Where have all the neurotics gone? – Looking for your neurosis?


By David Joel Miller

Do people still get treated for being neurotic?

SquirrelOn my book shelves are a whole lot of older books on mental health and mental illness. Many of them talk about neurosis. A couple even have the word Neurotic or neuroses in the title. I mentioned “Be glad you are Neurotic,” by Bisch in a previous post. With all the literature on Neuroses where have all the neurotics gone?

Neurosis was a pretty inclusive term. In the older psychological literature you could get three diagnosis, Neurosis, psychosis and that group that seemed to move back and forth across the line got called “Borderline” because they appeared to live at the border between Psychosis and Neurosis.

Today our understanding of the possible mental illnesses is getting much more complicated. For example one new piece of research from University of Buffalo seems to suggest to me that over a hundred different genes may be causing schizophrenia because of their effect on one structure in the brain. Eventually we may diagnose and or treat dozens or even hundreds of different types of psychoses.

The word Neurosis has leaked from psychiatry into the popular vocabulary. It like so many other words means different things to different people.

Some dictionary definitions include “relating to, involving, affected by, or characteristic of a mild psychiatric disorder characterized by depression, anxiety, or hypochondria” and “overanxious, oversensitive, or obsessive about everyday things.”

So by this definition of neurosis most of the things that today we break out into anxiety, mood disorders, obsessive compulsive disorder and a few other disorders would all be thrown in to the category neuroses.

Neuroses have been completely dropped from modern psychiatric diagnosis, largely because neuroses were based on theories of what is going on inside the person like dreams and the unconscious. Current preference is to primarily use symptoms that are visible to others or can be described by the client, like lack of sleep, loss of pleasure or similar characteristics as the basis of diagnosis.

This older term, neurosis, also included most of the currently recognized personality disorders.

One effect of this move from the simple classifications system, you ether had a psychosis or a neurosis, has been that people with many symptoms now may get a number of diagnoses.

Neurosis used to include symptoms of both depression and anxiety. Now that the two are separated and further separated into many types of anxiety disorders and mood disorders, many people qualify for both a depressive diagnosis and an anxiety diagnosis. The overlap is so large that a combined depression and anxiety disorder was considered for the new DSM-5. (It did not become a separate diagnosis but there are specifiers for this.)

All the neurotics now get to have dozens or more of new diseases and disorders that are the result of refining our system of classification rather than in any real change in human behavior or the way in which mental illnesses affect people.

So you can go on feeling you are neurotic if you chose. You can say others are acting neurotic, but the diagnoses that the clinician will give you will have one of the newer disorder names.

Photo courtesy of Wikipedia

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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5 thoughts on “Where have all the neurotics gone? – Looking for your neurosis?

  1. Hi David! *waving* I’m Borderline but still struggle to understand what that actually means? I get the anxiety mood disorder, the Bipolar 2 and the mild OCD. Maybe you can give me a better understanding than what I’ve been told… Maybe then I’ll get it! Lol hugs Paula xx

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    • Hi Paula, thanks for your continued support of my efforts. Your question really needs a long answer but for tonight this will have to do.
      OCD is an anxiety disorder, Bipolar is a mood disorder. So sounds like you have been told you have some kind of mood disorder (Bipolar) and some sort of anxiety disorder (OCD.) Those two together are the most common combination of axis one diagnosis. Kind of like ordering Chinese food you get one from column A and one from column B. We have dozens of anxiety and mood disorder names we could use here.

      Borderline is a personality disorder. That goes on axis Two. A personality disorder is a long term pervasive way of adjusting to the world. This is saying that you have a certain kind of “personality.” But in the case of a Borderline personality the way you react to things is causing you problems.

      Borderline suggested you had some painful experiences early in life and learned ways to cope that worked back then but are not working as well now that you are an adult. People can have personality problems with or without an Axis one mental illness. It takes more work sometimes to change a personality disorder because there is a reason you learned to do things that way when you first learned them. That makes it harder to change the basic way you cope with the world now.

      Hope that made some sense. David

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