"You can know name of a bird in all languages of world, but when you're finished, you'll know absolutely nothing whatever about bird
So let's look at bird and see what it's doing that's what counts. I learned very early difference between knowing name of something and knowing something."
Richard Feynman, Physicist and 1965 Nobel Prize laureate (1918-1988)
"You have all I dare say heard of animal spirits and how they are transfused from father to son etcetera etcetera well you may take my word that nine parts in ten of a man's sense or his nonsense, his successes and miscarriages in this world depend on their motions and activities, and different tracks and trains you put them into, so that when they are once set a-going, whether right or wrong, away they go cluttering like hey-go-mad."
Lawrence Sterne (1713-1758), "The Life and Opinions of Tristram Shandy, Gentleman" (1759)
II. Personality Disorders
III. The Biochemistry and Genetics of Mental Health
IV. The Variance of Mental Disease
V. Mental Disorders and Social Order
VI. Mental Ailment as a Useful Metaphor
VII. The Insanity Defense
Someone is considered mentally "ill" if:
His conduct rigidly and consistently deviates from typical, average behaviour of all other people in his culture and society that fit his profile (whether this conventional behaviour is moral or rational is immaterial), or
His judgment and grasp of objective, physical reality is impaired, and
His conduct is not a matter of choice but is innate and irresistible, and
His behavior causes him or others discomfort, and is
Dysfunctional, self-defeating, and self-destructive even by his own yardsticks.
Descriptive criteria aside, what is essence of mental disorders? Are they merely physiological disorders of brain, or, more precisely of its chemistry? If so, can they be cured by restoring balance of substances and secretions in that mysterious organ? And, once equilibrium is reinstated is illness "gone" or is it still lurking there, "under wraps", waiting to erupt? Are psychiatric problems inherited, rooted in faulty genes (though amplified by environmental factors) or brought on by abusive or wrong nurturance?
These questions are domain of "medical" school of mental health.
Others cling to spiritual view of human psyche. They believe that mental ailments amount to metaphysical discomposure of an unknown medium soul. Theirs is a holistic approach, taking in patient in his or her entirety, as well as his milieu.
The members of functional school regard mental health disorders as perturbations in proper, statistically "normal", behaviours and manifestations of "healthy" individuals, or as dysfunctions. The "sick" individual ill at ease with himself (ego-dystonic) or making others unhappy (deviant) is "mended" when rendered functional again by prevailing standards of his social and cultural frame of reference.
In a way, three schools are akin to trio of blind men who render disparate descriptions of very same elephant. Still, they share not only their subject matter but, to a counter intuitively large degree, a faulty methodology.
As renowned anti-psychiatrist, Thomas Szasz, of State University of New York, notes in his article "The Lying Truths of Psychiatry", mental health scholars, regardless of academic predilection, infer etiology of mental disorders from success or failure of treatment modalities.
This form of "reverse engineering" of scientific models is not unknown in other fields of science, nor is it unacceptable if experiments meet criteria of scientific method. The theory must be all-inclusive (anamnetic), consistent, falsifiable, logically compatible, monovalent, and parsimonious. Psychological "theories" even "medical" ones (the role of serotonin and dopamine in mood disorders, for instance) are usually none of these things.
The outcome is a bewildering array of ever-shifting mental health "diagnoses" expressly centred around Western civilisation and its standards (example: ethical objection to suicide). Neurosis, a historically fundamental "condition" vanished after 1980. Homosexuality, according to American Psychiatric Association, was a pathology prior to 1973. Seven years later, narcissism was declared a "personality disorder", almost seven decades after it was first described by Freud.