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Nancy Schimelpfening

What Is Normal?

By July 30, 2010

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I just read about a briefing conducted by some mental health experts on July 27, 2010 which I found quite disturbing.  Apparently when the new 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the so-called Bible of mental health disorders, which clinicians use to help them categorize and diagnose mental disorders, comes out in 2013 there are so many newly proposed disorders (Toddler tantrums are a disorder? Really?) that these experts are in fear that soon no one will be "normal" anymore.

Some of the proposed additions - which include "mild anxiety depression," "psychosis risk syndrome,"  "temper dysregulation syndrome", and, yes, "toddler tantrums" - have the experts in fear that soon we will all have some sort of mental disorder.  "It's leaking into normality," said Til Wykkes of the Institute of Psychiatry at Kings College London.  "Its is shrinking the pool of what is normal to a puddle."

In a joint statement, Wykkes and colleagues Felicity Callard, also of Kings' Institute of Psychiatry and Nick Craddock of Cardiff University's department of psychological medicine and neurology, said many in the psychiatric community are concerned about the widening guidelines.  "Technically, with the classification of so many new disorders, we will all have disorders," they wrote.

The scientists also pointed to the current edition of the manual, the DSM-IV, citing how broadening of the definitions of attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders had "contributed to false epidemics" of these conditions, especially in the U.S.

"During the last decade," read the statement, "how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn't really need it?"

If you'd like to learn more about this issue, Wykkes and Callard published a comment in The Journal of Mental Health, which expresses the essence of their concerns, as well as highlighting another 10 papers in the same journal from scientists with similar concerns.

What do you think about this issue?  Are we at risk of turning normal into a disease?  What is normal anyway?

August 3, 2010 at 12:53 pm
(1) RebeccaOlesen says:

hey I know this isn’t the right place for this, but, I couldn’t find the forum spot where you discussed something you called “brain shivers” ?? I just wanted to tell you my information – on both lexapro AND effexor – I experienced this, I knew exactly what you were talking about just from the name, but, I always called them “electric zaps” it does always start in the head area but shoots down, usually for me down my back and into my arms, even at times causing my hands to involuntarily clench, while an electrical feeling spreads across my back. I have spoken to SOOO many people who have experienced this, the fact that the pharmaceuticals never even mentioned it makes me want to vomit. I knew all about it and so did anyone else I knew who ever took paxil, effexor, lexapro. The worst part about lexapro was that this effect was NOT a withdrawal, it was a SIDE EFFECT in the beginning – if I even SNEEZED i’d get that brain zap & my forearms & hands would lock up like a mini-seizure. And YEAH the doctor said he never heard anything like that. My personal opinion is that they never “hear” about this stuff because they just dont LISTEN !!!! I’m trying to get off Effexor now, if I had known how hard it is to get off, I never would have taken it – why don’t doctors tell people about that stuff? :(

August 11, 2010 at 4:49 am
(2) Michele says:

The subject of what is normal any more is interesting. i have been thinking about that for quite some time. I have depression issues for many years now. The drugs help but it is not a cure. When I worked as a nurse in Emerg. and Psychiatry 10 years ago you did not hear about all of these new diagnosis. Major depression and anxiety and bipolar was most common and schizophrenia. There has been Multiple Personality Disorder which is still difficult to diagnose and treat. A child having a temper tantrum in my opinion is not a disorder unless there is an indication of abnormality in the brain. Children have been having temper tantrums since there have been children. Now they are going to turn it into a disorder. The problem with all of these new emotional or mental issues is it gives people too much time to look at the symptoms and say I think that is what I have. Some people given enough information will have the ailment because they are over analyzing themselves with all of these new symptoms and disorders. What is normal anymore. I have to say that there are likely are large percentage of people that would tell you “I really don’t know.”

August 11, 2010 at 7:16 am
(3) Pat says:

I have been on Effexor for some time now and never had what you called a “Brain Shiver” Maybe I’m just one of the lucky ones who never experienced that side effect. This medication has helped me but I’ve heard that it is hard to get off from. I hope it will become easier for you.

August 11, 2010 at 7:48 am
(4) Marilyn Kaplan says:

Anything is normal that is not triggered by a bodily manfunction such as eipilepsy. Everyone reacts to life situations differently which is normal such as feeling sad, lonely, ugly, diminished in some capacity. All these things are normal feelings in human beings and we have given it the name of depression. If your life situation feelings become severe then it can require medication.

August 11, 2010 at 8:05 am
(5) Raymond Bernucho says:

Ms Nancy,
I suffer with Major Depression and possible PTSD. As a child growing up in a dysfunctional home, I was beaten all the time by my hateful father every time I did a little bit of nothing; by my brothers for not doing what they wanted me to do so that my hateful father would beat me. Also I was sexually abused by one of my brothers for about 6-7 years.
And now that I am a sex offender and found a 12 step program to help me with my addiction to sex, I’m just starting to understand what life is about. I don’t have a clue about what is “normal” in life, nor do I believe that Mental Health Professionals know either.
So when you find out what is “normal” truly is please let everyone know.

August 11, 2010 at 8:07 am
(6) QuestionAuthority says:

Re: Rebecca’s comment. I’ve been on these drugs for about 15 years. I can’t say that I’ve ever had the symptoms you describe. That doesn’t mean you aren’t having them, of course.

