Mad as Hell

We had our first class in psychiatry yesterday and will be taking time every Tuesday to go into a mental health ward and interview patients who have all sorts of conditions, ranging from eating disorder and depression to schizophrenia and PTSD.

While this is all really interesting, I’m already apprehensive about this class. Don’t get me wrong. I’m not skeptical about mental health – quite the opposite. Rather I’m skeptical about the medicalization of mental health, essentially an overzealous categorization of “abnormal” behavior as mental health illness.

In class we watched a video clip of a man ranting and the instructor told us to diagnose his mental status, suggesting that he was suffering from some kind of mental health disorder that was making him mad. “Be sure to examine his appearance. Is it disheveled? How about his speech? Is he exhibiting abnormal behavior?”

Not only do I feel strange diagnosing someone in a movie that’s supposed to be satirical in the first place, but also I feel like we were diagnosing his mental status without understanding why he was ranting in the first place. While I recognize the value of being able to help people with mental health problems, I’m not sure why we had to go about examining him as if he were already “mad.”

And that’s where I feel like medicine falls short in helping people with mental health problems – that it’s become more about diagnosing and prescribing medication and less about getting to know the person behind the illness. Maybe that’s not fair to the psychiatrists out there who aren’t like this, but in any case we need to do more to change this culture. We’ve come a long way in recognizing the mentally ill as human beings but there’s still more to be done.

I later went online to look up what movie this clip came from. The main character, a news anchor, had just learned that he was getting fired from his job, and feeling crushed and wronged because he had once brought the show high ratings, he unexpectedly starts ranting on air that life is bullshit. Of course then, he would be “mad as hell.”

Here’s the clip of the rant. It’s also a great speech:

One Response to “Mad as Hell”
  1. Thank you for sharing your perespective. It was insightful and honest. In many ways I agree with you, sometimes it appears as though it’s not
    about getting to know the patient behind the illness. However, many physicians and other healthcare providers do not trivialize disease and see the person as the focal point. I guess it depends on the person. It’s great to know you will be a physician that seeks to know the person before the illness.
    Keyon Mitchell

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