"Significant distress or impairment", k?
Does Emily experience clinically significant distress or impairment?
She's the one to ask of course. Without her input I think we could argue it either way.
Ok, I was a bit worried about that misunderstanding:
1) I chose OCD as an example, because I have personal experience with it. However, OCD is one of the illnesses where the afflicted themselves have a pretty good idea about
"shit being significantly wrong"; intrusive thoughts in OCD are ego-
dystonous, they are experienced by the afflicted as being alien to their own personality.
(An OCDer obsessing about hurting others will highly likely never actually hurt others, because even the thought is so distressing to them, to a degree that some choose voluntary social isolation to eliminate any risk of their ever hurting someone. With OCD, you know something is wrong. I obviously can't speak for every afflicted, but for me, there was no question about "significant distress" -> "HELLF***KINGYEAH! Something is definitely wrong here!" is what 16yo Case would have told you. I experienced the thoughts, their topics, their intensity, and their persistent intrusiveness as frightening, alien, inappropriate and bizarre.) That doesn't mean that everybody experiencing any sort of mental health trouble will notice something is wrong, or be the first to notice. Not all mental illnesses are experienced as ego-
dystonous. In fact, the wiki about "pathological jealousy" states that the feelings and thoughts are experienced as ego-
syntonous - "it's not me who's acting inappropriate, the others are lying/have no clue". Or the afflicted may lack the
capacity to evaluate their behaviour. I've read that many people with Narcissistic Personality Disorder don't seek help before their behaviour has had serious repercussions for them -> Getting fired from jobs, spouses leaving etc.
(There's one prominent psychiatrist who was intimately involved with creating the DSM-IV who objects to labelling Donald Trump as NPD for precisely this reason: Trump has never sought help for his behaviour, he does not seem distressed by it and apparently it works great for him.) My statement is that I'd translate
"(clinically) significant distress or impairment" as implying
"Someone, either the afflicted themselves, or somebody in their social/professional circle tends to notice that something is seriously wrong"Not every moody, obnoxious, self-obsessed female teenager suffers from Borderline Personality Disorder. Teenagers are sociopathic little monsters, what else is new? No, your sorting your record collection according to the Dewey Decimal system is probably not sufficient for a diagnosis with OCD, you're just a geeky librarian and that's one thing I like about you. No, I don't think you might 'have' ADHD, I think you should probably get more sleep.2) Impairment is probably more of an objective criterion than distress. Even in cases where the afflicted themselves know something is wrong, they
can reduce distress by arranging their lives in such a way as to avoid stressors. But that reduction of
distress is bought with
impairment -> you're giving up pieces of your life.
3) Notice the 'clinical' before the 'significant' - methinks that means: 'Significant in the opinion of a qualified mental health expert'. But getting an opinion from a qualified mental health expert usually implies that either the afflicted, or someone around them has come to the conclusion that "something is seriously wrong here". Shrinks don't usually wander the streets in search of people to diagnose with a mental illness - people
come to them, not the other way round.
TL;DR - IICIH, get a copy of the DSM or ICD-10 and just browse through it. I promise you that there' at least one disorder whose symptoms make you go
"Wait a minute ...". That could mean ... anything, really. I'd guess that
most likely it means that you're a normal, healthy person.
Without her input I think we could argue it either way.
Ok, I ... think I have made clear my opinion that I have a problem with the
"arguing either way", with
"pathologizing weirdness". Made it clear several times, in fact.
Beyond that: Even an certified expert with tons of clinical experience - a.k.a.
"person who can actually make a diagnosis about head-trouble whose opinion has more weight than that of the guy chewing off your ear in the bar next door" - could only ever diagnose
Jeph. Far as I know, jwhouk, being an experienced counsellor, is the only forumite who comes even
close to that.
Emily and Marigold are fictional characters. Even
if Jeph would think that they are living with a mental health disorder - and I don't see evidence for that - all that anyone could possibly diagnose would be Jeph's
idea of that disorder.