Wednesday, February 06, 2008

No, you really CAN'T relate

I should have educated some of my classmates tonight, and I didn't. We were reading a list of criteria for mental health and flourishing, which patterned itself on the DSM and included 'symptoms' like "has positive attitudes toward oneself and past life and concedes and accepts varied aspects of self (self-acceptance)" and "has warm, satisfying, trusting personal relationships and is capable of empathy and intimacy (positive relations with others)." There were 13 of these, and you had to manifest six of them at a high level to qualify for the diagnosis.

Obviously it's going to be really difficult for everyone to maintain all of these criteria all of the time. Conversely, people who are diagnosed with mental disorders also vary in levels of functioning, and don't always qualify 100% for their diagnoses. My clients never cease to amaze me with how well they function.

But one classmate took it a step further, opining that since none of us could be diagnosed with optimal functioning, it followed that we all could be diagnosed with some level of mental disorder. "When we were reading the criteria for Borderline Personality Disorder in my clinical practice class," she said, "all of us qualified for at least one of the symptoms at least some of the time. And during finals, aren't we all really depressed?"

Naive little thing that she is, she doesn't recognize the difference between saying, "I'm stressed out, I feel so depressed," and being clinically depressed. I'm willing to bet that she never lost or gained more than a quarter of her body weight during finals week.

I, on the other hand, shrunk to a skeleton during my first major depressive episode and bulked up considerably during subsequent episodes. I took a month's worth of medication and spent a week in a coma. I didn't shower or even brush my hair for weeks. On the flip side, while I was hypomanic I had sex with total strangers; launched a number of grievances/complaints against doctors, video stores, and anyone who got in my way and pissed me off; wrote a bunch of songs that I actually thought I could sell to record labels; bought 14 karaoke tapes and dozens of CDs; and got fired from more than one job. (Don't get me started on what people with borderline personality disorder have been known to do.)

That's the difference between the average person's experience of moderate distress and serious mental disorder. But I didn't think to say anything along those lines (not mentioning myself, of course). I just joked along and agreed with the other students. And now I feel like an idiot for missing an opportunity to really educate them.

Hopefully at some point during the semester I'll be able to get that point across.
Copyright (c) "Ayelet Survivor"

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