Not Mad

‘He’s mad as a hatter’, ‘The kids are acting like madmen’, ‘She’s mad as a fruitcake’.

Most people use phrases like this without thinking. But what do we really mean when we talk about ‘being mad’? What is madness?

A person diagnosed with multiple sclerosis, heard to say ‘At least I’m not mad’, means that her illness has a physical cause. The brain scan showed plaques in the brain that cause the MS, you can point to the picture and say, ‘That’s what’s causing the symptoms’. No longer does she have to wonder, and worry, that the problem is a psychological one.

The man with post-traumatic shock disorder, saying ‘At least I’m not mad’ has found out there is a reason for his psychological symptoms. It was the past trauma that caused it, something that can be identified and pointed to. The worry here was that the symptoms were without cause – being not-mad means having a reason.

Somebody who is diagnosed with depression finally has a label for their symptoms. ‘At least I’m not mad’ means that they can name the problem, and therefore hopefully find a solution. No longer is it a nameless and unclassifiable entity.

Dissociative Identity Disorder (formerly known as multiple personality disorder) may seem like madness from the outside. But being diagnosed may still be cause for relief because, ‘At least I’m not mad’. To the DID sufferer, madness meant psychosis. They may still experience things differently to the rest of us, but the DSM – the bible of the psychiatric profession – classifies DID differently to psychotic disorders, so the sufferer is relieved of that worry.

A teenager, recently diagnosed with schizophrenia, may still experience the relief as, ‘At least I’m not mad’. He is relieved that his disorder, however mad it may seem to us, is a defined thing. No longer unique and terrifyingly without a label, its terror has been somehow contained by the diagnosis.

All that is left to be madness is the undefineable, the unnameable, the vague, the scary. The word leaves us with images of the mad woman in the attic, the asylum. People whose behavoir has no rhyme or reason, even to the high priests of psychiatry. The unfathomable.

Well, at least I know I’m not mad.