Re: “Normal” I recall taking a psychology class where the PhD teacher told us that “normal” was whatever society was doing at the moment. The idea of “normal” really is a nebulous thing and depends much on who is making the determination. I do agree that some of the new diagnoses seem to be stretching things. I don’t think temper tantrums shoud be a disorder, but a possible symptom of something else. In itself, I find it hard to buy that diagnosis as a stand alone after having raised two children.

August 11, 2010 at 8:37 am
(7) TNJ says:

I am a Licsenced Clinical Social Worker and I have been taught from my schooling on that basically everyone has “quirks” every one could read the DSM and find sometrhing that they identify with. The difference between actually having a mental illness and having the traits are more indepth. A lot ofthings have to fit to be diagnosed! Its actually hard to find people who meet all the crtieria! Another difference is that people with daignosable menatl illness have not been able to cope with thier traits and function normally in life (job, relationship, etc).

August 11, 2010 at 8:46 am
(8) Sarah says:

I am with all of you about these dx’s and not knowing what “normal” is. I have been dx’d with borderline personality disorder about 12 years ago. At that time, no one had hardly heared of this disorder. I think my psych just gave me that dx because they didn’t know what else to call it. I also do have a dx of Major Depression. I have what is called “treatment resistant” depression. Nothing works for me. I have had this so long I have no idea about what it is to be “normal”.

August 11, 2010 at 8:50 am
(9) brianp says:

I was once told the real importance of the DSM is for it’s insurance labeling role. A person shouldn’t need a large amount of help unless there is something substancially wrong. Maybe the reason normal and abnormal should be used is to identify people that need to be on S.S.I. and S.S.D.I. because of a problem that prevents them from normal work. Everyone has things involving their mind that could be viewed as deppression, bi-polar disorder, anxiety, etc., but what normal seems to be to me is the ability to make a living. (This “making a living” should include people that make minimum wage but have to resort in government assistance with insurance because wages are a social problem but not relavent to this imediate subject. Every person should have fair access to medical care and we should all pressure for everyong to be able to get medical treatment when they need it. Mental healthcare IS medical treatment.) I.E. – a peroson diagnosed with Asperger’s syndrome but able to hold a job and own a house and car and pay bills on time should be thought as normal, but, another person with Asperger’s syndrome but appears to be less autistic should be considered not normal when this person can’t hold a job due to their disorder.

August 11, 2010 at 9:48 am
(10) BEN says:

Perhaps a criterion for distinguishing true disease or disorder from normal ranges of human mental behavior /emotion would be that to be a disorder /disease a symdrome or symptoms must cause serious pain and/or potential serious risk of harm to one self or others which the sufferer i s more likely than not to be unable to alleviate by his or her own unaided will power or positive thinking or behavioral change activity. a serious depression characterized by total anhedonia, paralyzing anxiety, suicidal ideation, even if not acted on or about to be, severe psychic pain, radical alarm responses, inability to motivate oneself to act positively, and flat affect sometimes alternating with weepiness of a hopelessand unrelieving sort is not likely a symdrome that eh sufferer unaided by a professional or medication is likely to be able to alleviate and end himself or herself by positive thinking, efforts at self-help other thaqn damaging self medication by alcohol, etc., and which non-professionals and lack fo use of medications is are not likely to lead to a termination of within a reasonable period of time is a dangerous condition destructive of human relationships and of anyh stability fo functionality in “normal”life. Such a criterion more professionally defined should eliminate the tendency to define normal unhappy or troublesome behaviors as “disease” or “disorder”. Simply being a PITA is not a disorder or disease if the PITA could help it and not be one!

August 11, 2010 at 12:56 pm
(11) Sue says:

I agree with TNJ that it is important to distinguish between “traits” “quirks” and a full-blown diagnosable disorder that leaves the individual unable to function in current society. I also think that by expanding the guidelines, more people will hide behind their “diagnosis” and use it as an excuse not to do the hard work involved in healthy relationships, parenting, working, and so on. I already hear a lot of, “Well, that’s just the way I am” as an excuse for any number of self-absorbed behaviors that do not contribute to stable relationships or work patterns.

August 11, 2010 at 4:57 pm
(12) Susan says:

Maybe those who define “Normal” are really the abnormal ones :-) )

August 11, 2010 at 8:59 pm
(13) studying says:

why would anyone go by the dsm definitions when they don’t have a clue as a treating psychiatrist and don’t take any notice of what you say to them or what your carer says. here here susan. fully agree and couldn’t have said it better myself.

August 12, 2010 at 4:32 pm
(14) Nigel says:

Your ability to function in all/most areas of life sucessfully for me is a prime definition of normal.
Of course, what your definition of sucess is can vary wildly from one person to another. It would probaly be your definition of sucess that is important.
You could have a great job and make a good living but not be able to function in a marriage, then you have issues.
I doubt there is one definition of the word normal, so once again I defer to the idea of being able to function sucessfuly in every area of your life.
And is it a Journey or a Destination?

October 27, 2010 at 3:12 pm
(15) redshakti says:

like michele’s comment . . . why not attempt meditating under the direction of a qualified teacher? why not refrain from gazing @ ones belly button and think of all that is . . . reach out . . . do anything other than whine!!!

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