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Failure to function adequately
 
Most people suffering from psychiatric illness are in some way unhappy. 
 
  • Depression leads to very low mood, apathy, despair and in extreme circumstances sufferers seek to end their lives.
  • Anxiety disorders lead to excessive feelings of stress resulting in the patient being too fearful to lead a ‘normal’ life.
 
Society (that word again), recognises or sets the standard for how people should lead their lives, a failure to meet this standard of functioning could therefore be regarded as abnormal.  Some see this approach as the most humane since it is left to either the person themselves, or those close to them, to decide if professional help is required.
 
Sue et al (1994) believed that most people seeking psychiatric help are suffering from a sense of distress or discomfort as a result of their problem.   This is supported by the view of Miller & Morley (1986) who saw distress as the primary motivation behind seeking help.
 
Rosenhan & Seligman (1989) decided on seven criteria for ‘failing to function’.  It is important to remember that any one, or even small number of these, is by no means unusual.  However, if a person is experiencing many or all of them, then this would constitute cause for concern.
 
Evaluation
This definition does take into account the experience of the patient.  It can also be assessed objectively.  For example we can see whether a patient is able to feed themselves, maintain hygiene etc. 
 
However, many of these depend upon context, brightly coloured hair would be fine at a fancy dress or punk reunion, exposing body okay on a nudist beach or rugby club!   At various times most of us will adopt at least some of these behaviours, swearing in a pub, behaving in a dangerous way, showing mood swings, talking to ourselves etc.  Deciding on abnormality using this method is very subjective, open to interpretation and very context dependent.
 
Cultures have different expectations about how people should behave.  What we would see as irrational, vivid and unpredictable might not be seen so odd by people in other cultures.  Yet again we have the issue of imposed etic.  A theory developed in the West is rolled out and used to judge other cultures
 
Maladaptive behaviour may not be as maladaptive as it seems.  It may get the person the attention they need or crave.  Transvestism is, according to DSM IV a psychological disorder.  However, some people make a good living from it.  Similarly transsexuals in Pakistan make a living by working as tax collectors.  The arrival of these taboo figures quickly persuades non-payers to pay up!
 
Distress alone is not a good indicator of abnormality.  There may be an obvious cause such as bereavement.  In some disorders such as schizophrenia, the patient is unaware of their problem.  It’s those around them that endure the suffering and usually report the condition.  The patient themselves believe they are functioning adequately. 
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