[izzydata]

Aren't most mental disorders just behaviors that differ from the norm and make it difficult for those people to function in everyday society? Some cultures wouldn't recognize some things as a disorder if it wasn't difficult for those people.

My point being that I don't understand where you draw the line. If someone had such a need to wander the world that it meant that they couldn't live properly in modern society then it seems as much of a mental disorder than most others.

[DoreenMichele]

Labeling someone "crazy" is often a convenient means to assume there is nothing wrong with the world. It's normal. People who have an issue with it are simply disordered.

The article even lists an actual diagnosis invented to call runaway slaves crazy:

In the United States, physician and noted racist Samuel A. Cartwright invented a related mental disorder called drapetomania, the urge that led slaves to run away. He claimed the only treatment was extreme whipping.

That example seems farcical, but, to this day, most homeless people are written off as crazy and therefore unhelpable due to a random and unfixable personal defect. I'm routinely told on HN that the crazy high cost of housing has nothing at all to do with homelessness.

Women have historically been labeled "hysterical" and there is a long tradition of prescribing women Valium when a divorce might have been a better prescription in some sense. Though, really, societal sexism was likely the larger issue that helped make the marriage so bad to begin with and divorce such an undesirable choice that Valium seemed to make more sense.

[acct1771]

Is this a gender thing, or should we just not have benefits/health coverage held over our heads in marriages and jobs?

Seems they both really cut down on mobility and freewill. For marriage, I get the State's motive, the "entice people to build a family unit" idea, but that's clearly not happening anymore.

[maxheadroom]

>Aren't most mental disorders just behaviors that differ from the norm and make it difficult for those people to function in everyday society?

(Story time.) I went to a presentation one time at work about mental health. (It was part of the government's mental health awareness campaign[0].) In this presentation, the presenter mentioned bathing/lack of changing clothes as a marker for possible mental health issues.

As someone who grew up in a very poor area, where the water came from wells (which oft could dry-up) or the folk couldn't afford but to wash their clothes once a month in the local washateria (if that), I took issue with this idea.

From a privileged, lower-middle class or above perspective, sure, you could say that it's a possible indicator of mental health issues; however, if this were a normalised version of someone's life, having growing up so poor/destitute, would it really be a sign of mental health issues or would it just be a byproduct of their lower social-class life?

So, I guess I have to say that the answer to your question is, "yes": Your "norm" could be vastly different from someone else's.

[0] - https://www.mentalhealthireland.ie/

[penagwin]

I think the real qualifier is if lack of self-care is due to personal choice then environmental resources.

You don't have clean water to regularly wash clothes/yourself? That's not a personal choice (in this instance).

If you DO have clean water and aren't taking care of your basic hygene, then there's an issue. If asked "why" and the answer is "no point" then that's a pretty clear sign of depression. "I don't know how to use my washer" would likely be an indicator of anxiety (because a "mentally fit" person should be able to figure it out, or seek help with figuring it out), etc.

[jackbravo]

But people tend to get used to the environments they grow in. So if you had low access to water, you end up learning to shower only once in a while, and you take it as something natural. Like the cliche (racist cliche?) of people in America complaining about people from Europe or Asia having a more apparent body odor. This also reminds me of the movie (or books) Dune. Where people from Arrakis are used to drinking very little water, and deem people from other planets as "fat on water" because they can even smell their "excess" off water on their bodies, and see it as a sign of wastefulness.

[programbreeding]

I think you have a totally valid point/concern, but that logic could be applied to nearly everything. For example, anorexia is a marker for possible mental health issues, but someone who doesn't eat because they can't afford it doesn't have anorexia.

I think it's assumed that a diagnosis/marker is valid only to that particular person based on their background.

[anjc]

Access to water in Ireland is assumed to such an extent that it isn't even listed in the ESRI's criteria for poverty. As such, it's very obvious that lack of bathing/changing clothes will almost NEVER be due to lack of access to water. Even temporary halting sites must have access to water considered by local councils.

> From a privileged, lower-middle class or above perspective

Very confused as to why you think 'water' might be limited to the demographic who work as teachers, Gardaí, and above, or why access to water indicates privilege.

[jackbravo]

In Mexico it is more common to have water shortages on low income areas in big cities. Whereas rich areas can even have their own water wells.

