Is bitterness a mental illness?
Posted by: Gillian Green in anger management on Jun 17, 2009
Bitterness is a common occurrence, ranging in strength according to the reason for it. As two extremes, think of how the Jewish people viewed the Nazis during WW2, compared to a person today who harbours feelings against a bank who has refused him a home loan. At one end of the scale, a traumatic event can make a whole people angry, pessimistic, aggressive and hopeless. For most, though, it is a fleeting emotion, one that slips away as readily as any other as the hours progress and new thoughts seep in to push out the bitterness.
The American Psychiatric Association (APA) generated a measure of incredulity recently by debating whether bitterness should be labelled a bona fide mental disorder. They've even come up with a new name for it: post-traumatic embitterment disorder (PTED), stating that it could be due to a chemical imbalance in the brain.
But, is it a mental illness?
I agree that there's certainly a lot of anger and bitterness in the world at the moment. From global issues to personal financial meltdown, there's no lack of things to feel embittered about. ‘Why me?' is the constant refrain.
In contrast to known mental disorders like post-traumatic stress disorder, which is a way of reacting to a personal trauma, sufferers of PTED are left seething for revenge. But, when anger at the many incompetences in the world is discussed as a sign of mental illness, it could be conceived as insulting to an individual who is merely using his intelligence to react to world events.
In its discussion of post-traumatic embitterment disorder, the APA may have correctly gauged the mood of the people, but it has ignored the reasons for it in its attempts to pathologize the individual in all of his frustrated grievance.
Some psychiatrists feel that this new syndrome is a stage more complex than anger. It's a sign that people are not just angry but also helpless, they say.
I agree, but does this make people psychologically ill?
It is estimated that between 1% and 2% of the population is embittered. Others note that PTED includes "a high degree of co-morbidity [and] diagnostic uncertainty.. 66% adjustment disorder, 40% dysthymia, 34% generalized anxiety disorder, 18% social phobia, 18% agoraphobia, and 16% personality disorder."
But adjustment disorder, a difficult concept in itself, is a rather loose term to describe predictable, largely routine responses to stress. Why, then, is the APA discussing the inclusion of a new term that not only overlaps so strongly with existing disorders, but also has so many obvious, identifiable causes in the world?
Part of the incredulity the APA discussion has generated in the media and blogosphere is doubtless because bitterness strikes the person feeling it as a justified response to a social ill or personal wrong.
Yes: it is good when medical professionals bring to light improvements in our knowledge of mental health disorders.
Their bitterness is similar to that that may be encountered in the grief cycle following death or any loss, but unlike the usual angry resentment this bitterness does not pass with time. Instead it can become an engrained way of being with thoughts of unfair loss and perhaps revenge always close to the conscious thought.
As such it is the catastrophic thinking that causes the problem and blocks the person's return to a normal balance of happiness, or at least acceptance. Time has not been the healer for the cronic embittered and therapeutic work is needed.