Nuts

So how does one tell if one is nuts?  I mean crackers, wacko, off, screwed up, wackadoo, loony, bonkers, deluded, hallucinatory, schizophrenic, loopy, raving mad, around the bend, screwball, ditzy, weirdo, disturbed, psychopathic, sociopathic, insane?  Crazy, in other words?  And what difference does it make, when you get right down to it?  If you're not crazy, then everyone else is, right?

There is a master reference work called DSM-5.  The "DSM" part stands for "Diagnostic Manual of Statistical and Mental Disorders." (As for the "5," that's there because there have been four other versions of the manual before it, duh.)  The DSM-5 is utilized by professionals to diagnose the particular flavor of nuttiness of their patients, and while there's a lot of controversy within the head-doctor community about some of what's set forth in the DSM-5, it's pretty much representative of the "consensus" in the field... until the DSM-6 comes along, of course.

Since the DSM-5 was published on May 18, 2013 there is no longer any such thing as "Aspberger Syndrome," did you know that?  If you thought you had that on May 17, you're just "autistic" today.  Now there's no "bereavement exception" to save you from a diagnosis of  depression if you're depressed because a loved one died, and there are fewer flavors of schizophrenia, and if you're confused about your gender, you no longer have "gender identity disorder," you have "gender dysphoria" instead.

Some have expressed concerns to the effect that the pharmaceutical industry may be exerting an undue influence on the content of the DSM-5... and on mental health treatment in general.  The knee-jerk response of many doctors is to medicate first, and ask questions later, if at all.  There are jillions of pills available, all different sizes, shapes and colors, and they are doled out like candy to anybody who asks nicely (and a lot of other patients, too.)  Hell, if you live in a major urban area, your GP may be willing to pass out some anti-depressants, based on your self-diagnosis, without any kind of a mental examination at all.  You might even be given a free sample of mind-candy.

Look, we're animals.  Organisms.  According to some scientists, what we experience as emotion is really just hormones and enzymes and things bubbling around in response to electrical alarms going off in the nervous system.  So it makes sense to smooth out the ride by introducing a little equalizer into the system, sort of like dumping a can of STP into the gas tank of your car to increase performance and get rid of engine knock.  Right?  Well, it seems that pill-popping is in the ascendance in the head-shrinking world, and that the efficacy of the Sigmund Freud / Tony Soprano-style "Talking Cure" is being called into question more and more.

The problem with seeing what is euphemistically called a "professional" to chat about what's wrong with you is that it costs a lot of money and takes a lot of time.  Americans are O.K. with spending a lot of money, especially if they can brag to their friends and neighbors about how much they're spending and what a good deal they're getting.  But they don't like to spend a lot of time doing anything except dashing to their next meeting, youth soccer match, hair appointment, restaurant date or personal training session.  Heck, shows get bounced off TV if it turns out they're hard to follow if the "viewers" don't actually sit down and watch the screen.  So fast-acting drugs are preferable to someone who doesn't feel well, as opposed to pouring one's heart out to a paid sympathizer for a couple hundred bucks an hour for years and years.

The other problem with non-drug therapy is that the patient actually has to be willing to confront the issues.  Since their unwillingness to confront the issues is usually the catalyst for the festering unhappiness that drove them to the "professional" in the first place, this is asking a lot of most patients.  They prefer to be given the answer to the problem, which in fact no responsible "professional" will even attempt to do.  "The answers lie within."  In other words, somewhere deep down inside you know for sure that your mother never liked you, and why, and that you're unhappy as a result and that because you're unhappy you eat ice cream in the middle of the night a lot and that because you do that you don't get enough sleep and are doing a crappy job at work and everybody now perceives you as fat and lazy and so you have no friends and no life.  But you'll never get over it until you confront the root cause of the problem, acknowledge your mother's faults, get angry with her, forgive her, let go and jump start your life.  And by the time the "professional" obliquely prods you into doing all that you'll have spent a whole lot of time and money.

Or... you could pop a few pills and feel better right away (unless you become manic or suicidal, as the fine print in the little booklet that comes with your pills will tell you). 

Or... you could pop the pills and go once a week to talk with the "professional," and spend the time talking about how much better or worse you feel each week without ever having to get down to the nitty gritty of why.  Some "professionals" are easy to fool.  Some don't care.  And the rest stick with the Prime Directive and go through the process of obliquely prodding you into figuring out that you're spinning your wheels.  Some people (Woody Allen, for example, or at least his movie persona) are able to remain in therapy for decades this way.

Unhappiness is the usual catalyst for a trip to the "professional," I'm told.  This is interesting, because it is only in the last couple of hundred years that "happiness" has been considered a possibility by most people.  For most of human history, the closest anybody ever usually got to happiness was to get through a whole week without developing a goiter or leprosy, having their village sacked and burned, or having a spell cast upon them by a witch.  And given the present state of the world as reported by the media you have to allow for the possibility that it might be the people who aren't unhappy who are the crazy ones.

And as implied in Paragraph One above, it simply may not matter whether you're officially crazy or not.  There really doesn't seem to be a whole lot of "normal" out there.  What most people seem to mean by "normal" is either "like me" or "boring."  (And when talking about most people, those two labels mean the same thing.)  Most of the truly happy people I've come across would fall into the category of "eccentric" or "free-spirited," terms which any "normal" person would recognize as euphemisms for "crazy." 

On the other hand, there are a lot of evil, depressed, violent and angry people, too.  But anyone who's studied history would recognize these terms as descriptive of a lot of high achievers, from Genghis Khan to Edith Piaf to Adolf Hitler to Andy Kauffman to Richard Nixon to Vincent Van Gogh.  In fact, you couldn't write the history of the human race without a lot of emphasis on the evil, depressed, violent and angry people, aside from a couple of short chapters on Clara Barton and Mahatma Ghandi, and what would be the point of that?  In any event, anybody who's been through History 101 knows enough to tell you that "normal" for the human race is definitely shaded toward the dark side.

"Times have changed, though," the optimists say.  True.  And we change with the times, too.  What may have passed for socially acceptable behavior in a Viking raider probably wouldn't make it in Manhatten these days (remember those credit card commercials with the barbarians asking "What's in your wallet?") but a lot of the assholes wandering around Wall Street in their two thousand dollar suits are just as dangerous.  Are they crazy, too?  Or are the rest of us crazy for propping up the system that bailed out their bonuses?

Eric Berne wrote a book called "I'm O.K., You're O.K." back in the 60's or '70's.  I doubt if transactional analysis is still en vogue anywhere, but the title of the book is worth thinking about all by itself.  I suppose at least some people (Anthony Weiner and that old dude in the Mayor's office in San Diego, for example) won't have any trouble with the "I'm O.K." part.  It's the "You're O.K." part that really causes trouble.  Sad to say, it's generally easier to see other people clearly than it is to see one's self-- if you take the trouble to look at all-- because we've got a little distance.  And then you've got to ask yourself, "If they're O.K. and they're not like me, how can I be O.K.?"

Maybe Anthony Weiner has it right.  Self-esteem trumps public opinion anytime.  And hubris is certainly a "normal" state for humankind.