Disorder and Dysfunction

The twentieth century saw the exploration of many avenues in the treatment
of mental disorders. Treatments ranging from classical psychoanalysis
to cognitive and humanistic therapies to the use of therapeutic drugs were
applied. Psychologists examined the effects of mental disorders on many aspects
of life, including cognition and personality. These disorders affect the
most essential of human functions, including cognition, which has to do
with the way in which the mind thinks and makes decisions. Cognition does
not work in “ordinary” ways in the person with a serious mental illness, making
his or her behavior very difficult for family, friends, and others to understand.
Another aspect of cognition is perception. Perception has to do with
the way that the mind, or brain, interprets and understands the information
which comes to a person through the senses. There is a general consensus
among most human beings about what they see and hear, and perhaps to a
lesser extent about what they touch, taste, and smell. The victim of mental
illness, however, often perceives the world in a much different way. This person
may see objects or events that no one else sees, phenomena called hallucinations.
The hallucinations may be visual—for example, the person may
see a frightening wild animal that no one else sees—or aural—for example,
the person may hear a voice that no one else hears, accusing him or her of
terrible crimes or behaviors.

A different kind of cognitive disorder is delusions. Delusions are untrue
and often strange ideas, usually growing out of psychological needs or problems
of a person who may have only tenuous contact with reality. A person,
for example, may believe that other employees are plotting to harm her in
some way when, in fact, they are merely telling innocuous stories around the
water cooler. Sometimes people with mental illness will be disoriented,
which means that they do not know where they are in time (what year, what
season, or what time of day) or in space (where they live, where they are at
the present moment, or where they are going).

In addition to experiencing cognitive dysfunction that creates havoc,
mentally ill persons may have emotional problems that go beyond the ordinary.
For example, they may live on such an emotional “high” for weeks or
months at a time that their behavior is exhausting both to themselves and to
those around them. They may exhibit bizarre behavior; for example, they
may talk about giving away vast amounts of money (which they do not have),
or they may go without sleep for days until they drop from exhaustion. This
emotional “excitement” seems to dominate their lives and is called mania.
The word “maniac” comes from this terrible emotional extreme.

At the other end of the emotional spectrum is clinical depression. This
does not refer to the “blues” of ordinary daily life, with all its ups and downs,
but to an emotional emptiness in which the individual seems to have lost all
emotional energy. The individual often seems completely apathetic. The
person may feel life is not life worth living and may have anhedonia, which
refers to an inability to experience pleasure of almost any kind.