The problem in finding an answer to this question is that one cannot get out of one’s own mind to objectively assess things, and our conscious mind has a limited capacity to access the totality of our mind, including our unconscious mind and the unhappiness contained in it. It is also not possible for us to get into somebody else’s mind so that we can compare our unhappiness with theirs. One can have a vague idea of the other person’s unhappiness by analyzing what is visible – language, behavior, and moods.

Mental Health Act 1983

Mental health professionals across the globe have struggled to find a satisfactory definition of mental illness. For the same reason, clarity about normal mental health would be equally difficult.

The Mental Health Act 1983 in the UK (Amended 2007) defines mental illnesses as – “any disorder or disability of the mind.” “Relevant professionals should determine whether a patient has a disorder or disability of the mind in accordance with accepted standards of what constitutes such a disorder.” This leaves room for a range of professional opinions that can be accepted as correct.  The definition of mental health that we come across generally is, “absence of mental illness.” In my opinion, it does not take us any further than where we already are in terms of our understanding of mental illness and mental health.

If one’s negative emotions are strong but their ability to manage them is also high, one may not see one’s suffering as abnormal, in fact, one will not be able to even notice it. On the other hand, if the strength of those painful emotions is low and their capacity to manage them is much lower, one may see the resulting unhappiness as unacceptable and abnormal.

There is also an issue here about whether one sees one’s unhappiness as ontological (inevitably related to existential issues such as ultimate separation, loss, and mortality) which has no solution, or ontic (which can be remedied), and there will be consequences to any confusion or miscalculations here.

Seeing one’s ontic suffering as ontological, one may not look for solutions to the problems which can be solved. On the other hand, seeing ontological suffering as ontic may result in unnecessary efforts to resolve it and the multiplication of one’s unhappiness.

At times, it is better to experience pain and suffering and grow, rather than stagnate. According to existentialism, we grow because of the enrichment of our life experiences, and this enrichment includes both happy and unhappy experiences. When consciousness expands, it expands in all directions. From this perspective, one can live in a limited subset of their true potential and avoid pain, and thus experience only normal human suffering. One can adapt one’s lifestyle in such a way that one avoids situations, people, places, and activities that make one anxious and thereby stay in the fold of normal human suffering. This normal suffering will not be desirable. As opposed to this, one may venture out into new territories and keep pushing their boundaries and experience greater pain. This abnormal suffering would be desirable. On occasions, we find that the path to greater joy passes through greater pain.

It has been documented in spiritual texts that before a spiritual awakening one can go through intense psychological pain, described in Christian literature as the dark night of the soul. Vivekananda, Raman Maharshi, Eckhart Tolle, and Neale Donald Walsh all experienced deep anguish, near-death experiences, and suicidal thoughts before the awakening of their souls happened.

I normally recommend understanding mental health in terms of one’s finances. Having a mental illness is like you have spent all the money you had and have started borrowing. It is quite normal to borrow money and almost all of us have done it at some point in our lives. However, it would be abnormal if we are not able to return the money. In a similar fashion, it does not matter what symptoms we have experienced in life; it will not be abnormal if we are able to bounce back to our everyday well-being and functioning.

Sometimes people have suffered from long-term psychological problems since childhood and have difficulty understanding what is normal. It is like somebody who was born with a visual impairment will not know how it feels to see things normally, and if by any luck they undergo a treatment that gives them their vision they will, for the first time in their life, know what normal vision is.

Similarly, children born in dysfunctional families have no idea how it feels to be brought up in a healthy family environment. They accept their experiences and feelings of growing up as normal, alternatively, some of us may have a very romantic view of life if we were brought up in idyllic settings. All this makes it very difficult to understand what is normal.

 Psychiatric texts describe the following seven ways of understanding and defining mental illness and mental health.

Statistical average – here the normalcy is understood in terms of the statistical average, assuming that things are normally distributed. Anything within one standard deviation (covering 68% of the population) or two standard deviations (covering 95 per cent of the population) would be classed as normal. The problem with this definition is that the outliers on the positive side will also be classed as abnormal. An IQ above 120 or 130 would be classed as abnormal. The second problem with this definition is that sometimes a problem affects most people in society, but it is still classed as an illness that needs treatment. An example of a physical illness would be of cataract. The majority of the elderly population will have cataract problems and it can be seen as normal using a statistical model. But it is also seen as an illness that should be treated with surgery otherwise one will continue to suffer.

The second approach to understanding what is abnormal is in terms of the maturity level. What is normal at age 20 may become abnormal at 40 or 60. At the age 60, a person is expected to be psychologically healthier than they were 20 or 30 years ago. Being socially awkward and shy during adolescent years would be quite normal, but the same behaviour would be classed as abnormal in their 30s or 40s. it’s okay for a three-year-old girl to talk to her barbie doll as if it was a living being, but the same behaviour from a 30-year-old woman would be abnormal. In this context learning, disability would be classed as abnormal.

Erik Erikson has described four stages of maturation and their failure as follows:

• Identity v identity crisis – seen in adolescence
• Intimacy v isolation – seen in your adults
• Generativity and stagnation – seen in midlife
• Integrity v despair – seen in elderly

George Valliant has added two more categories

• Career consolidation
• Keepers of the meaning

The third approach would be to look at one’s moral and spiritual development which should take place at the right time, in the absence of which one may be classed as abnormal. With growing up one must develop love, joy, forgiveness, compassion, faith, gratitude, awe, etc. One may find many of these qualities missing among psychopathic personalities, terrorists, mafia dons, etc which would be classed as abnormal.

Another dimension that should help us decide normality is – the lack of social and emotional intelligence. These will include the capacity to self-soothe, emotional regulation, understanding others’ emotions, interpersonal and social skills, etc. We see these lacking in people who are socially awkward – autistic spectrum disorder, emotionally unstable personality disorders, avoidant personality disorders, etc.

Subjective well-being – is another yardstick. The dictum is – “If you think you are unwell, you are unwell.”   Or “no man is happy who doesn’t think himself so.”

Mental resilience. It is about one’s coping abilities. According to Adolf Meyers (1975), there are no mental illnesses, there are only characteristic reaction patterns to stress in the form of denial, phobia, paranoia etc., and these are normal, vital phenomena related to healing. The examples given are – callus formation or clotting of blood are not illnesses, similarly diarrhoea and vomiting after food poisoning is not an illness, and swelling and redness after an injury is not an illness but the body’s attempts to repair. Along the same lines, anxiety, depression, and psychosis are individuals’ struggles to adapt to life.

Presence of psychological and psychosomatic symptoms that we do not see normally.

At times normal behaviour of an individual can be more painful to others than mental illness. I had a patient’s relative who said to me “my sister who has got an anxiety disorder is such a darling, I love her to bits, and can’t live without her, and my brother who doesn’t have any illness is hard work, we are constantly arguing, and we can’t live under one roof.”

We also see retrospective falsification, some clients understand their problems in terms of coming from a dysfunctional family, and when I ask them to describe their ideas of a dysfunctional family, I get a variety of different responses, and at times their definition of a dysfunctional family may differ from the definitions used by professionals.

Conclusion 

To conclude, I would say that we all have mental health issues, and we all should keep trying to better ourselves the way we try to improve our financial situation even if we are not in a dire financial situation.

Just because one does not have a diagnosable mental illness does not mean they do not need to work on their personality.

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