What does ‘Mental Illness’ mean? (Fun with Statistics).

In a random population sample between 5 to 6% of adult women and men experienced suicidal ideation. That’s a fairly hefty chunk of the general population considering that the prevalence of mood disorders stands at about 7.1%. Interestingly enough not all of those with suicidal ideation have a mood disorder: If you eliminated mood disorders you’d reduce suicidal ideation by 46.9%. So, that tells us that a fairly significant proportion of the population who experience a significant degree of suicidal ideation don’t come under any of the categories we currently use to quantify mood disorders. Why? It also says that there’s a large number of people with mood disorders who don’t experience suicidal ideation (not a big surprise there though).

That’s a pretty big gap there. A fairly large amount of people in the general community don’t fit into the neat little boxes we use to classify mental health issues. Instead they form a group for whom mental anguish is a part of their daily lives, often enough to have them contemplating getting off the highway a few exits early but who are for all intents and purposes ‘well’.

I’m then led to ask:

Is clinically significant suicidal ideation always a symptom of illness? Apparently not, according to the statistics. ‘Lies, damn lies and statistics’ or is something more complicated going on here?

A few percent of the population with suicidal thoughts who are just peachy? Seems unlikely. I mean, schizophrenia is thought of as a huge problem but its prevalence is 1%, almost universally. So in that light those few percent seem like they should fit into our mental health schematics somewhere, or at least our calculations.

Suicidal ideation can occur without the presence of a mood disorder, of course. However, its prevalence across quite a large section of the general population who aren’t ill seems to imply that we should be paying a bit more attention to what exactly we mean when we say someone has a mood disorder or is mentally ill.

I’m not advocating we create more ’sick’ people but that we recognise that our definitions of who is and who isn’t ’sick’ aren’t always based strictly in the facts of daily life, or indeed much at all in quotidian existence. Just because you think in a different way doesn’t make you mentally ill, just as simply owning a gun doesn’t necessarily mean you support the gun lobby. But if a few percent of the population who often think about killing themselves are just ‘fine’ according to the best diagnostic techniques we have available then maybe, just maybe we need to think about what it means to be mentally ill a little harder?

Having a mental illness isn’t about any one sign: it isn’t wanting to die, it isn’t addiction or a slump or grief, and it isn’t even a consistent pattern of any one particular cognitive or behavioural symptom. No, what we are talking about when we talk about mental illness is a dynamic, organic structure that’s the outcome of a state of extreme flux in someone’s emotional existence. Their mental systems have overloaded. It isn’t any one thought or deed or symptom or even a few of these but the cumulative, combined total of a range of general indicators that makes one person ’sick’ and another ‘well’. We’re talking about human systems, which are always about our innate capacities – that we are more than the sum of our parts, even when parts break down. If I have faith in anything it’s that.

Mental illness, just so you know, isn’t the result of weakness or lack, or even aberrant behaviour or thoughts. Pretty clearly a fairly large proportion of the general population experiences severe ’symptoms’ of mental illness (suicidal thoughts) without actually being mentally ill. So that tells us that mood disorders like depression and bipolar disorder are not just an excuse, they’re not a smoke screen for lazy or hopelessly incorrigible losers, they’re not the last refuge of the desperate and disdained but the consequence of the complexity that is being human. Emotions are very much about more than what meets the eye, and so, therefore, are emotional disorders.