WHEN YOU STUDY THE DSM-IV (which will soon be the DSM-V), you suddenly discover every single one of your friends and family members has a serious mental illness. You read it, therefore you diagnose it, as matter-of-factly as you wake up, therefore you get out of bed. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, is the current psychotherapist’s bible. It describes in painstaking detail every psychological disorder officially recognized by an elite team of mental health professionals.
I’ve heard the same phenomenon seizes wanna-be doctors when they attend medical school. They get a bellyache and wonder, Do I have appendicitis? Diverticulitis? Abdominal cutaneous nerve entrapment syndrome?
For those studying abnormal psychology, the diagnosing starts with ex-boyfriends, loved ones and pets. Your mother-in-law is histrionic. Your sister has obsessive-compulsive tendencies. The cat has panic attacks. Your ex-boyfriend is an asshole – oh, wait, that’s not a diagnosis – your ex-boyfriend has narcissistic personality disorder. The realization that everyone in the whole world is certifiably crazy soon extends to people you’ve never met, like the child throwing a tantrum in the grocery store who obviously has oppositional defiant disorder, sure to blossom into conduct disorder since his mother appears to be bipolar.
At three o’clock in the morning, when your partner is fast asleep beside you, and you are mid-way through reading the DSM-IV, all eight hundred eighty-six pages that your professor has insisted you memorize from beginning to end, you realize that you have the symptoms of two-thirds of the two hundred ninety-seven mental illnesses in the book. You, too, are diagnosably crazy, nuts, cuckoo, bonkers, wacko.
Panicked, you shake your partner awake. “I think I might be autistic,” you whisper. “Shut up,” she mumbles.
Now you can’t fall back to sleep until you’ve pinned it down. You have been feeling a little insane lately. You find yourself reading the DSM-IV late into the night like a cheap romance novel, scanning for the exciting parts, the detailed descriptions of dirty little secrets. Do you have Generalized Anxiety Disorder (300.02)? Adjustment Disorder with Mixed Disturbance of Emotions and Conduct (309.4)? Rumination Disorder (307.53)? Borderline Personality Disorder (301.83)?
While I was studying the DSM-IV, I arrived home one day to find my partner in the bedroom. The sheets lay in a heap on the floor, the mattress leaned up against the wall, and she had disassembled the bed frame into now unrecognizable chunks of pine that were once legs and slats and a headboard. This deconstruction of critical household objects happened frequently while I was out. My partner would tear apart a piece of furniture she had built or knock a hole in the wall, because she had a vision in her head of something better, stronger, more amazing. She was either schizophrenic, or she had an artist’s brain. I hoped it was the latter.
“Hey!” I shouted as she hammered and banged amidst a pile of debris. “Maybe you’ve got progressive destructive disorder!”
She looked up at me. “What’s that?” she asked.
“It’s when you build something new, and you’re pleased with yourself for about ten seconds and then you get disgusted because you realize you can do better, so you rip it all apart and start over again. You feel your creations are never good enough, so you have to constantly destroy and rebuild them.”
“Oh my god, that’s me!” she said. “There’s a name for what I have. I feel so relieved I’m not alone.”
“Actually, I just made it up,” I said, laughing. I stopped laughing when her face fell.
She glared at me. “For a split second, I felt understood,” she said. She turned back to the bed-to-be, and I grabbed my DSM-IV to look up the diagnosis for someone who derives great pleasure from picking on a loved one.