Mental health: What's normal, what's not (2/3) ---------------------------------------------------------------- By MayoClinic.com (Continued...) How signs, symptoms and function are interpreted How do mental health professionals determine whether the signs, symptoms and dysfunctions you're experiencing are normal or abnormal? Experts often use a combination of the following approaches: Your own perceptions. How you perceive your own thoughts, behaviors and functioning can help determine what's normal for you. You may realize that you aren't coping well or that you aren't able to or don't care to do routine activities or the things you used to enjoy. If you have depression, the dishes may go unwashed for days, you may stop bathing, put off socializing, lose interest in hobbies or yell at your family more often. You may feel sad, hopeless or discouraged. You might recognize these behaviors and feelings as a deviation from the norm. You may notice that something's amiss. Others' perceptions. Your own perceptions are subjective and may not give you an accurate assessment of your behavior, thoughts or functioning. Objective observers, on the other hand, might be able to do so. To you, your life may seem perfectly normal or typical. Yet to those around you, it may seem odd or abnormal. This is often the case with schizophrenia. If you have schizophrenia, you may have auditory hallucinations ?you'll hear voices and carry on conversations with them, believing it's a normal interaction with another person. To witnesses who observe this behavior, it may seem abnormal. "It's common that people have something wrong and not know it," Dr. Williams says. "That's true of both mental and physical disorders. People die of a heart attack who never even knew they had heart disease." Cultural and ethnic norms. Many times what's normal behavior or thinking is defined by your culture. But that means what's normal within the bounds of one culture may be labeled abnormal within another. Conversing with voices only you can hear may be an indicator of schizophrenia in Western cultures. But these kinds of hallucinations may be a normal part of religious experience in other cultures. And something may be normal or acceptable within your own family that's considered abnormal and in need of changing outside of your home. For instance, the behavior of a child with attention-deficit/hyperactivity disorder may be unacceptable in a structured school environment, but be perceived as normal and acceptable in a less structured home environment, notes Jennifer Fisher, Ph.D., a psychologist at Mayo Clinic, Rochester, Minn. Statistical values. Normal is often defined by what's statistically average. Most people fall in the middle ground, the average, while others fall to one extreme or the other. Length, severity of symptoms also considered In assessing someone's mental health, all four of these approaches are typically taken into consideration. Mental health experts may ask you how you feel, whether others have noticed a difference in your behavior or mood, and what your cultural background is. They also may ask you to fill out psychological questionnaires. Other factors are also considered. Among them: How long your symptoms have been going on How severe the symptoms are How upsetting the symptoms are to you How the symptoms disrupt your life It's normal to feel sad after a valued relationship ends. But if you feel intensely sad and upset for several weeks and you lose interest in daily activities, such as going to work, doing household chores, or visiting with friends, you may have depression. Similarly, if you get anxious before giving a presentation to a big client but forge ahead and manage the signs and symptoms, such as sweating or rapid breathing, you may just have a case of normal stage fright, and not social phobia (social anxiety disorder). And if you cut someone off in traffic or yell at a store clerk, you may just be having a bad day or be a generally ornery person. But if you're abusive, violent, manipulative, exploitive or irresponsible, or if you disregard the law ?traits that are persistently maladaptive and inflexible, and cause functional impairment or distress ?you may have antisocial personality disorder, sometimes known as sociopathy. Mental health as an evolving continuum... Page 2 of 3 Next >