or diabetes can. Neither do they tend to stand up to scientific scrutiny as distinct constructs. For people with a diagnosis of schizophrenia, there is no specific treatment or predictable outcome. To take another example, most people with a diagnosis of depression have symptoms of anxiety, and vice versa.

Framing problems as being part of distinct disorders is a powerful thing to do, and loads of the categories that reach our diagnostic bibles appear relatively new, historically. Many can be traced back to the pharmaceutical industry, which has a direct interest in shaping behaviours and emotions into various symptoms, to be sold back to consumers as disorders requiring medication. This has led people to argue that these categories do not represent real illnesses.

Such arguments can come across as diminishing the lived experience of mental anguish, its embodiment, and the potential role of medication. Some mental health problems are less contested than others, and medication does save lives.

Full article with lots of links: Guardian

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