Mental illness, self destructiveness and cultural norms

[Laura Corin]

Two people:

 

Person one smokes, drinks more than is probably healthy, eats a highly-processed diet and takes no exercise.

 

Person two doesn't enjoy having people in the house and isn't handy. Over time, the central heating breaks down, the lights don't work, there are draughts around the windows and doors, there is a hole in one of the stair treads....

 

Both people might be considered to have unhealthy, self-destructive life-styles. I suspect that the second is more likely to be considered mentally ill. Is this just a question of cultural norms? Or is there some other difference?

 

For the sake of argument, assume that both people are at the same point on the happy/unhappy scale.

 

These people are entirely imaginary: I have just been thinking over these issues and made them up to spark conversation.

 

Laura

[Seasider]

Well, this is just a knee jerk observation and far from all-encompassing, but in your description I sense shades of extrovert versus introvert. And I'm pretty sure that today's Western culture has a decided preference for extrovert-type social behaviors.

[Jean in Newcastle]

At the level which you described, neither sound mentally ill.

 

Person 1 is at risk of alcoholism and an eating disorder if he continues on the continuum.

 

Person 2 is at risk of (some sort of phobia) if he continues on the continuum

 

To me, it makes a difference when the person is controlled by their behavior instead of making conscious choices based on preference.

[Seasider]

Oh, are they at the same point on the income scale? And would that be a point at which person number one could afford healthy consumption choices if he so desired? Such that person number two could pay a handy man to take care of necessary repairs, and order lots of good reading material from amazon to be delivered to his doorstep?

[PrincessMommy]

Well, this is just a knee jerk observation and far from all-encompassing, but in your description I sense shades of extrovert versus introvert. And I'm pretty sure that today's Western culture has a decided preference for extrovert-type social behaviors.

 

I was thinking the same thing... .although I do think (since these are made-up people) that talking about the condition on one person's house without the others is a bit slanted. Do all recluses have hoarding tendencies? Do all extroverts have clean, tidy homes?

[Laura Corin]

Oh, are they at the same point on the income scale? And would that be a point at which person number one could afford healthy consumption choices if he so desired? Such that person number two could pay a handy man to take care of necessary repairs, and order lots of good reading material from amazon to be delivered to his doorstep?

 

Yes, both have the resources to live otherwise.

 

Laura

[Spryte]

I think more information is needed. :)

 

You've actually perfectly described our next door neighbor. She is, sadly, a combination of A and B, and she is agoraphobic, depressed, and has other mental health issues (she has told me the various diagnoses over the years, I just don't remember them all). But there is more to her story than just the above symptoms/scenarios.

[Mergath]

My initial reaction to these people is that while person one may very well have some kind of mental illness, many of those behaviors can also be learned, cultural behaviors. Where I grew up, the vast majority of the parents spent all their free time drinking, smoking, and eating junk, and no one ever exercised. So their kids, the ones I went to school with, now post pictures on facebook of themselves always drinking and smoking, and quite a few of them are very overweight. I don't think they're all mentally ill; they're just doing what their parents did.

 

With person two, I don't see a learned behavior, though of course it could be. But letting a house go unrepaired when you have the money to fix it seems more tied to mental illness to me.

[Kim in Appalachia]

Well, I've known both of those people.

 

person 1 didn't exercise (but worked a physically demanding job) drank a lot, smoked, and ate not the healthiest diet

 

person 2 let his home literally fall down around him, didn't care to be in the company of other, and also ate poorly (but no drinking or smoking).

 

The first one fit in better socially. He looked "normal" to his neigbors, and even to his family. Though he drank, he also worked, and he was very handy around the house. Since he could "function" in society he looked ok.

 

The second one was viewed poorly because he let his house fall apart. He wasn't very social (but his wife was, and she was well liked). But he always worked, so he was respected for that.

 

In this culture it is not viewed well if you let your home fall apart (on purpose), never taking care of it. You affect the value of other homes in you neighborhood.

 

And knowing both these men, I would view the 2nd as having a mental illness (clearly depression). The first was just an alcoholic. His food choices were normal for the culture and he started smoking when he was around 12 (which at the time was not uncommon). I guess any addiction is considered a mental illness. But he could function with his addiction. Nor do I believe any counseling or medication would have helped him stop drinking. Where as the other man may have been helped by the appropriate medicine and counseling.

 

It is a cultural thing, since the abilitly to function in society is important. When you can't function and at least meet the basic accepted norms, something is considered wrong.

 

Sorry, that's a lot of rambling thoughts.

[Julie Smith]

Opps.

