MIND Reviews: What is Mental Illness?
December 31, 2010 ||
by Richard J. McNally. Belknap Press of Harvard University Press, 2011
When a breakup is one-sided, the rejected party’s behavior and mental state often change dramatically. A veil falls upon the world. Sleep becomes elusive. Food and sex are suddenly strangers to pleasure. Concentration dwindles to a rare resource. Intrusive memories and spiraling pessimism worm their way into every moment of consciousness.
These changes are an expected response to loss. Sometimes, however, they are also symptoms of major depression. In his new book, What Is Mental Illness?, experimental psychopathologist Richard J. McNally explores how to identify the line that separates an appropriate response to loss from a dysfunctional one. In other words, how do we distinguish mental distress from mental disorder? “There is a fuzzy boundary, but mental illness has properties that mental distress does not have,” McNally says.
Although McNally asks a direct and important question, he never gives a straightforward answer. Instead of clearly outlining exactly how mental illness and mental distress differ, he swims through eight chapters in which he tries to answer a series of new and daunting questions. For instance, the chapter “Are We Pathologizing Everyday Life?” asks whether we misdiagnose our reactions to stressful events, such as going through a breakup or getting a speeding ticket, as more grave than they actually are. And in the chapter “Is It in Our Genes?” McNally tries to parse out to what extent our biology dictates our mental health. When we arrive at the final chapter, “So What Is Mental Illness Anyway?” we can only conclude that the most succinct and accurate response is, “Well, it depends.”
In the end, that is actually McNally’s main point. Understanding mental illness requires context, and when making a diagnosis, we cannot simply tick off criteria on a checklist. We need to consider the symptoms and the causes as well as our biology, genes and culture.
If you are looking for definitive answers to complex questions, this is not the book for you. If you want to delve into the complexities of mental illness, however, then join McNally in grappling with some of the toughest issues facing psychology today.