Growing up, everyone tells you to dare to be different. Being different is good — it makes us unique, gives us personality, flair, style. But pair this with “dysfunction” as defined by some clipboard-wielding doctor clad in the quintessential white lab coat and your deviation from the norm is labeled a “disorder.” Suddenly, we all seem to be skating on thin ice.
According to the DSM-5, a mental disorder is a “syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning.” The manual goes on to state that “an expectable or culturally approved response to a common stressor or loss … is not a mental disorder” (emphasis mine). But who decides what responses are “expectable” or “culturally approved”? Doesn’t this imply that someone in the U.S. diagnosed with a mental disorder could, theoretically, move to a different society with vastly different cultural norms and there be considered perfectly healthy?
We tend to think of medicine as, well, clinical: hard science, filled with latex gloves, lab coats, and strange smells, designed to produce real answers and tangible results — solutions that would not change depending on the doctor or specialist. But when it comes to mental health, there is only this vague “dysfunction” to separate eccentric yet “healthy” members of our society and those who are “disordered.” Once you remember that the therapists who diagnose these “dysfunctions” are themselves steeped in our cultural norms, it starts to seem like a rigged game.
So where do we draw the line? How do we avoid diagnosing people simply because we fear difference, and they happen to deviate from the norm? Surely there are cases in which dysfunction results solely from perceived negativity toward those who are different.
I have at times been overwhelmed with social anxiety — the fear that everyone, everywhere, is judging me for the worse. Eventually, I started seeing a therapist, who decided I had an adjustment disorder, which is defined as an emotional or behavioral response to a stressor. But what stressor, you may ask? Something quite simple: I was worried that others would see my social anxiety and how I acted differently because of it, and that they would judge me for it.
What if we recognized that some students genuinely don’t like speaking up in class unprepared? What if being shy were acceptable? I certainly wouldn’t have stressed over my anxiety, avoiding my development of a “dysfunction” and a (somewhat abrupt) diagnosis. But society as a whole does not understand this; indeed, we are hypocritical about outliers. There are plenty of negative affect disorders, but never any “happiness disorders” — despite Richard Bentall’s satirical paper about how happiness actually meets the criteria of a mental disorder.
Why do we ignore this? For the same reason that society accepts the genius miser yet shuts out the innocent child with Down syndrome: genius and happiness are seen as beneficial. In other words, our irrational society makes value judgments about emotions and personality traits. We humans have yet to realize that variation works both ways.
I think it’s time we re-evaluate our definition of mental disorder. Call me unrealistic, but we should live up to our childhood ideal of uniqueness by accepting the unexpected in others instead of questioning why it exists and trying to tear it down.
Margaret Hansen is a rising senior in the College. Disorderly Conduct appears every other Friday.