[tom_]

Right, but this post refers to the Republic of Ireland, a sovereign state in the British Isles, a part of the world where there is, on average, zero shortage of water in general. It literally falls out of the sky.

[maxheadroom]

Because Ireland has no immigration and, therefore, everyone who lives and/or posts from Ireland is automatically Irish, yeah? /s

[maxheadroom]

Intsead of assuming an amicable posit, say that I were an immigrant (hint: I am) or the like, you - instead - opt for the worst: That I must've come from the land of Eire and that I must, therefore, be talking out of my arse - because the ESRI doesn't constitute access to water as criteria for poverty and because we could only be talking about someone who grew-up and lived in Ireland their whole life, yeah?

So, pardon me for asking this question but does this not demonstrate the myopic view that the aforementioned privelege entails? In other words, just because you (as an overall whole) had this kind of access (e.g.: water, socialised medicine, etc.) your entire life, it doesn't equate to everyone having had the same, yeah?

[Dylan16807]

Assuming that a guide in Ireland is mostly for people born in Ireland isn't privilege. It is myopic, but that doesn't make it wrong. It's a searching tool, not expected to be perfect, and impossible to make perfect; no matter what someone is doing, there could always be some healthy reason.

It's not about just you.

[fit2rule]

>would it really be a sign of mental health issues or would it just be a byproduct of their lower social-class life?

Indeed, I think you've hit on a modern malady - the belief that modern society is no longer engaged in class warfare, and that psychological 'ordering' of society is no longer aligned on those boundaries which benefit the ruling class.

Because, in fact: that belief would be wrong.

[asveikau]

What you should watch for is not the habits themselves, but sudden changes in such habits. Some conditions like bipolar, schizophrenia, schizoaffective, etc. can be episodic, and see abrupt changes in things like hygiene during these transitions.

[LyndsySimon]

Fair enough.

I'd modify that statement to read "behaviors that differ from _their_ norm". If someone suddenly changes their behavior without apparent cause, I'd consider that to be an indicator of something being amiss.

Of course I'm not a doctor, much less a psychiatrist.

[eeZah7Ux]

"marker for possible ..." != "clear evidence"

[whatshisface]

>Some cultures wouldn't recognize some things as a disorder if it wasn't difficult for those people.

There are a few mental disorders like that, but it's important to bear in mind that most of them (major depression, mid to low functioning autism, anxiety, schizophrenia, and so on) lead to objectively reduced functioning independent of society and a lot of suffering in whoever has them. It's not something to be romanticized.

[Nasrudith]

There is also the converse - what is accepted as "normal" or even praised as a virtue is harmful and destructive.

To give real examples smoking was normal, as was pedestray and ironically the Roman gladiatoral combat which is considered peak decadence was intended to combat decadence!

Normal is a pretty shitty heuristic for being good.

[admax88q]

> Normal is a pretty shitty heuristic for being good.

A few counter examples doesn't mean that the heuristic is bad. Heuristics will always have counter examples, that's why they're heuristics, not rules.

[shkkmo]

I would argue that inherent discrimination against minority traits is what makes that heuristic bad.

Given a single counter example, the burden of proof should be on the users of the heuristic to show why the use of that heuristic is an improvement over the alternatives (which have no counter examples).

[50656E6973]

How many counter examples do you need before determining if a heuristic is bad, in your opinion?

[SirLuxuryYacht]

IMO, probably when the counterexamples outnumber the examples by which the heuristic is defined.

[coldtea]

And maybe even not then: the negatives from the counterexamples should also outweigh the positives from the heuristic.

If a heuristic has 100 majorly good applications, and 1000s of counter-examples of minor or no real consequence, it will still be good to use...

[jeroenhd]

I don't see how Roman gladiatorial combat is so different from modern sports. The only major difference is the fact that nearly all gladiators were slaves, but otherwise I see no difference between gladiators and UFC fighting tournaments (or for that matter, American football).

I just don't see the peak decadence point.

[coldtea]

>I don't see how Roman gladiatorial combat is so different from modern sports. The only major difference is the fact that nearly all gladiators were slaves

How about modern sports aren't "to death"?

[tk75x]

Only a small fraction of gladiatorial combat was to the death. Gladiators were expensive to acquire, train, and maintain so their masters didn't prefer them to be killed.

