Fela, Denrele & what mental illness really is
I've been talking in my last couple posts about what mental illness is beginning by looking at what it is not, and some of the ways we talk about it that are unhelpful to those living with it. Today I want to talk about what it is. This is going to be a little bit technical, but I'll explain all the technical bits. (Yes, it's going to be a longer-than-usual post.)
Every now and then, when I introduce myself and my specialty, one of the more common responses I get is something along the lines of:
- Is it true we all have a bit of madness?
- Don't you think our leaders need to see you guys?
- Aren't you afraid you'll become like your patients?
The short answer to all of those questions, of course, is "No." But the very fact that there are such questions makes it pretty clear how little many people understand mental illness.
So what is mental illness, or mental disorder? The DSM (Diagnostic and Statistical Manual of Mental Disorders), widely known as "the bible of psychiatry" defines it thus:
A clinically significant behavioral or psychological syndrome or pattern that occurs in an individual [and] is associated with present distress...or disability...or with a significant increased risk of suffering. (Emphases mine.)
Okay, so let's break that down. We're talking about mental disorder, right? That's two words: "mental" and "disorder"? Now watch how they break down:
- Mental: behavioral or psychological pattern in an individual.
- Disorder (or illness): associated with present distress, disability or significant increased risk of suffering.
Fela, Denrele—& Yekini
Is it getting clearer? Okay, before we go on, I need to clarify something. Sometimes, I'm asked what I think about people like Fela or Denrele (and at least once, about Hon. Pat Obahiagbon!)—don't they have mental disorder of some sort? No they don't—not if you're basing your diagnosis on their behaviour.
You see (and this is also in the DSM), we can't diagnose a person with mental disorder just because they do stuff that's contrary to social norms, which can be vastly different from one place to place and generation to generation. We might as well say people are mentally ill just because they do stuff we don't like! (Oh wait, we do that already with annoying drivers and political leaders!)
On the other hand, Rashidi Yekini (who passed away a year ago last month) seems more likely to have had a mental illness. Why would I say that, when there were people who claimed to have spoken with him and found him able to hold a conversation?
Well, for the simple reason that he met the criteria: he had abnormalities in his behaviour that caused his family distress (they tried unsuccessfully to get him treated) and caused him disability (he wasn't doing things he normally should have been able to). True, I can't categorically make a diagnosis without having had a professional consultation, but I can say that he was at least very likely to have had a mental illness. (Of course, he wasn't likely to have died of that, but it could possibly have prevented him going for treatment of whatever eventually he died of.)
Are you beginning to see how this works? It's beyond Fela's performing in underpants or Denrele's high heels and spiked hair. As far as anyone can see, none of that has caused them or their loved ones any distress, or made any difference to their functioning. But in Yekini's case, something seems to have been evidently wrong.
Understand, this isn't about going around making diagnoses—best leave that to professionals. But if we all have a basic sense of what mental illness is and isn't, like we have about ill-health in general, maybe we'll recognise it earlier in those we know who may be struggling silently. (Tweet that!) And maybe we'll also avoid wrongly labelling those who are maybe just different.
[bctt tweet="If we have an idea of what mental illness really is, maybe we'd recognise it earlier…" username="DocAyomide"]
What do you think? Share your own mind in the comments below!
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Read more from the Understanding Mental Health series: