Cora shares information from the Mental Health Association in Forsyth County:

A mental illness is a disease of the brain that causes mild to severe disturbances in thought and/or behavior, resulting in an inability to cope with life’s ordinary demands and routines.  There are more than 200 classified forms of mental illness. Some of the more common disorders are:  clinical depression, bipolar disorder, dementia, schizophrenia and anxiety disorders.  Symptoms may include changes in mood, personality, personal habits and/or social withdrawal.

Cora writes: I intentionally rendered David’s mental illness vague to keep from labeling him with one specific psychological disorder to which the audience could attach immediate pre-packaged categories/judgments. If I had to categorize his behavior, I’d say that David had “severe psychotic and emotional disturbances.” 

It’s been a challenge in fiction to directly address “abnormal psychology” (whatever that rather nebulous term means) in a way that feels real and not reductionistic. Of course, we could ask, what is “abnormal” psychology (aren’t we all kind of abnormal in our own way when it comes right down to it)? I’m concerned about dropping a psychiatric categorical term in the characters’ dialogue like “depression” or “schizophrenia” or “bipolar disorder” or “Asperger Syndrome” or “psychosis” when many of these “mental” disorders have such vast manifestations and often there can be a combination of disorders in a single person (an anxiety disorder can be mixed with a psychotic or dementia or eating disorder, etc).

While there are over 200 classified forms of mental illness, the five (5) major categories of mental illness are:

• anxiety disorders
• mood disorders
• schizophrenia/psychotic disorders
• dementias
• and eating disorders

(though this paradigm doesn’t seem to accommodate “personality” disorders), I’d say that David falls largely into the psychotic disorder category, his mother into dementia, and Adrienne herself into anxiety/mood disorder. More information on these “categories” can be found on the Mental Health Association in Forsyth County website.

Are Adrienne’s concerns about Victoria justified? Please take a look at the page on genetically inherited mental illness.

The Mental Health Association in Forsyth County website also provides Warning Signs & Symptoms of Mental Illness for children, youth, and adults.

Cora: I’m very interested in what happens to the continuum of psychological “health” when we start categorizing people into these “mental illness” categories—where is the line between “illness” and “normality”?

For information on psychosis, please look at the website Cora reviewed for information on psychosis: the Centre for Addiction and Mental Health. I share it here not for diagnostic purposes, but to show how complex these illnesses can be:

Schizophrenia
The term schizophrenia refers to a type of psychosis in which a person experiences some psychotic symptoms for at least six months, with a significant decline in the person’s ability to function. The symptoms and length of the illness vary from person to person.

Schizophreniform disorder
This type of psychosis is the same as schizophrenia except that the symptoms have lasted for less than six months. The illness may completely resolve or may persist and progress to other psychiatric diagnoses, such as schizophrenia, bipolar disorder or schizoaffective disorder.

Bipolar illness
With this type of illness the symptoms of psychosis relate more to mood disturbance than to thought disturbance. A person will experience mood elevations (mania) and sometimes depression, which may persist or fluctuate in intensity. When psychotic symptoms arise, they often reflect the person’s mood. For example, people who are depressed may hear voices that put them down. People who are experiencing an elevated mood may believe they are special and are capable of doing amazing things.

Schizoaffective disorder
During this type of psychosis, a person will experience symptoms of schizophrenia and symptoms of a mood disturbance, either at the same time or alternating over time.

Depression with psychotic features
Sometimes a person will experience a severe depression with symptoms of psychosis without the mania associated with bipolar disorder. This type of depression is referred to as a psychotic depression or depression with psychotic features.

Drug-induced psychosis
The use of drugs such as marijuana, cocaine, LSD, amphetamines and alcohol can sometimes cause psychotic symptoms to appear. Once the effects of the drugs or alcohol wear off, the symptoms of psychosis will usually resolve. However, the symptoms themselves may require medical treatment.

Organic psychosis
Symptoms of psychosis may appear as a result of a physical illness or a head injury. A thorough medical examination should be conducted to rule out or confirm this type of psychosis. This examination may involve some tests or investigations such as a brain scan.

Brief psychotic disorder
Sometimes symptoms of psychosis come on suddenly and, in some cases, are triggered in response to a major stress in the person’s life, such as a death in the family. This type of psychosis usually lasts less than a month.

Delusional disorder
This type of psychosis consists of very strong and fixed beliefs in things that are not true. Changes in perception, such as hallucinations, are not seen in this illness. A delusional disorder does not usually affect a person’s ability to function.