[notahacker]

Whatever you think about the risks and violence of modern combat sport, they don't use the certainty of somne of the combatants dying and/or the involvement of the crowd in determining whether they had fought well enough to be permitted to live after defeat as marketing strategies...

[Nasrudith]

Well let me know when sports stars sack a city and lead to massive damages and people still decide to keep on doing it that way. (Third Servile war - although slavery was involved.)

Although often well paid gladiators often were slaves which brings up the next big difference - consent!

[balfirevic]

> I don't see how Roman gladiatorial combat is so different from modern sports.

If someone were to properly incentivize you (say, by offering to give you $10000 or whatever) I bet you would be able to come up with few more very important differences.

[Dylan16807]

"You'd change your opinion on a trivial matter if I paid you a giant pile of money" is a very strange way to argue a point...

[thaumasiotes]

> what is accepted as "normal" or even praised as a virtue is harmful and destructive.

> To give real examples smoking was normal, as was pedestray

From an objective perspective, in what way was classical pederasty "harmful and destructive"? What was the harm and destruction that resulted?

[watwut]

They were society in which violence had completely different meaning. Just like slave holding was something normal in other societies. ISIS was stoning and beheading people just few months ago.

These are differences in moral values that have nothing to do with mental health.

[coldtea]

>Just like slave holding was something normal in other societies.

Well, until the 1860s in the US too. And until the '70s, open segregation.

[LifeLiverTransp]

Almost like biological determined scoutships for a group, arent they?

Imagine a bunch of hunte/gatherers, who just entered a new continent (like north-america)- having those loonies orbiting the group, reporting new ressources, scouting ahead- sounds well adapted.

[chubot]

Yeah I agree with this. I thought I read that scientists claim there's no such thing as "group selection" in evolution, i.e. where one individual in a group will do something bad for himself but good for the group (reproductively speaking).

Yeah it looks like wikipedia has a page on this controversy:

https://en.wikipedia.org/wiki/Group_selection

Richard Dawkins apparently doesn't believe in it, and neither does Steven Pinker.

But just based on casual observation I think group selection is real (yes I know that's not scientific). Humans are like ants in many ways... some of us are "programmed" to perform specific roles.

[jadyoyster]

Don't ants in a colony all share the same genes and have the queen do all reproducing? (From the sperm of a single male possibly? I'm not super familiar.)

[chubot]

Yeah I'm not sure. I think ants are an extreme case, but I do think groups of humans have similar sorts of "mechanisms".

The book Sapiens repeats this over and over and I tend to agree. Religion, government, corporations, etc. are ways in which we cooperate with thousands or millions of others. We don't have to have the exact same genome, and it's not perfect cooperation, but there's something there.

[koverstreet]

If group selection wasn't a thing, multicellular organisms wouldn't exist.

[sevensor]

In the case of dromomania's "patient zero", his wanderlust appears to have resulted from traumatic brain injury. I don't think this squares with your theory.

[izzydata]

Would you happen to know if there is some classification difference between a mental disorder that may involve some kind of chemical imbalance and a personality disorder which would be more like having a personality that makes daily life difficult? I feel like they get lumped together, but maybe I'm just ignorant about how these terms are used.

[whatshisface]

Here is a link describing the categories. They are divided up into AMI (any mental illness) and SMI (serious mental illness). Illnesses categorized in AMI may even involve no impariment, those are probably what people are referring to when they talk about fresh air and a walk being the best medicine.

https://www.nimh.nih.gov/health/statistics/mental-illness.sh...

[coldtea]

There's no "chemical imbalance" per se. People can and do have "serious mental issue" with no specific chemical markers to tell...

It's mostly a marketing slogan for drugs, and a gross over-simplification.

[DanBC]

> that may involve some kind of chemical imbalance

This mostly doesn't exist.

> a personality disorder which would be more like having a personality that makes daily life difficult?

Go careful with that. People with the dx have usually been harmed by early childhood abuse (although there's some difference between UK and US diagnosing) and many people with the dx feel it's an entirely unhelpful construct.

[50656E6973]

The "chemical imbalance" theory is a Big Pharma marketing slogan, not a real scientific fact.

[johnchristopher]

> My point being that I don't understand where you draw the line.

