What Is Mental Illness?

"The boundary between mental distress and mental illness will never be neat and clean," says Harvard professor McNally (Remembering Trauma) in this dense and well-researched scholarly work. He explores changes in society and science that influence how we distinguish disorder from distress. Though McNally serves as an advisor to the DSM (psychiatry's diagnostic bible), he warns against its over application and asks if we should look at mental illness as a spectrum, as we do physical illness; mild expressions would count (and, perhaps, their treatment would be reimbursed for by insurance companies) as much as severe cases. Alternately, the expansion of a disorder's definition, which would include more and more people, does a disservice to patients as well. McNally explores the genetic components of mental illness and looks to evolutionary psychology to explain its persistence. A standout chapter examines the social construction of mental disorders, comparing, for example, the ways that depression sufferers in China and the United States describe their symptoms. This is no pop psychology handbook and will not appeal to the casual reader, but those involved or interested in the field will find it useful. (Jan.)