Many Psychological Experiences As Disorders

People who do this a lot are often dismissed as just worriers. But at what point does a worrier become someone who has an anxiety disorder? Is the worry there most days, or just occasionally? All of these factors are taken into account to determine whether someone is a bit of a worrier, compared with someone who might usefully be considered to have a disorder. I don’t, and even at my worst I never did. First, you need to have worried excessively for more days than not each week, for at least six months, and about many different things. Second, you must find it difficult to control the worry. I was nine or ten, in a geography class at school, looking at a huge world map that spanned the wall behind my teacher. I’m sure I was anxious before then, but in my memory that moment marks the start, the beginning of many years of frequent, excessive anxious thoughts. From then on, my mind was riddled with private, absurd worries that I couldn’t control. At other times, pathological worries arrived suddenly, fully formed. Even though much therapy has taught me that the vividness of these scenarios bears no relation to their likelihood of happening, this can be difficult to accept. When they occasionally still appear, the images feel as real and true as a punch in the face. In my childhood and teenage years, I kept the extent of my anxiety to myself.

Don't Fence Me In

My parents knew I worried, and that there were certain things I was extremely reluctant to do because of it, but they had no idea how bad it was. This was partly because I didn’t tell them, but it was also because they had no framework or context to realize that worry could be that bad, because no one talked about this stuff back then. And there’s no way I would ever have told my friends, wouldn’t have even contemplated it. The worries were a constant part of my existence, but an entirely silent and private one. I don’t know if I was ashamed about them, as such. I just didn’t talk about it. I was never aware that I might have a disorder. Even with the description right in front of me, I didn’t make the link with my own experience, not until things got considerably worse. Indeed, not quite reaching this boundary doesn’t mean you’ll be turned away from treatment. Having found a way to manage this problem, however, we soon meet another. The multiplicity of symptoms that make up each disorder means that, for some disorders, two people with the same diagnosis might actually have quite a different set of problems. Some have difficulty getting out of bed because they are sleeping so much, while others can’t sleep at all.

Time Stands Still

How can these different symptoms usefully form the basis of the same diagnosis? For a long time, it’s been recognized that depression is about much more than low mood. It thus remains nearly incomprehensible to those who have not experienced it in its extreme mode. But the low mood combines with many other symptoms. Depressed mood most of the day, nearly every day. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. Fatigue or loss of energy nearly every day. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. Diminished ability to think or concentrate, or indecisiveness, nearly every day. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for suicide. The reason we encounter so many different versions of depression is that a person need only experience five out of these nine symptoms to meet the official criteria. Now when I sit at the piano, none of this seems relevant or captivating.

Just Another Word For Pain

I just stare at the keys. I cannot think what could possibly have been interesting about listening to music. I can’t hear it anymore. But even though most experts know that there are different versions of depression, no one can tie down exactly what those subtypes are. If we could diagnose specific types of depression, more targeted treatments could be offered, reducing suffering and improving outcomes. This imprecision is not for lack of trying. For now, all we have is one label, depression, its breadth reminding us once again that catching and fencing off mental illness is a rather tricky thing to do. And I’m afraid to say that it doesn’t get any simpler from here. It would be reasonable to assume that the total number is quite high, given the sheer vastness of human experience. What about stimulant use disorder where the drug is amphetamine versus stimulant use disorder involving cocaine? In these examples, the clinician is asked to specify which category the patient falls into, but it’s up for debate how distinct they actually are. One possible reason for this is that over time we have discovered the existence of more disorders. Maybe we’re now labeling too many psychological experiences as disorders, applying the term illness to things that shouldn’t be called illnesses at all. Because in almost all cases, the boundaries around what is officially considered to be an illness are expanding. Horizontal expansion refers to the fact that, in Haslam’s words, an increasingly wide assortment of psychological phenomena [now] fall within the psychiatric domain.5 Existing disorders are being extended to include more symptoms, and entirely new disorders are being described. They might worry about social situations weeks in advance, or avoid them altogether, and experience panic attacks when in social situations or when contemplating them. Everything becomes difficult, you get so insanely aware of how extremely social even the smallest things are. When I’m having a good day then I do not think about how many people I actually meet, or how many people I have to interact with.