The purpose of this post is to provide an argument for why I think it is important for people in general, rather than just those of us studying or practicing psychology, to understand at least a bit about the nature of psychological disorders. A psychological disorder is a pattern of abnormal thoughts, feelings and behaviours which lead to disturbances in the lives of those suffering from it, and those close to them.
The main component of my argument is that psychology is the study of the human mind, how it operates and how it responds to its environment. Seeing as we are all human, it is necessarily of primary importance for us to understand it to at least some degree.
Just How Common Is It?
The statistic from John Hopkins Medicine states that 1 in 4 people suffer from a mental illness in a given year. In a large proportion of these cases, they will be suffering from more than one mental disorder simultaneously. This statistic does not include the further 10-13% percent of people who suffer from the dysfunctions of having a personality disorder. I suspect that the real statistic is in fact, much higher.
Not everyone seeks help, which can be the case for a number of different reasons, not least because we still have not fully overcome the stigmatizing at a universal level. Also, the very nature of some of these disorders can be the driving factor preventing people from seeking help and contributing to the statistics.
It would make sense for this to be especially true for certain personality disorders with paranoid and antisocial elements, as seeking help is directly in opposition to the nature of these personality types. Those suffering from paranoia are already on edge, thinking that people are out to get them, and being diagnosed as paranoid would, in their eyes, be another avenue for people to persecute them.
Why Is It Important?
Given these statistics and the gregarious nature of the human being, I think it is safe to say that the probability that we could manage to go through life, without ever having to come into close, meaningful contact with the effects of psychological problems, is astronomically low.
Furthermore, the diagnosis of a psychological disorder is not always black and white, and there is plenty of mental suffering to be found within the grey areas. For example, to be clinically diagnosed with a particular mental disorder, one would have to meet a certain number of the diagnostic criteria. If for example, there are eight diagnostic features, of which one needs to meet six to fully qualify for that disorder, what happens to the people who meet five criteria rather than six? How about those who meet a substantial amount of the criteria for not only one, but several mental disorders? They would not be clinically diagnosed with anything, but to say this means they are not subject to psychological dysfunction would be ridiculous.
Therefore, I think simply understanding the different elements of psychological disorders can really help us to identify what are the different things that can go wrong with the human mind? What aspects of our personalities and behaviours are dysfunctional? How might we target them and try to improve them?
Mood Disorders
Mood disorders are disorders which effect people at the state level, meaning that they distort the mood or emotional state of the afflicted individual. Examples of such disorders are major depressive disorder, anxiety and anxiety related disorders, bipolar, mania just to name a few. These disorders are ego dystonic, what this means is that the manifestations and symptoms are not in harmony with or reflections of the individuals actual personality. A person may be quite open and extroverted at the trait level, but as a result of being burdened with depression, they withdraw from socializing and say no to invites to social events. Being able to recognize these patterns and identifying the incongruencies with their usual behaviour patterns, understanding the nature of what they are going through can help us to generate greater degrees of empathy and patience for them, or even ourselves. Am I wrong to presume that this can only be a positive thing?
Personality Disorders
This category of disorders is really a whole other ball game, and some of them are just about near impossible to treat. However, that doesn’t mean that we cannot benefit immensely from being aware of them and optimize how we approach them when life throws them our way. Unlike mood disorders, they are ego-syntonic, which basically means that the behaviours associated with them, really are reflections of that individual’s actual personality, at the trait level. It’s kind of just the way they are. Let’s take the example of antisocial personality, more commonly known as psychopathy. Psychopathic people, as we all know, are notorious for their inability to feel empathy, how can you treat that? Many ardent researchers have tried and failed. Something that seems like a good idea at face value, like administering them doses of oxytocin ( the hormone responsible for social bonding) renders volatile results. It some cases it seemed to have a positive effect, but in a substantial proportion of trials, it made them worse.
It has proven rather difficult to just make them feel empathy, when their genetic and neurological make up, simply does not permit it. Being able to recognize traits of this disorder, could save many of us a lot of pain. When we are dealing with the likes of narcissistic and psychopathic individuals, it would serve us well to understand their boundaries, before subjecting ourselves to abuse and manipulation. Without understanding the true nature of the problem, many of us are liable to think that the problem is us, repeatedly trying and failing to mend relationships and get something from them which simply cannot be gotten.
Why Some and Not Others?
There are a vast sea of reasons and factors which influence whether or not someone will end up with mental disturbances. I will not go through each of them in detail here, but rather just talk a little about the backbone of it all. The gene-environment interplay.
