Classification of Mental Illness

                        Difference between ‘normality’ and ‘abnormality’ what is normal and what isn’t, is a major question that has been discussed on for a long period of time. During earlier times, you were considered abnormal if you did not follow social norms, or certain uncommon behaviour that deviated from social culture. Measures were taken to silence or control such individuals. Being abnormal is considered as a sign of mental illness. Formally defining a mental illnesses from today’s perspective we say, “Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work or family activities.”-as stated by the American Psychiatric Association. Having a mental illness is a very common thing, just like everyone faces physical problems. Be it today or during early ancient times, people have always faced mental illnesses. Years of research and classification has been done to classify and understand what mental illness are. Something that is abnormal or a reason for mental illness has been defined by various different people using various different measures. So, now we’re going to go forward and discuss the various ways that people classified mental disorders from earlier times to the 21st century now, 

• Ancient times: Trephination is considered an example of explanation for mental illness. Trephination, was a form of psychosurgery that was needed to treat mental illness. It was found after study of various scriptures and illustrations the insides of caves, that holes were drilled into the skulls of people as means of treatment for head injuries, epilepsy and even to free a person from supernatural control. (Restak, 2000). During earlier times, that mental illnesses were considered to be an effect of supernatural things like demonic possessions, witchcraft or curses. In 1900 BC, in Mesopotamian and Egyptian papyri if women suffered from hysteria, they believed it was because the uterus has disloged and relocated itself and attached to some other bodily organs like liver, etcetera. 
• Hippocrates: It was around 400BC when Greek Physicians started rejecting ideas of supernatural things being and explanation for mental disorders. Hippocrates (460-370 BC) made an attempt to give medical reasons for mental illness. He classified the mental illness into four different categories, epilepsy, mania, melancholia and brain fever. Mania, is considered what we can psychotic in today’s time, when a person loses control over oneself and as one says is the the verge of ‘losing his mind’. Melancholia, is what we would call, depression and brain fever is also known as ‘phrenitis’. The classification was based upon, the cause of illness that is because of a change in bodily fluids and bile and other things that are happening.
• Philippe Pinel: This is another classification given by a French physician, Philippe Pinel (1745-1862). He gave a more refined version of classification based on Cullen ‘neuroses’, nothing down to four basic types of mental disorder: Melancholia, mania, dementia and idiotism. Melancholia, here again can be said to be as depression during today’s time, mania again would be insanity and dementia is a mental illness characterised by loss of memory. In later editions, a classification of ‘partial insanity’ was also added which can be said to be as an illness under which the feelings of the person are affected rather than causing any type of harm to their reasoning ability. This classification was considered to be a major contributor to modern psychology. 
• Karl Kahlbaum: This classification is given by a German psychologist, Karl Ludwig Kahlbaum (1828-1899). He gave a classification related to the biological aspect in psychology. His work in psychology, in the 19th Century, acted as an pioneer of applied modern psychology and had a lasting impact in the long run. His idea was that classifying disorders based on their outward symptoms is something very futile and thus he decided to classify them based on the course of the illness and it’s outcome. He worked on the classifications with Ewald Hecker. The classification included some very descriptive terms like, dysthymia, cyclothymia, catatonia, paraphrenia and hebephrenia. Dysthymia, would be defined as a persistent period of gloomy or sad mood; Cyclothymia is a disorder in which person faces various mood swings, the ‘highs’ and the ‘lows’; Catatonia is when a person faces problems moving normally; Paraphrenia in this, the person faces various delusions and paranoid thoughts; Hebephrenia is a severe disorder in which a person has disordered thoughts, hallucinations and bizzare behaviour. 
• Emil Krapelin: Going through the nineteenth century, as we moved towards modern psychiatry, many psychologists and psychiatrists contributed largely to the development. One such contributor was Emil Krapelin (1856-1926), a German Psychiatrist. He was the first to make a major attempt at classifying mental disorders. He used three approaches towards classification of disorders: clinical-discriptive, the somatic and the course. The primary classifications that he made were manic depressive psychosis and dementia praceox. Thus bringing in manic and depressive disturbances together into one illness, also distinguishing it from chronic deterioration illness known as ‘dementia praceox’ later named as schizophrenia, that is based on its periods of remission. Kraepelin divided mental illnesses into ‘exogenous disorders’ which according to him were caused by external conditions and thus considered treatable. Endogenous disorders, which had such biological origins and caused due to organic brain damage, metabolic dysfunctions, or hereditary factors and thus could be cured. He made various distinctions, that remain valid even today, like that of schizophrenia and manic depressive psychosis. 
• Eugen Bleuler: The name of Eugen Bleuler (1857-1939), a Swiss psychiatrist, is very famous in the psychiatric society, he coined various important terms like ‘schizophrenia’, ‘schizoid’ and ‘autism’ and created a huge impact. It was during a lecture in Berlin on the 24th September, 1908 that he first introduced the term ‘schizophrenia’. He said he believed, the term ‘dementia praceox’ isn’t associated with either dementia or pre-cociousness and was of the view that it needed to be distinguished, emphasizing that splitting of psychic functioning is was essential function of schizophrenia. He distinguished schizophrenia into two parts, primary and secondary and stated that the disorder has some primary characteristics. That is the for A’s, meaning, abnormal association, autistic behaviour, abnormal effect and ambivalence. 
• ICD and DSM:  The full form of ICD is Indian Classification of Diseases, used to classify and give distinctive feature to organise and understand the symptoms of various diseases, for health management and also for clinical purposes. ICD was introduced in 1893, most recent version of it being the ICD-10, condiering of various sub-types and categories. This is something used worldwide and is common for all, it is maintained and updated by the World Health Organization (WHO) under guidance of the United Nations (UN). Then there is the DSM which stands for Diagnostic and Statistical Manual of Mental Disorders, introduced by the American Psychological Association (APA), world’s largest psychiatric organisation. The DSM consists of only mental disorders and has been revised almost five times, the lastest one being DSM-V. The DSM-IV has classifications of mental illnesses too, and the classification is done based on a ‘multi-axial’ system of classification, through various dimensions.