Nurturing Understanding: An Exploration of Less Common Forms Of Mental Illness
Most people are familiar with common categories of mental health conditions. Symptom features of many of these conditions exist on a continuum ranging from the occasional occurrences in the “normal” population to more severe forms of diagnosable mental illnesses.
For example, depression and anxiety are common emotional experiences familiar to most of us at different times in our lives.
However, more severe and persistent symptoms of anxiety and depression may be associated with a diagnosable condition that requires professional help, including traditional psychotherapies and medication or forms of nontraditional or holistic treatment methods.
Familiar Types of Mental Disorders:
Some classes of mental illness are probably familiar to most people. I’ve written blogs about several of these more common conditions, such as:
- Bipolar Disorders
Navigating Bipolar Disorder: Key Information on Diagnosis and Treatment
- Schizophrenia and Related Psychoses
- PTSD and related forms, such as C-PTSD (Complex Posttraumatic Stress Disorders)
Breaking the Silence: Uncovering the Lingering Impact of Hidden Trauma
I want to draw attention to some lesser-known types of mental health struggles. You may have heard of some of these, but others might seem unfamiliar and obscure. Shining light on some of these conditions serves two purposes:
First, learning about less common conditions demystifies them, making them seem less frightening. Second, increasing awareness of them helps us understand and empathize with people who may suffer in the shadows.
My review is not exhaustive; some conditions are more common than others. Whichever is the case, knowing something about these will humanize the experiences of those who suffer from such conditions.
Let’s begin with some that will sound more familiar and work our way to some rarer forms of mental illness. When appropriate, I’ve included links to sites that provide more information about treatments for these conditions.
You’ve Also Probably Heard Of:
Conversion Disorders
Now called Functional Neurological Symptom Disorder in the DSM-5-TR, in which sensory, perceptual, and motor symptoms or alterations in other functions are incompatible with recognized neurological conditions.
OCD
Stands for Obsessive Compulsive Disorder and is characterized by having recurrent, unwanted, and intrusive images, thoughts, and impulses called obsessions and an intense pressure to perform repetitive actions in response to obsessions. These activities are called compulsions, which the individual feels unable to control.
Dissociative Disorders
Are a group of conditions characterized by a disruption or disconnection of psychological functions such as consciousness, memory, emotion, perception, identity, and behavior. The essential feature is a loss of continuity in one’s subjective experiences of ourselves or the world around us.
We may become detached from or strangers to ourselves and the environment where things (or we) do not feel real.
Removing ourselves from threatening events may be a form of self-protection in highly stressful situations; however, the defensive process of dissociation may develop into a condition that severely disrupts the continuity of our experiences.
Dissociative disorders are often associated with psychological trauma.
Less Common Mental Health Conditions:
Lesser-known variants of neurological conditions, anxiety, depression, OCD, trauma-spectrum disorders, and psychoses include some of the following disorders:
Narcolepsy
Is a sleep disorder in which individuals suffer from recurrent “sleep attacks,” characterized by an irresistible need to sleep or suddenly drifting off during the daytime.
Individuals with narcolepsy may experience cataplexy, which may involve a sudden loss of muscle tone for brief periods of time that may be precipitated by laughter or joking.Other features may include sleep paralysis and hallucinations associated with sleep onset or awakening.
Body Dysmorphic Disorder
Is related to OCD and is characterized by a preoccupation with perceived defects or flaws in one’s physical appearance, which make them appear ugly and deformed. Body Dysmorphic Disorder has some similarities to the eating disorder Anorexia Nervosa in that both involve severe body image distortions that others cannot detect.
Some believe Michael Jackson suffered from Body Dysmorphic Disorder, which led him to seek repeated cosmetic surgeries.
Dissociative Identity Disorder (DID)
Previously referred to as “Multiple Personality Disorder,” is a severe variant of dissociative disorder in which the individual has more than two distinct personalities, which show different cognitive, emotional, sensory, and social characteristics.
The development of separate and discrete personalities is typically the result of severe, complex trauma.
Synesthesia
Synesthesia is another neurological condition in which sensory and cognitive pathways become connected in atypical ways. Thus, stimulation of one pathway creates an autonomic connection to another neurological pathway so that the individual experiences two sensory phenomena simultaneously.
For example, music or numbers may have different shapes or colors. Synesthesia is less of a disorder and more of an anomalous neurosensory condition that can enhance creativity.
Micropsia
Is a condition more often seen in children in which the perception of one’s body, time, and space is distorted. For such individuals, objects appear much smaller than they are. Micropsia has been referred to as “Alice in Wonderland” or Todd Syndrome.
