The Many Faces of Mental Illness

THE tragedy of mental illness takes many forms. It can be likened to an actor who wears various costumes or disguises, depending upon the character he portrays.

So much uncertainty exists about the condition that some widely known psychiatrists even claim that there is no such thing as mental “illness”! They feel it is merely a matter of ‘erratic behavior.’ But there is evidence that blood taken from schizophrenics and injected into sane persons can cause them to become temporarily insane, which would seem to refute this claim, as does the fact that the condition is often hereditary.

There are also some authorities who strongly object to using such words as “schizophrenia” and “manic depression” in describing mental illness. They say that use of these names, which have a terribly ominous meaning to many persons, only makes matters worse.

However, a patient and his family should not allow a diagnosis and a name given the illness to cause them to be frightened or to abandon hope. The fact is, mental illnesses are seldom precise insofar as the symptoms and cause of the disease are concerned. This makes diagnosis and treatment inexact and so there may be considerable disagreement among authorities. Actually there are differences of opinion as to which names should be applied to which conditions.

“Organic Illnesses”

It is a general practice to divide all mental illnesses into two classes, “organic” and “functional.” Among the many faces of organic illness are those present at childbirth or shortly thereafter, such as cerebral palsy, mongolism, cretinism and other forms of mental retardation.

Other organic illnesses make themselves felt late in life, such as senility with its varied mental aberrations, often characterized by childishness. Such mental conditions call to mind the words of Shakespeare about being ‘once a man but twice a child.’

Neuroses

In contrast with organic mental illnesses, there are functional mental illnesses, a common and mild form of which is a neurosis. Those suffering from it are termed “neurotic,” usually mistakenly implying that little if anything is really wrong with the individual.

A neurotic person is in touch with reality but is handicapped by a lack of confidence, or by mistrust and/​or by tension. A person suffering from a neurosis may be excessively anxious about his job, his family or his health. He may have exaggerated fears about people or places, such as being afraid to use an elevator. Among his symptoms may be compulsive eating, being edgy all the time, or having violent outbursts of temper at slight provocations. Generally he is aware of his problem but not of its cause, and does not seem to be able to control it.

You may think you can readily recognize a neurosis. But then again you might not, for neuroses have a way of disguising themselves. How is that? In that they often cause physical ills, because of the psychosomatic principle involved. So the sufferer may concentrate on the physical ailments instead of getting to the real cause. Neuroses may be evidenced physically in many forms, such as digestive disturbances, heart trouble, difficulty in breathing and skin rashes.

In contrast to the neurotic person, the psychotic or truly insane person has a more extreme problem. He actually loses touch with reality and reacts and responds in, grossly abnormal ways. Thus there is a common saying: “The neurotic builds castles in the clouds, the psychotic lives in these castles, and the psychiatrist collects the rent.”

Depression’s Face

While a measure of depression may be experienced by neurotic persons, psychotic depressive states usually go further, reflecting a more serious state of mental illness. Depression, of varied degrees, has been labeled “the leading mental illness in the United States.” The United Nations World Health Organization called it the world’s top health problem. The present decade has been termed “the age of melancholy,” because of its prevalence.

Associated with depression are feelings of loneliness and in particular the feelings of hopelessness and uselessness. This doubtless accounts for the great number of suicides among those afflicted, thirty-six times as many as among the population in general. Often persons suffering depression have extreme feelings of unworthiness or guilt. They may show little interest in food, clothing or members of the opposite sex. Such symptoms likewise often mark what is popularly termed a “nervous breakdown.”a Women are more likely to suffer from depression than are men.

In its more severe form this problem is termed “deep depression” or “depressive psychosis.” Many such affected persons alternate between times of excitement and activity and periods of deep depression​—this ‘up and down’ condition being called a “manic-depressive” state. It is these persons who are more likely to be assaultive and destructive. And yet such persons, when in their “manic state,” are at times highly creative.

The Schizophrenias

Among the most serious and widespread forms of mental illness is schizophrenia. It also has many faces, for which reason psychiatrists often refer to it in the plural form. Schizophrenia is the main cause of hospitalization, at least in the United States. It has well been said that, while heart disease causes the most deaths, schizophrenia causes the most heartaches.

About three out of every one hundred persons will be affected by some degree of schizophrenia sometime in their lives, primarily between the ages of sixteen and thirty. Rightly it is termed “one of the most disruptive and disabling of mankind’s afflictions” and “one of the most appalling of human experiences.”

Those suffering from any one of the schizophrenias often withdraw from social life and retreat into an inner fantasy world, even to the extent of experiencing hallucinations and/​or delusions. They have gross changes in the functioning of their senses, in their feelings and in their behavior. People and objects may take on strange appearances; food may taste peculiar; odors may become repulsive; sounds may become either unbearably loud or scarcely audible. Internally the person may suffer from depression, tension and fatigue. Among schizophrenia’s more serious forms are paranoia, that is, delusions of grandeur, a sense of hostility, fear of being persecuted, and so forth; also catatonia, a stupor characterized by inability to speak and/​or to move one’s limbs.

Generally those suffering from any one of the schizophrenias are more dangerous to themselves than to others. Thus one psychiatrist stated that in a neighborhood comprised entirely of schizophrenics, there would be far less violence than in the average neighborhood. But suicides among them are twenty times as frequent. It is estimated that one third recover spontaneously, one third remain as they are and one third worsen.

However, it should be observed that for most of his life the average schizophrenic is not actually insane. Thus schizophrenics have made and can make outstanding achievements.

Hyperactive and Autistic Children

Mental and emotional ills are also taking their toll among the very young. A modern malady affecting ever more children is hyperkinesis or hyperactivity. Such children want to be on the go constantly. They are very restless, troublesome and have a very brief attention span, ever jumping from one thing to another. Five percent of the children in America, or upward of one and a half million, mostly boys, are afflicted in this way.

To the opposite extreme are autistic children. Autism is defined as “a mental state marked by daydreaming and fantasy with a loss of interest in external reality.” It likewise is far more prevalent among boys than among girls, in fact, four times as much. Thirty years ago both the term and the condition were relatively unknown. But today recognized cases of autism are quite common. There are even societies for autistic children in America, Britain, Germany and Japan (noteworthily all highly industrialized countries where stress and pressures abound).

The foregoing describes only the more common or better known kinds of mental illness. Truly it has many faces, and there are varying degrees of severity to each, from very mild to extremely severe. Regardless of the name given, no two cases are exactly alike.

But why do some people develop mental illness while others do not? What are the underlying causes of mental illness?

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