"You're driving me insane." ... "I think I'm going crazy."
Words like "insane", "insanity", and "crazy" are used freely in our culture. But what do they really mean? Often, we use the term "insane" to describe someone who is just a little bit different like an eccentric but lovable aunt or an obnoxious neighbor. At other times, we use it to describe ourselves when we feel a little out of sync with the rest of the world. If you're going through a stressful or busy time in your life, you might feel distracted or anxious. Although these feelings are perfectly normal, you may find yourself proclaiming, "I think I've lost my mind. I'm going insane."
"That is insane."
On one hand, different words have evolved to carry different meanings and are used in conversation to convey feelings (such as, "This is driving me insane!") On the other hand, learning to be sensitive to people with mental health needs or disorders is important. As a society, we must find careful and caring ways to speak about and to people who require acute treatment for mental wellness. But how does one define "insane?" Is there such a thing? And if so, what are the signs of being insane? How do you know if a friend, a loved one, or even yourself might be struggling with legitimate mental health challenges?
The answers to these questions are more complex than you might think.
Some "Crazy" History
"How do you know I'm mad?" said Alice.
"You must be," said the Cat, "or you wouldn't have come here."
-Lewis Carroll, Alice in Wonderland
Throughout history, as far back as Biblical times and probably even earlier than that, there was an acknowledgment that some individuals could not conform to social norms and conventions. All kinds of labels have been applied to these people:
The kinds of people and behaviors fitting these labels have varied throughout the ages, and methods of treatment have changed as well.
In Greek and Roman civilizations, behaviors we might call "insane" today were actually perceived as signs of a special connection to the divine. If someone had a hallucination and heard a voice telling them to murder someone, it didn't mean they were ill. This meant they were touched by the gods. However, they did experiment with medical treatments for various delusions and other inappropriate public behavior.
At the other end of the spectrum, there have been cultures in which simply holding a controversial opinion was enough to make people call you "insane." In the 1970s, for example, the Soviet Union proclaimed that anyone who disagreed with their regime was mentally ill, leading to mass hospitalizations of Soviet dissenters.
This leads us to our next question.
Is Insanity a Relative Concept?
"Insanity is relative. It depends on who has who locked in what cage."
You will be relieved to know that, in most parts of the world, simply disagreeing with a government or an authority figure will no longer earn you the title of "insane."
In fact, the definition of "insane" varies a great deal depending on who you ask. There are several definitions, including a popular and oft-quoted one that is frequently misattributed to Albert Einstein or Mark Twain: "The definition of insane is doing the same thing over and over and expecting different results." In fact, no one knows who said this.
While this definition accurately describes dysfunctional behaviors that might accompany Obsessive-Compulsive Disorder or some forms of frontal lobe brain injury, it's not in itself a catch-all definition for "insane." On the contrary, there are some situations where it's both desirable and healthy to repeat the same action over and over again. It's helpful, for example, if you are practicing a new skill or sending out job applications.
So, this definition, although it's catchy and smart, won't help you to determine a person's true mental state. Let's turn to Merriam Webster. Here we find three different possible definitions of being insane:
Because the third definition seems to be more conversational and less a way to define a mental state, we'll focus on the first two, which leaves us with both a medical and a legal definition of insanity.
Insanity is a legal term, not a psychological one. The legal definition supports our understanding of insanity as a defense in a U.S. court of law. To meet the legal definition of insane, a defendant must prove that they were unable to tell the difference between right and wrong at the time a crime was committed due to the severity of their psychosis.
In one form or another, the insane defense has existed since at least 1581. Over the years, governing bodies have constantly had to revise the ways insane could be used as a defense for heinous crimes. In the U.S., the legal definition of insane has changed several times after the public felt it was applied too broadly or too narrowly in specific cases. Even today, most people are skeptical of this defense, and it is rarely used in courtrooms. When it is, most states hold to the original definition – that the defendant was unable to tell the difference between right and wrong.
While history helps us understand insane in legal terms, we must also understand the medical definition, which states that being insane is a state of mind resulting from a specific disorder. This definition is more applicable to our relationships.
Moving Past Negative Terms
"We do not have to visit a madhouse to find disordered minds; our planet is the mental institution of the universe."
- Johann Wolfgang von Goethe
When we discuss mental disorders, the most definitive source of information is the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published and revised every year by the American Psychological Association. You will be hard-pressed, though, to find a definition of "insane" within it.
In fact, the word "insane" is not used at all in the mental health community. Today's therapists and psychiatrists will not describe anyone as "insane." Even Merriam-Webster considers its first definition as "dated."
Although plenty of stigma still exists around mental illness, our culture is moving away from words like "mad," "crazy," or "insane," at least in a professional context because they have such negative connotations.
How to Discern Mental Wellness
If you worry that you or someone you love might have a mental disorder, here are some of the warning signs:
If you or your loved one shows any combination of these symptoms, it can be confusing and frustrating. In addition to the distress caused by the illness itself, there is the additional social stigma attached to mental illness, which can still make people feel embarrassed and ashamed.
The good news is that most people with mental disorders can find relief. In most cases, they will be able to function normally again, usually with the help of a good therapist, the right medication, or a combination of both.
Meeting with an in-person or online counselor can give you the understanding and emotional support you need to move past your symptoms.
How BetterHelp Can Support You
If you’re considering online therapy, visit BetterHelp to receive compassionate, non-judgmental counseling services from professionals who are trained to help those who have a mental illness. Encouraging people to seek help is an important expression of love and care, and it doesn't mean that someone is insane. BetterHelp professionals can meet when it’s most convenient for the person seeking therapy. And, because the counseling takes place online, the person can receive care in the comfort of their own home. BetterHelp has helped countless people with acute mental health challenges. Read the reviews below to learn more about our counselors.
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It's human nature to put people in a nice little box with a label of "insanity" or "insane", especially when we don't understand their behavior or what is happening to them. But history has shown that carelessly using words like "insane" without knowing the true definition of "insane" does more harm than good. Living a fulfilling life with a deeper understanding of ourselves plus the people around us is possible – all you need are the right tools. Take the first step today.