[StephanieZ]

Person two would be considered mentally ill in that person two's idiosyncrasies impact his ability to handle basic living tasks. If your quirkiness makes it so that you can't take care of keeping your home habitable, you have an illness. Person one might be lazy and a bit careless about their general lifestyle, but those character traits aren't impacting basic self care as generally defined in mental health circles. I.e, self care and tasks of basic living including keeping clean, having medical needs addressed, keeping the utilities on and the home habitable.

[Laura Corin]

Person two would be considered mentally ill in that person two's idiosyncrasies impact his ability to handle basic living tasks. If your quirkiness makes it so that you can't take care of keeping your home habitable, you have an illness. Person one might be lazy and a bit careless about their general lifestyle, but those character traits aren't impacting basic self care as generally defined in mental health circles. I.e, self care and tasks of basic living including keeping clean, having medical needs addressed, keeping the utilities on and the home habitable.

 

This is what I was thinking.

 

But person two is no more likely to become ill/die than person one. I haven't said that person two is dirty or isolated - just that s/he doesn't like having people in the house and is not handy. In fact, person one might actually be causing him/herself more harm. Is the dilapidation of the house more important than the dilapidation of the body?

 

I'm not arguing with you - just trying to tease this out.

 

Laura

[Jean in Newcastle]

This is what I was thinking.

 

But person two is no more likely to become ill/die than person one. I haven't said that person two is dirty or isolated - just that s/he doesn't like having people in the house and is not handy. In fact, person one might actually be causing him/herself more harm. Is the dilapidation of the house more important than the dilapidation of the body?

 

I'm not arguing with you - just trying to tease this out.

 

Laura

 

Depends. If not having heat and lights makes the living situation dangerous - due to climate where the person is living and the possibility of falls, then yes. But if the person is able to adapt by wearing more clothing, using the fireplace instead, being able to safely light their way with candles or a flashlight, then no problem. Central heat and electricity are cultural norms. Having a warm shelter that provides safe passage are necessities that transcend culture. Mental illness comes in if the person isn't able to provide the necessities even if they go outside of cultural norms.

[StephanieZ]

 

 

This is what I was thinking.

 

But person two is no more likely to become ill/die than person one. I haven't said that person two is dirty or isolated - just that s/he doesn't like having people in the house and is not handy. In fact, person one might actually be causing him/herself more harm. Is the dilapidation of the house more important than the dilapidation of the body?

 

I'm not arguing with you - just trying to tease this out.

 

Laura

 

 

I totally get what you are saying. But, I think that moderate neglect of the body is culturally accepted to be within the norms of our society. In fact, in the U.S., I'd say a good quarter or more of the population fits person one, and more than half if you leave out the overdrinking. To be recognized as a mental health problem, the bodily neglect would have to be more severe.

 

I'd liken not fixing the broken step (or non functional lighting) to not fixing a broken ankle. Person one is not ignoring a broken ankle, but person two is ignoring a broken step.

 

If person one refused medical care for obvious ailments, then, yes, they might well be considered to be mentally ill. If person two simply chose to keep the walls with a fading twenty year old paint job and clean-but-ancient carpeting, but the home was structurally sound and functional, then they aren't mentally ill, just not focused on the home being house beautiful.

[Catwoman]

I wouldn't consider either of their lifestyles to be any of my business.

 

There was no mention of either of them being unhappy as they are, nor that either requires any kind of immediate, emergency intervention, so why would I judge them? Sure, they're both different from me, but so what? (I'm sure they'd have a few comments to make about the way I live, too! ;))

[Laura Corin]

 

 

I'm not entirely sure I understand the question(s) though.

 

I'm just musing on what societies consider normal and abnormal. When someone's mental illness is described, it's often in terms of 'self-destructive' or 'a danger to themselves.' But what makes some forms of self-destructiveness or self-endangerment normal, and others signs of mental illness?

 

Laura

[Jean in Newcastle]

I'm just musing on what societies consider normal and abnormal. When someone's mental illness is described, it's often in terms of 'self-destructive' or 'a danger to themselves.' But what makes some forms of self-destructiveness or self-endangerment normal, and others signs of mental illness?

 

Laura

 

 

Usually the term "danger to themselves" is used very specifically to mean that they are in danger of injuring themselves critically or even killing themselves through their mentally ill behavior or thought processes. Many people are self destructive in some way but because psychiatric health is on a continuum, only people who are self destructive to a certain degree have it "count" as mental illness.