The line is drawn once it becomes dangerous for people around the person, or the person itself, or when the person is suffering from that condition (and not just "society misunderstanding him").

For instance, I have been the focus/target of a schizophrenic person whose condition was abruptly worsening at the time. He became a danger to me and my significant other (we are talking physical threats, punching walls, etc.). It escalated with him going to the police to file a complaint against me and two other parties for computer fraud which I only learned 6 months after he had gotten out of my life.

So, that's why mental disorders aren't just "behaviors that differ from the norm". I wish it were just cushy misadaptations but it's not.

[50656E6973]

Nothing you described was indicative of that person having a "mental illness" so much as exhibiting anti-social behavior.

[johnchristopher]

> Nothing you described was indicative of that person having a "mental illness" so much as exhibiting anti-social behavior.

I know this is the internet and for all you know I could be a dog but this is HN and I assume that if I say that person suffered from schizophrenia you know I am not saying that lightly.

Now what more do you want ? A transcript of the conversation between his mother and the department director where she explained his meds were off and they had been waiting for their psychiatrist to adjust the dosage - if that was possible, because she was contemplating to temporary force him to get into a psychiatric hospital ? A YouTube video of how he told me the friction between us was from the bad energy coming from electrical outlets and that the Koreans had taken advantage of him while he was sleeping to replace his heart with a nuclear missile so that we would fight but now it's okay because we are on the same side ? A testimony of another party about the damage he did to a wall with his fist while holding him close to his other fist and screaming "your pal was this close to get it" ? An audio copy of the message I left on my SO voicemail telling her that during the interview at a police station for an IT position they asked me what those fraud computer charges were about (yeah, nice way to find out...) ? A screenshot of the newspaper I was reading on my laptop at that time, it had a picture of something that reminded him of his sister or her wedding and he concluded I had hacked his computer or his sister's computer to get those photos ?

A written note from his doctor ? A wikipedia entry to cancel <citation needed> card ? Bordel.

Now, don't get me wrong. Schizophrenia doesn't define these people. They are human beings, I value them as much as the next one. But with a bad diagnostic and treatment or during a crisis ? They can get hard to relate with.

On a personal note: it's a bit worse for me since I tend to consider myself a good listener and too much empathic for my own good. It doesn't mix well with people in that state. But you'll get no data points for that.

[50656E6973]

That's much more indicative.

>if I say that person suffered from schizophrenia you know I am not saying that lightly.

Unfortunately, it is very common (even on HN) for people to toss around labels like "crazy", "nutjob", and "schizo" against people they disagree with because it exempts oneself from the burden of empathizing, introspecting, and thinking deeper.

[watwut]

That person was supposed to be schizofrenic which makes me assume there was diagnozes. The rest of anti-social behavior he describes is behavior schizofrenic have when their condition is bad. The impact on those around them is very real.

[coldtea]

At the extremes, the two are not really different categories of things. It's not like a sociopath is just an emo teen...

[DanBC]

> make it difficult for those people to function in everyday society?

They normally add in "and causes the person distress".

[jdietrich]

The standard formulation in the DSM stipulates that symptoms should cause "clinically significant distress or impairment in social, occupational, or other important areas of functioning". About half of the listed disorders contain this clinical significance stipulation. Given the inherently subjective nature of psychiatric diagnostic criteria, the authors of the DSM have gone to a reasonable effort to avoid pathologising healthy eccentricity.

[shin_lao]

It's not just about making it hard to function in society, it's also preventing these people from achieving their goals and being happy (whatever happy is for them).

Usually you can spot a personality disorder objectively if the person has no continuity of any kind in her life: relationships, career, personal achievements...

In the case of wanderlust, it can be an unhealthy coping mechanism: "Something is wrong, I will ignore the problem and travel away".

I have healthy and unhealthy examples of wanderlust in my friends.

One healthy example is a couple of friends traveling together to find out where they would like to settle down and live (there is a goal, the motivation is positive).

One unhealthy example I have is a friend traveling randomly because she doesn't know what to do with her life. When I asked her about her latest travel she couldn't tell me much except "it was great". (no tangible goal, negative motivation, does not seem to enjoy traveling that much).

[bagacrap]

So every hobby must have a practical purpose or it's unhealthy? I'm glad for my own sake I don't agree.

