Who Is Insane? : From Psychiatric to Sociological Explanation of Mental Health Issues

This paper challenges the individual-focused explanations of psychiatry for mental health issues like anxiety disorders, offering a sociological perspective instead. Based on the analysis of 30 case studies, I observed that individuals with these disorders often possess traits like deep self-reflection, a strong moral compass, better understanding of emotions and concern for others’ emotional well-being. These individuals, often seen as immature by their peers, struggle to conform to traditional definitions of success. They internalize values such as honesty, empathy and passion, which society outwardly promotes but inconsistently practices.

Building on the Power Threat Meaning (PTM) framework proposed as an alternative by some psychologists to the Diagnostic Statistical Manual of Mental Disorders, society functions with coping mechanisms divided by power hierarchies. Those at the top reject the idealistic values focusing on profit. People lower in the hierarchy live a dual life—outwardly espousing the idealistic values but privately adopting behaviors to succeed. Some feel conflicted yet maintain this duality for survival, while others use defense mechanisms like denial to adapt.

However, individuals with mental health issues often refuse or are unable to adopt this duality, remaining true to their values. This challenges the implicit social contract maintained between different levels of power hierarchy, leading to their diagnosis with mental disorders. Psychiatry, as Thomas Szasz argued, serves as a tool to label those who resist societal norms.

Psychotherapy for these individuals involves two paths: helping them conform to societal expectations or fostering their strength to maintain their integrity against immense social pressure. Both paths are challenging, with the latter requiring resilience that can lead to emotional breakdowns. Ultimately, this paper suggests that these individuals' mental health issues stem from their struggle to adapt to the hypocrisy inherent in the society. It also explores other options to address their mental health struggles more effectively.