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Thursday, October 17, 2019

I find that people are generally very curious about mental health and mental illness. The human mind is a fascinating thing and people are interested to know what motivates us to do what we do and feel how we feel.

This week, I thought I’d share some of the more common questions I hear. At a later date, I’ll write a more formal article about mental illness because there are still many misunderstandings about what it is.

Just one point of caution first. In no way should anyone read this and try to diagnose themselves or others. It may be tempting to say, “Hey, that sounds familiar. My mother-in-law or my father-in-law has that.” Such arm-chair diagnosing is ill-advised. While personally gratifying, it can result in major problems in your marriage and in your physical well-being should your spouse or in-laws learn about your diagnosis of them!

Question: What is mental illness? (Again, this will be addressed in greater detail in a future article about mental illness.)

Answer: Mental illnesses come in all shapes and sizes (so to speak). The broadest definition is that it is a collection of symptoms that are so powerful that they disrupt a person’s ability to function healthily in their life.

It’s one thing if I just feel anxious. But, if I feel anxious, I’m constantly worried, my concentration is poor, I’m not sleeping well, and I’m not performing well at work, I may have an anxiety disorder.

Unfortunately, there is still a great stigma surrounding mental illness. Many people fear that having a mental illness means they’re defective as a person. The truth is that having a mental illness is no different than having a physical illness, such as cancer or arthritis. Some mental illnesses are very common (e.g., anxiety and depressive disorders) while others are less so (e.g., Schizophrenia).

Having depression or bipolar disorder, for example, doesn’t mean there is something wrong with us as a person. Rather, it means there may be something wrong with our brain chemistry. Or, perhaps there is something unhealthy with how we think about ourselves and the world around us (in a previous article, I wrote about the impact our thoughts have on our feelings).

Question: What is psychosis?

Answer: There are several illnesses that include symptoms of psychosis and the symptoms vary depending on the illness. In short, psychosis refers to a significant break with reality. In other words, the person doesn’t perceive reality accurately. For example, he or she may experience hallucinations. There are five types which correspond to the five senses, of which auditory and visual hallucinations are by far the most common.

Another psychotic symptom is delusional thinking in which the person firmly believes something that is patently not true. These are entrenched beliefs that fly in the face of overwhelming evidence to the contrary. For example, the person might believe he is someone else (e.g., God or Elvis) or that his every move is being watched and recorded by some nefarious entity (one of my former patients was convinced his left arm was replaced by a robotic arm and a microchip was implanted in his brain during an imaginary trip to Egypt).

Schizophrenia is a psychotic illness and has several subtypes depending on the person’s specific symptoms. Hallucinations and delusions are common. Paranoia is also somewhat common. (We can thank Hollywood for perpetuating the misconception that people with Schizophrenia have multiple personalities, as it seems this is how these characters are often portrayed.)

Question: Are people with a psychotic illness violent?

Answer: I recently encountered someone on a social media website who declared with certainty that statistics show people with psychosis are usually violent (he even cited his psychiatrist brother as a source to “prove” he knew what he was talking about). Actually, the majority of people with a psychotic illness are not violent.

Question: If someone is very depressed, are they probably suicidal?

Answer: There are two categories of suicidal ideation (i.e., thoughts of suicide): passive and active. Someone who has passive suicidal ideation may wonder what it would be like to be dead. They may even passively wish they were dead at times. However, they have no desire to actually do anything to end their life. Someone who has active suicidal ideation not only wants to die, they have a plan to end their life and they may intend to follow through with their plan.

While people who think about ending their life are usually depressed, most people who have depression (or any other psychological disorder, for that matter) do not want to commit suicide. They may experience passive suicidal ideation at times, but it doesn’t reach the point where it becomes active.

On the other hand, we should be careful not to dismiss the possibility that a person can develop active thoughts of suicide. Reaching out to someone in great emotional pain and expressing concern about their well-being is a very meaningful gesture. This display of concern and support might mean the world to someone who may really be suffering.

I hope the above has been informative. If anyone has a mental health-related topic they’d like me to discuss, or has mental health questions they’d like answered, please feel free to write to me, either at the Jewish Link ([email protected], to my attention) or at my email address below. (For those seeking advice, kindly direct your letters to our advice columnist Shuli, at [email protected])

Dr. Gur-Aryeh is a clinical psychologist with a private practice in Saddle Brook, NJ. He works with a wide variety of clients seeking mental health treatment and specializes in mood disorders and addiction in particular. If you would like to contact him, you can do so at [email protected], at 201-406-9710, or through his website at www.shovalguraryehphd.com.

By Shoval Gur-Aryeh, PhD