Unfortunately, referring to his neurological conditions as Alice in Wonderland Syndrome may trivialize the individual’s suffering. Todd Syndrome may be the result of brain injury, tumors, severe migraines, or drug abuse and may trigger hallucinations and panic.
Alien Hand Syndrome (AHS)
is another neurological disorder characterized by a conviction that one’s hand has an independent life. Sensations in the hand may be normal, but the hand feels autonomous, as if it had a life of its own.AHS has been called “Dr. Strangelove Syndrome,” based on the 1964 dark political satire starring the unforgettable Peter Sellers as the mad nuclear scientist who tries to subdue one of his hands as it repeatedly tries to strangle him.
Like Todd Syndrome, AHS is a severe brain-related illness that is unfortunately minimized by referring to it by the name of a fictional character.
Cotard’s Syndrome
is a delusional condition that bridges the syndromes of schizophrenia and anxiety disorders. The essence of the delusion is the fixed belief that one is dying or already dead. A psychotic disorder that is sometimes associated with auditory hallucinations, Cotard’s delusion may lead a sufferer to stop eating or taking medication.
Cotard’s has also been called “The Walking Corpse Syndrome.” As we have seen above, people may attempt to lessen their anxiety about such rare and severe conditions by referring to them by names that minimize the severity of symptoms or dehumanize the people afflicted with such conditions.
Capgra’s Syndrome
is another delusional disorder in which the person believes that an imposter has replaced a close friend or family member. It may exist as a freestanding delusional disorder or as a symptom of schizophrenia, a traumatic brain injury, epilepsy, or dementia.
The Role of Culture in Distress and Illness
Culture influences how one experiences suffering and distress. The most current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR, 2022, American Psychiatric Association) includes a separate section on culture and mental health conditions.
In addition to offering mental health professionals guidance in conducting culturally informed assessments, the DSM describes ways that culture can influence and shape how people experience, interpret, and express illness and distress.
Additionally, the DSM presents examples of specific cultural concepts of distress. Here are a few examples:
- Ataque de Nervios, a condition found in Latinx culture, describes intense symptoms of emotional dyscontrol, panic, and physical upset, which may include dissociative and seizure-like experiences. Ataque may result from a stressful event relating to one’s family.
- Hikkomori is a Japanese condition involving severe social withdrawal that can result in a complete loss of in-person interaction. A typical scenario may involve a young male who does not leave his bedroom in his parents’ house.
- Khyâl cap is a syndrome found within Cambodian cultural contexts, which includes panic attacks, dizziness, shortness of breath, and other anxiety-related symptoms. Also referred to as “wind attacks,” Khyâl cap may consist of a catastrophic fear that a wind-like substance may arise within the body and cause devastating effects.
- Maladi dyab is a culturally based illness explanation for a variety of mental health and medical disorders within the Haitian communities. The model holds that envy and malice may lead people to have sorcerers send illnesses, such as anxiety, depression, psychosis, or functional incapacitation.
This brief review of mental health syndromes, some more familiar than others, is a small sampling of the myriad symptoms of distress and dysfunction that individuals may struggle with at some point in their lives. Understanding and naming what appears foreign and strange brings us closer to empathizing with others’ struggles and appreciating our shared humanity.
Unusual Mental Health Conditions Depicted in Literature
One of my favorite books, The Echo Maker, by Richard Powers, is a poignant story about a man suffering from Capgras Syndrome after an automobile accident. Powers writes about his sister’s anguish at her brother’s belief that an imposter has replaced her.
Capgras delusion, also described in Jonathan Rosen’s chilling book, The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions leads to a tragic act of violence when a man misbelieves that a robot has replaced his wife.
I was so moved by this story that I made it the focus of a recent blog.
The Stigma of a Mental Illness and the Tragedy of Not Recognizing the Reality of It
In Talking to the Dead, Harry Bingham, originator of Jericho Writers, has created a crime series that introduces us to Fiona Griffiths, a detective who suffers from Cotard’s Syndrome.
Flora Rhreta Schreiber’s 1973 classic Sybil introduced us to the plight of a young woman suffering from Dissociative Identity Disorder, whom she called Sybil Dorset.
In my own mental health fiction, Tears Are Only Water, The 11th Inkblot, and my work in progress, Whispers, I’ve created characters struggling with neurodiversity and conditions ranging from bipolar disorder to narcolepsy, PTSD, and traumatic and drug-induced psychosis.
Writing about a character’s mental health condition reminds us that we’re all human. Their journeys help us connect to experiences, and their tragedies may make us feel more fortunate and ultimately more hopeful.
I believe that writing about individuals who struggle to overcome their mental illnesses humanizes their struggles, makes them seem less strange and alien, and ultimately helps us become more compassionate.
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