Most of us are familiar with the nature- nurture argument. Do you think we are born like this? Or do we become like this over time? Good questions. The truth appears to be somewhere in the middle.
A series of twin studies in Northern Europe, which involved huge databases of twins either growing up in the same environment or in separate adopted households, revealed how much of a role genetics really plays. It plays a huge role not only for our susceptibility for developing certain types of physical illness throughout our life, but also for mental illness, and interestingly, personality traits!
Nature Nurture?
The genetic heritability for personality traits is in and around the 50% ballpark, more accurately between 40 – 60%, depending on the trait in question. If you have open minded and hardworking parents, the likelihood that you will be open minded and hardworking is significantly higher than someone who doesn’t. This is true, even if you have never met your parents, which rules out the environmental factors. Also, as time goes by, the older we get, the more we abide by the nature of our genetic code, and the less our environment plays a role. However, this is true for ordinary circumstance, of course and abnormally harsh environment would have a larger effect.
So, we are built in a certain way, and we are also subject to the influences of our environment. Though, two people in the same environment, say two nonrelated children in the same adopted household, are still likely to grow up to be quite different. They have different genetic code, and they are responding to the same environment, but in distinctly different ways. This is the gene-environment interplay, in short, how our genetic make up responds to our environment.
Cognitive Behavioural Model
There are also other reasons why one may become psychologically dysfunctional. One note worthy model, is the cognitive behavioural model. According to this, our engagement in negative and dysfunctional cognitions plays a huge role. In cognitive behavioural therapy we would focus on firstly identifying these dysfunctional cognitions, what they consist of, when they occur, and so on. We would then set out to target them and put efforts in to rectify the negative patterns of thought. This has shown to be a rather effective form of treatment, which would propose some truth to the cognitive behavioural model.
The Utility of Understanding Cognitions
Something that I found particularly useful to have learned, and hope can be useful for others, is the concept of rumination and catastrophic thinking. These concepts pertain to anxiety and anxiety related disorders. Although, I have not ever been diagnosed with such a disorder, the experience of anxiety is for me, like many others, very real.
Ruminations can be considered deep, persistent, and intense thoughts, and in relation to anxiety, they are often catastrophic. Assuming the worst, preparing for the worst, remembering the worst.
Pre-event rumination refers to the catastrophic thoughts one has before coming into contact with a particular event. The event could be anything, a social event, an exam, a job interview. This is a common phenomenon for individuals with high levels of anxiety. Just by having these catastrophic thoughts, we put ourselves in a state of heightened anxiety and experience physiological changes. Our body temperature rises, our heart rate increases, our perspiration becomes excessive. By the time we actually come in contact with the event in question, we are in such a state of anxiety, both psychologically and physiologically. Anything that occurs will be associated with those visceral anxious feelings.
With anxiety, we are essentially warping reality with our minds, processing the occurrence of otherwise neutral events as catastrophic and terrible. Upon leaving the event in question, we enter into the post-event rumination phase, wherein we are recalling the contents of the encounter with a similar sense of catastrophe. We further consolidate the memory as something terrible and traumatic, so by the next time we are exposed to a similar event, we have all of these dysfunctional memories associated with it. This creates a very vicious cycle.
However, simply knowing about this phenomenon, being aware and able to identify these cognitions, gives us the window of opportunity to hack them in a sense. Once we know when and how they are occurring, we can dedicate our mental faculties to dismantling them and rectifying the damage. We cannot fix a problem that we are not aware of.
The Purpose of this Series
This article is meant as a sort of introduction to a series of articles still to come, the purpose of which will be to shed some light of topics of mental disorders. In this series, the most common mood disorders will be discussed in fair detail. We will be writing about some of the research pertaining to the nature, causes, and the available treatments for a range of these disorders. Additionally, we will dive into the world of personality disorders, of which there are 10, discussing them one by one.
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References
John Hopkins Statistics For Mental Disorders
Statistic For Prevalence of Personality Disorders
CHRONIC MOOD DISORDER AND DEPRESSIVE PERSONALITY
The Role of Oxytocin in Antisocial Personality Disorders: A Systematic Review of the Literature
CLASSICAL TWIN STUDIES AND BEYOND (Dorret Boomsma, Andreas Busjahn, and Leena Peltonen)
Gene-Environment Interaction in Psychological Traits and Disorders
Cerebro Somata 