[Catwoman]

I'm just musing on what societies consider normal and abnormal. When someone's mental illness is described, it's often in terms of 'self-destructive' or 'a danger to themselves.' But what makes some forms of self-destructiveness or self-endangerment normal, and others signs of mental illness?

 

Laura

 

 

I guess I don't view either of your Example People to be abnormally self-destructive. OK, one smokes and drinks and doesn't eat well. That probably describes millions of people, the vast majority of whom you'd never notice in a crowd or even at a party. They'd act normally and blend right in. They may have bad habits, but I doubt that most of them think they're being self-destructive. Sure, they know that smoking isn't good for them, but they figure they'll dodge the bullet and be fine. The same goes for the drinking. They like to drink, but probably aren't alcoholics. And a bad diet? Join the club. Probably most of the people they know are eating the same way.

 

The second person doesn't enjoy having people in the house and isn't handy. OK, that would describe millions of perfectly average people, too. Many people don't like having company over to their homes, and I don't think it's at all uncommon for people not to know how to fix things around the house. And if over time, the central heating breaks down, the lights don't work, there are draughts around the windows and doors, there is a hole in one of the stair treads, that may not indicate anything more than laziness and a lack of interest in having the house look nice. They may not be mentally ill; they may simply not care. And you didn't say that Person #2 was completely anti-social; many people don't like having company, but are great fun at parties and are friendly around the neighborhood, and get along well with others at work.

 

While I think Example Person #2 has more issues than Person #1, I think you need more extreme examples! :D

[Danestress]

I don't get what you want. I don't consider smoking and drinking to be particularly related to whether one keeps up with household repairs. The alcoholics I know tend to be high functioning. I know there are some who aren't.

 

I also don't think being reclusive and 'not handy' is related to household maintenance for those who can afford it. I am both (and I drink and hate exercise). I still fix household problems that seem important to me, which might differ from the repairs that seem important to you.

 

I know you are purposely hiding the ball on your point here, but I am confused.

[Laura Corin]

It's mental illness when they can't control it. If #1 has withdrawal symptoms when going without, he's definitely a substance abuser and that is considered mental illness.

 

Scenario two describes many people. I can look around my neighborhood and see tons of elderly who won't give up the house that is too expensive for them and move into an apt. They'd rather live like people did a century ago. Then there are the poor, who won't budget well enough to keep the power, heat, and telephone on. That's not considered mental illness, but rather willfull ignorance or personal choice or learning by experience.

 

Okay, so it's not mental illness if it's a choice? That's how I see it, but often I see suggestions that people be assessed for mental illness because of developments from scenario two. Perhaps number 2's electricity becomes a fire risk (to him alone). It's still his choice to live like that, but the risk of death redefines it as a mental illness? Or is it because (as a previous poster suggested) society is uncomfortable with unsocial people?

 

Laura

[Jean in Newcastle]

Okay, so it's not mental illness if it's a choice? That's how I see it, but often I see suggestions that people be assessed for mental illness because of developments from scenario two. Perhaps number 2's electricity becomes a fire risk (to him alone). It's still his choice to live like that, but the risk of death redefines it as a mental illness? Or is it because (as a previous poster suggested) society is uncomfortable with unsocial people?

 

Laura

 

It isn't a choice if they can't choose to let someone come in and fix things. An overwhelming fear of people coming into the house would be mental illness. Someone who doesn't mind things being a bit shabby or who has assessed the situation and has chosen to live with it does not have mental illness. They may be a slob. They may be cheap. They may be a procrastinator. They may be more introverted than most people. But anyone with those tendencies can make a choice to act differently in certain situations as warranted.

[albeto]

I've got two lightbulbs in the ceiling sockets that have been out for months now.

 

Does that mean I'm on the path to insanity?

 

:huh:

 

I think I need a drink!

 

:laugh:

[Blessed Mommy]

One word comes to mind: LAZY

[albeto]

One word comes to mind: LAZY

 

Guilty as charged!

 

:sneaky2:

[Soror]

Neither one sounds mentally ill, maybe lazy, introverted or quirky. I don't think being self-destructive is some new thing. Drinking has been around for ages, as has smoking and gluttony isn't new either. Our culture makes it much easier to treat yourself poorly though. There is little physical activity needed in our day to day lives these days and junk food is often easier and cheaper to obtain than real food. This reminds me of a discussion I had with dh the other day. I scheduled him an eye appt but not one for myself as I don't wear glasses. He freaked out that I wasn't taking care of myself and setting myself up for glaucoma. I pointed out to him that I could quite easily name several ways he doesn't care for himself yet it isn't acceptable for me to make such demands.