The Meaning of Madness

The mad genius, the cracked shaman, the successful psychopath… What if mental disorder were a double-edged sword?

This award-winning book, written by a psychiatrist and philosopher, aims to open up the debate on mental disorders, to get people interested and talking, and to get them thinking.

For example, what is schizophrenia? Why is it so common? Why does it affect human beings but not other animals? What might this tell us about our mind and body, language and creativity, music and religion? What are the boundaries between mental disorder and ‘normality’? Is there a relationship between mental disorder and genius?

These are some of the difficult but important questions that this book confronts, with the overarching aim of exploring what mental disorders can teach us about human nature and the human condition.

Areas covered include: personality disorders, schizophrenia and other psychotic disorders, depression, bipolar disorder, anxiety disorders, and self-harm and suicide.

A really accessible and thorough approach to a complex and often impenetrable subject. —British Neuroscience Association

Ultimately, this is a work of contradictions, an undemanding read that could challenge your view of the world. —Medical Journalists’ Association

Neel Burton succeeds brilliantly, not only in explaining different types of mental illness in simple terms, but also in the breadth of understanding he brings to aspects of life outside the mental straitjacket. —British Medical Association Book Awards (Winner, Young Authors’ Award)

This remarkable book provides a highly readable and at the same time authoritative account that by combining literary and scientific sources shows the deep connections between madness and some of our most important attributes as human beings. —Prof Bill Fulford, University of Oxford

★★★★★ Eminently readable and accessible … I found it incredibly fascinating. —Jamie Bee, Amazon.com Top 50 Reviewer

Burton guides the reader to unlearn, rediscover, and return to wholeness. It is a journey out of Plato’s cave… —The International Review of Books

Burton is never short of an interesting and sharp judgment. —Prof Peter Toohey, Psychology Today

I’ve read many Neel Burton books. He’s a wonderful writer and able to immerse you lightly in pretty heavy stuff. —Adrian Bailey, Vine Voice

Neel is an incredibly insightful and elegant writer, with a deep knowledge of all he surveys. —Dr James Davies, medical anthropologist and psychotherapist, author of Cracked

About the author

Dr Neel Burton FRSA is a psychiatrist, philosopher, and wine-lover who lives and teaches in Oxford, England. He is a Fellow of Green-Templeton College in the University of Oxford, and the recipient of the Society of Authors’ Richard Asher Prize, the British Medical Association’s Young Authors’ Award, the Medical Journalists’ Association Open Book Award, and a Best in the World Gourmand Award. His work has featured in the likes of Aeon, the Spectator, and the Times, and been translated into several languages.

A critical guide to mental health and illness

In the UK, mental ill health is recognized as the single largest cause of disability, contributing almost 23 per cent of the disease burden and costing over £100 billion annually in public services, lost productivity, and reduced quality of life. Every year in the EU, about 27 per cent of adults are affected by mental disorder of some kind. In the US, almost one in two people will meet the diagnostic criteria for a mental disorder in the course of their life. Data from the US National Health Interview Survey indicate that, in 2016, 10.2 per cent of boys aged 4-17 had been diagnosed with attention deficit hyperactivity disorder (ADHD), up from just 6.1 per cent in 1997. 

There is no denying that a lot of people are suffering. But are they really all suffering from a mental disorder, that is, a medical illness, a biological disorder of the brain? And if not, are doctors, diagnoses, and pills the best response to their problems? 

Since 1952, the number of diagnosable mental disorders has almost tripled, from 106 to over 300. In that time, depression has grown into a global pandemic, albeit a silent one that rarely makes the headlines. Are we really to believe that the human brain is so poorly designed that one in five Americans will at some time in their lives suffer from a mental disorder called ‘Major Depressive Disorder’? Despite growing concerns about their effectiveness, or lack thereof, sales of antidepressants continue to grow, and, in England, almost doubled in the decade to 2018. Selective serotonin re-uptake inhibitors (SSRIs) in particular have become something of a panacea, or cure-all, used to treat not only depression but also anxiety disorders, obsessive-compulsive disorder, and bulimia nervosa, and even some physical disorders such as hot flushes in menopausal women. In the UK, the SSRI fluoxetine is so commonly prescribed that trace quantities have been found in the water supply. 

Despite all this apparent progress in diagnosis and treatment, people who meet the diagnostic criteria for such a paradigmatic mental disorder as schizophrenia tend to fare worse than in resource-poor countries, where, still today, human distress can take on very different forms and interpretations to those outlined in our Western, scientifical classifications. 

Psychiatry is in a crisis precipitated by its own success, and, if it ever did, the medical or biological model is no longer helping. The specialty for the heart is called cardiology, the specialty for the digestive tract is called gastroenterology, and the specialty for the brain is called neurology… and also psychiatry. But whereas neurology [Greek, neura logos] means ‘knowledge of the nervous system’, psychiatry [Greek, psyche + iatros] means ‘healing of the soul’. Some mental disorders undeniably have a strong biological element, but even these have many more aspects and dimensions than ‘mere’ physical disorders. 

This book aims to open up the debate on mental disorders, to get people interested and talking, and to get them thinking. For example, what is schizophrenia? Why is it so common? Why does it affect human beings but not other animals? What can this tell us about our mind and body, language and creativity, music and religion? What are the boundaries between mental disorder and ‘normality’? Is there a relationship between mental disorder and genius? These are some of the difficult but important questions that this book confronts, with the overarching aim of exploring what mental disorders can teach us about human nature and the human condition. 

The first five chapters treat of common mental disorders (personality disorders, schizophrenia, depression, bipolar disorder, anxiety disorders), and the sixth, final chapter of suicide and self-harm. I recommend reading the chapters sequentially, although, if needs must, each one is quite able to stand on its own. Each chapter assumes little prior knowledge of the mental disorder under consideration, and begins with a brief, textbook-like description of the forms that it takes. This enables the reader to learn about the mental disorder and, more importantly, to engage with the broad discussion that follows. 

The first chapter, on personality disorders, is exceptional in that it begins with a discussion of what makes a person a person, and the extent to which you and I can be held accountable for who we are. 

I hope you relish the read, and welcome to the Ataraxia series!

Purchase now from Amazon or Apple, or go back to the Ataraxia series page.