14Psychological Disorders

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VIRGINIA WOOLF LEFT HER WALKING STICK ON THE BANK OF THE RIVER, put a large stone in the pocket of her coat, and made her way into the water. Her body was found 3 weeks later. She had written to her husband, “Dearest, I feel certain I am going mad again. … And I shan’t recover this time. I begin to hear voices, and I can’t concentrate. So I am doing what seems the best thing to do” (Dally, 1999, p. 182). Thus life ended for the prolific novelist and essayist, a victim of lifelong “breakdowns,” with swings in mood between severe depression and unbridled mania.

The condition afflicting Woolf is now known as bipolar disorder. At one extreme were her episodes of depression: She was sullen and despondent, and she was sometimes bedridden for months. These periods alternated with mania, when, as her husband recounted, “She talked almost without stopping for 2 or 3 days, paying no attention to anyone in the room or anything said to her.” Her language “became completely incoherent, a mere jumble of dissociated words.” At the height of her spells, birds spoke to her in Greek, her dead mother reappeared and scolded her, and voices commanded her to “do wild things.” She refused to eat, wrote pages of nonsense, and launched tirades of abuse at her husband and her companions (Dally, 1999, p. 240). Between these phases, Woolf somehow managed a brilliant literary life, producing nine novels, a play, five volumes of essays, and more than 14 volumes of diaries and letters. In a letter to a friend, she remarked, “As an experience, madness is terrific” (Dally, 1999, p. 240). The price that Woolf paid for her genius, of course, was a dear one. Disorders of the mind can create immense pain.

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IN THIS CHAPTER, WE FIRST CONSIDER THIS QUESTION: What is abnormal? Virginia Woolf’s bouts of depression and mania and her eventual suicide certainly are abnormal in the sense that most people do not have these experiences, but at times, she led a perfectly normal life. The enormously complicated human mind can produce thoughts, emotions, and behaviors that change radically from moment to moment. How do psychologists decide when a person’s thoughts, emotions, and behaviors are “disordered?” We will first examine the key factors that must be weighed in making such a decision. We’ll then focus on several of the most common mental disorders: anxiety, obsessive-compulsive, and trauma-related disorders; depressive and bipolar disorders; schizophrenia; disorders that begin in childhood and adolescence; and self-harm behaviors. As we view each type of disorder, we will examine in turn how it is manifested and what is known about its prevalence and causes. As we’ll see in the next chapter, a scientific approach to understanding mental disorders offers some remarkably effective treatments, and for other disorders, it offers hope that pain and suffering can be alleviated in the future.