Losing Our Minds: The Challenge of Defining Mental Illness by psychologist Lucy Foulkes explains why it’s so hard to define what mental illness is and how it happens. The author herself has experienced mental illness, and while this is not a major focus in the book, I thought it was great that she did bring that perspective into it.
The author explains that it’s important to understand not only what mental illness is, but also what it isn’t. Regarding the medicalization of mental illness, she advocates for making a distinction between normal, unavoidable human distress and the more severe manifestations that constitute illness. The book takes a very middle ground kind of approach, acknowledging that psychological pain exists, causes distress, and is valid, but recognizing that not all suffering constitutes a disorder.
The first chapter looks at reported rates of mental illness in the population, breaking down what those numbers mean and questioning whether or not more people are experiencing mental illness now compared to in the past. I thought the author did a good job of taking readers through her process of evaluating different statistics and making it clear that numbers can’t simply be taken at face value.
The book then looks at the normal/disorder continuum and how that fits with categorical diagnostic systems like the DSM. Attention is given to various factors that can influence the development of mental illness in the areas of biology, environment, and the various processes going on during adolescence. The author takes the approach that mental illness is complex, and it can’t be reduced down to either all one thing, whether that’s biology or environment.
There’s an interesting chapter devoted to social media, and again, the author’s approach was very balanced. She addressed both positives and negatives associated with social media use, cautioning against oversimplification, especially when there isn’t a lot of data to go on. She suggested that social media may be more likely to reflect and amplify what’s already going on for individuals rather than create brand new issues. For example, cyberbullying is a problem, but most people who are being cyberbullied are also being bullied in their in-person world.
After looking at these different factors that can influence the development of mental disorders, the book returns to the question of whether mental illness is becoming more prevalent, as seems to be a common perception. The author points out how difficult this is to determine. For example, if suicide rates are going up, how much is that influenced by changes in reporting of suicides (in 2018, the standard for reporting suicides in England and Wales shifted from beyond a reasonable doubt to a balance of probabilities) or under-treatment of depression in children and adolescents due to the FDA black box warning on antidepressant use in this population group?
In the chapter devoted to language, the author advocates for reserving some language for serious illness rather than using the language of disorder to refer to all experiences of distress. She adds that linguistic inflation can contribute to people getting the wrong advice for what they’re actually experiencing.
The book ends with two chapters focused on getting help. The first is about professional help, the different forms that may take, and the reality of how difficult it can be to actually access. The final chapter looks at ways we can help ourselves and other people in our lives. The author reiterates that experiencing distress is hard, but it’s a fundamental part of being human, and not everything is immediately fixable.
I really liked this book. There’s so much talk of black and white in popular conversations about mental health and illness, and this book fully embraces the grey areas. The author skillfully validates both illness and non-illness experiences of suffering, while at the same time establishing that treating all experiences of suffering as though they’re the same or as though they’re all disordered doesn’t serve anybody.
The book brings together a lot of different ideas about mental illness in a very balanced way, making it clear that not every idea is going to match up with every individual’s experience. The author draws on a lot of research findings, but these are presented in an accessible way, with appropriate context to help readers understand what those pieces of information actually mean.
I was impressed by the way that the author presented the complexity of mental illness in a simplified way without sacrificing that inherent complexity or getting into reductionism. Overall, I thought that the book was extremely well done, and it will make an interesting read both for people who have personal experience with mental illness and those who do not.
Losing our Minds is available on Amazon (affiliate link).
I received a reviewer copy from the publisher through Netgalley.
You can find my other reviews on the MH@H book review index or on Goodreads.
My latest book, A Brief History of Stigma, looks at the nature of stigma, the contexts in which it occurs, and how to challenge it most effectively.
You can find it on Amazon and Google Play.
This one really appeals to me: I’m going to have to head to the library and check it out (pardon the pun). Your reviews are really well done 😊
Thank you!
Sounds quite interesting. It does seem that labels do help, although they can hurt too. It’s finding that balance for each individual.
I think that social media has definitely enhanced mental illness especially among younger people because it is such a prominent part of their lives, plus the pandemic does not help.
Yeah, the pandemic has definitely added a whole other layer of risk.
What did this mean? Are there examples: “the author advocates for reserving some language for serious illness rather than using the language of disorder to refer to all experiences of distress. She adds that linguistic inflation can contribute to people getting the wrong advice for what they’re actually experiencing.”
I don’t recall specific examples, but she was basically saying that the right advice for someone experiencing low mood is not necessarily going to be the same as treatment recommendations for someone with major depressive disorder, and using the term “depression” to refer to both kinds of experiences is likely to create confusion rather than being helpful to people.
That makes sense. Thanks
1 am definitely going to look for this book
It’s a really interesting read.
Thank you. I really liked this review and what I know of this book. This is the statement that meant the most to me: “Regarding the medicalization of mental illness, she advocates for making a distinction between normal, unavoidable human distress and the more severe manifestations that constitute illness.” I am 37 years into a bipolar diagnosis. My daughter during covid last year and remote learning had some anxiety and depression. I would like to think that those aspects of her mental health may be “unavoidable human distress” rather than automatically a mental health diagnosis. I am sure this is a mom’s wishful thinking but still, I think you can have signs of mental distress without having a full-blown medical diagnosis from the DSM-V.
I agree.