[shin_lao]

Could you tell me where you think I wrote that? I was not talking about hobbies but general life attitude.

[CobrastanJorji]

Ultimately, that's most every field aimed at helping people, though. In order to make things better, you need to define which direction "better" is. This comes with a mess of thorny problems. Medicine gets it easiest, but even the seemingly objective goal of "healthy" comes with terribly hard ethical questions.

Psychology has it much worse. What the heck is "better?" Is being a jerk a psychological disorder? Psychologists have a lot of trouble defining diagnoses, and then they have trouble deciding if any one person matches it.

This happens with government, education, public works projects, you nave it. If your goal is to improve things, it comes with an opinion on what an improvement is.

[forgottenpass]

>Aren't most mental disorders just behaviors that differ from the norm and make it difficult for those people to function in everyday society?

Yes. Exactly this.

>My point being that I don't understand where you draw the line.

When the person with the norm-non-following behavior is unable integrate with wider society.

I was lucky enough to study psychology under someone with a streak of playful contempt for the unwanted self-seriousness that the field has. His definition of "mental disorder" as deviation from norms made sense on the first day, the definition at the top of the "mental disorder" wikipedia page is just a rabbit hole of using words that need to be defined clearly and specifically for the definition to mean anything.

Defining mental disorder as an inability to integrate can feel unsatisfying because it's essentializes the current norms of one's societal context. We know them to be entirely flexible over a short timescale (for definitions of "short" that include a decade) and it drives a line between those who can't adapt but by chance happen to ingrate and those who don't. But if you think about it for a while, you'll realize: what else could it be?

[xkcd-sucks]

>I was lucky enough to study psychology under someone with a streak of playful contempt for the unwanted self-seriousness that the field has.

I studied psych with someone that had this posted on his office door, headlined "Advances in Psychosurgery" :)

https://www.nytimes.com/1988/02/25/us/brain-wound-eliminates...

[Mirioron]

>Some cultures wouldn't recognize some things as a disorder if it wasn't difficult for those people. My point being that I don't understand where you draw the line.

This is explicitly how it works for ADHD: it must be infringing on the person's life for it to be treated (and dismissed?).

[opan]

A lot of illegal things are also just what somebody didn't like at one point and then we were told to not like. Going back to mental disorders, I came across the terms "neurodiverse" and "neurodivergent" which you might find interesting. Everything from anxiety and autism to schizophrenia. I find myself liking this perspective. I'm not diagnosed with anything, but I don't doubt I could be, so these topics interest me somewhat.

[mcv]

> If someone had such a need to wander the world that it meant that they couldn't live properly in modern society then it seems as much of a mental disorder than most others.

But what if they can but simply don't want to function that way in society? What about people who wouldn't be able to function in a different kind of society but don't have to?

And what if society is so crazy that the crazies are the real sane ones?

[beenBoutIT]

Outside of individuals who can't function at a MVP level(running around naked biting people, throwing poop, etc.), the definition of a mentally ill person is a person who believes that they have a mental illness. Other cultures might have a witch doctor in place of a licensed psychiatrist but the phenomenon of mentally ill people seeking help from non-scientific 'experts' remains consistent.

[ARandomerDude]

> My point being that I don't understand where you draw the line.

Agreed – one reason I'm opposed to aborting babies suspected of having a mental disorder.

[ionised]

I'd be more inclined to blame society itself for the individual feeling that way.

Much of our modern western society is highly individualistic and exploitative. We are encouraged to exploit as much and as often as we can to reap wealth. It's totally at odds with our nature as a social species and it's honestly not surprising to me that mental illness is on the rise all over the developed world.

[LifeLiverTransp]

I would go one step further by now- nearly all mental "disorders" make perfect sense as adaption to one or another state in a swinging habitat.

What we would declare a psychotic killer, is perfectly adaptet to a humanity locked into a state of constant strife. In such a world, actually not beeing a psychotic killer is "mentally sick" as in - bad adapted to the circumstances. As with all adaptions to circumstances, one trys to keep the circumstances optimal for ones own adaption. Meaning, someone adaptet to strife, will try to keep the environment stable, preventing the return of peacefull times- where they must subsist on institutional cruelty and torturing animals. Humanity is legacy hardware.