Act normal!

Are you feeling a little down or depressed? Would you describe your child as being lively or is he/she suffering from AHDH? At what point does feeling sad become a disease that has to be treated? And does that treatment consist of medicine or cognitive therapy? Is a psychological disorder genetically determined or is it mainly caused by environmental factors? What is a psychological disorder exactly and does it help to make worldwide agreements about it? And what role does politics play in prevention, and in caring for patients?

In her book ‘Doe eens normaal; over zin en onzin van psychiatrische diagnoses’ (loosely translated: ‘Act normal; sense and non-sense about psychiatric diagnoses’, only available in Dutch), investigative journalist Malou van Hintum goes into these types of questions in detail. It’s a definite ‘must read’ for all managers, HR managers, coaches and trainers as she writes in a refreshingly accessible manner about the issues I just mentioned. But she also voices her doubts about the effectiveness of the current approach in politics that considers ‘mental health care’ as predominantly a cost to be limited and as a responsibility for the individual. It’s an approach that is geared towards placing the burden of costs on the individuals concerned.

In a well-constructed argument, Malou shows how psychological disorders are largely a social issue requiring a different approach to the current individual, medication-based one. What does she base her opinions on? In contrast to what many people think, biological factors generally play a minor role in the origins of a disorder. Today, the ‘nature or nurture’ debate is tipping in favour of ‘nurture’: ‘Our genetic makeup is overflowing with possibilities, both negative and positive, and our environment plays a big part in determining which of these possibilities actually manifest themselves.

How is it that the lower educated, relatively speaking, more often suffer from depression, are more often victims of heart disease, smoke more, are more obese and have a lower life expectancy? ‘The difference in a healthy life expectancy is significant: higher educated individuals live on average 15 years longer without any restrictions than lower educated persons, and nine years longer without any chronic illnesses. The difference in life expectancy between higher- and lower educated persons is also striking :7 years longer.’ Do the lower educated then have ‘bad’ genes or other biological factors that result in them being extra susceptible for these diseases? Not at all! It has a lot do with environmental factors. But once you become aware of the fact that the group of lower educated persons is the least receptive to an individual approach, then it becomes very difficult to believe that the political choice to further individualise health care and to get the ‘originator’ to pay will ever work.

Marlou also treats the topics of ADHD, depression and autism comprehensively in her book, explaining what these disorders are and what misconceptions exist concerning their cause and treatment. Doubts are raised about the use of medicines (at all or excessively). At the same time, she answers the question of whether we are currently being too zealous in attaching ‘disorder labels’ to individuals. This label attaching is done, ironically, based on agreements defined in the manual for psychiatry – the DSM-IV. But does it make any sense to make worldwide agreements about when certain behaviour is to be considered a disorder? Is the method of describing corresponding behaviour just too vague and their categorisation outdated? Is enough allowance being made for cultural differences? And will the DSM-V that is due to be published next year label even more ‘deviant’ behaviour as a disorder? The answers given by several specialists are clear. ‘They don’t believe for a minute that there is something wrong with so many people. And they consider that we are deliberately being made ill – by doctors, researchers and the pharmaceutical industry, who all gain financially as a result. There’s a lot to be earned in the sickness industry after all.‘ Just watch this film. Is the child extremely curious and perhaps a bit restless or is it a case of ADHD? Make up your own mind.

And finally, let me present some statistics with regard to psychological disorders in the Netherlands (statistics outside the Netherlands are not available).

  • 40% of Dutch citizens have had a psychological disorder at some point in their lives.
  • This figure has remained constant for more than 10 years.
  • Every year 1.9 million Dutch people between 18 and 64 suffer from a psychological disorder.
  • Of these, almost 550,000 suffer from a depression and almost 400,000 from a social phobia.
  • Anxiety- and mood disorders occur most frequently: 2 in 10.
  • 1.5 in 10 Dutch people suffer from alcohol abuse.
  • 1 in 10 Dutch people suffer from attention deficit- or behavioural disorders.
  • Almost half of those with a disorder suffer from more than 2 illnesses.
  • The chance that someone of lower education will suffer from an antisocial behaviour illness is 3 times greater than someone with a higher education.
  • The chance that someone with a low income will suffer from ADHD is 8 times greater than for someone with a high income.
  • People with narcissistic and psychopathological tendencies are over-represented in the top echelons of companies and institutions.

In other words, the chance that someone you know or meet has a psychological disorder (diagnosed or not), or has had one in the past, is considerable. How do you view them and what is your responsibility as a manager, HR manager, trainer or coach? What do you know about these disorders? Do you know how you should act if someone displays ‘deviant’ behaviour? If these questions have aroused your curiosity, then read more about psychological disorders.

Enjoy being (ab)normal!

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