“On a scale of 1-10, how do you feel?”

It’s a question that most psychiatrists ask when assessing mood and medication maintenance. The scale is used to monitor feelings of anxiety, depression and other mental health issues. A patient’s response is the main test used for treatment.

But if 1 means that a person feels ecstatic, and 10 means they are suicidal, what is a 6 or a 3? What happens if a patient feels like something is wrong, but nothing has happened? Or if they can’t stop crying since their dog died last week? How much of an impact do average issues have? Are they really feeling an 8 or is the magnitude of sorrow dependent on the specific moment they are experiencing at the time? The scale has problems of its own.

“Normal” is a popular word in U.S. culture. We all want to feel it, but the definition is murky. To believe in something unreal seems abnormal. For example, schizophrenia involves hallucinations or magical thinking that falls under the category of psychosis. This has no basis in reality. Religion, however, involves unexplained theories and ideologies that also may not have basis on this earth. According to the Pew Research Center, 70.6% of Americans are Christian. Are Christian’s abnormal?

The difference between “average” and “normal” can be found in the societal connotations that ‘normal’ holds. Average is a game of numbers. If 70.6% of people in the United States believed their bodies were melting from the inside, someone concerned about their organs liquefying may be considered average. Normal, is another definition.

The Harris Poll, a survey answered by wide populations of America, reported that in 2016, American happiness was on the decline. On a scale from 1-100, the Happiness Index Number is a 31 compared to its average number in the mid thirties.

Some of the makeup of happiness involves gender, economic status, and education. Women are generally happier than men. People whose annual income is between $50,000 and $74,000 are generally more happy than people who earn between $75,000 and $99,999. People who have a college degree also find higher scores of happiness.

Splitting up these sections of people would mean the average for happiness would change. Does that mean psychiatric treatment or medication changes should be taken into consideration depending on gender, money, or location?

Aside from what is average, the reason many seek professional treatment for mental health related issues, depends on psychological distress.

Many serious causes of psychological distress can include:

  • Major physical health concerns
  • Bullying
  • Sexual, emotional, or physical abuse
  • A career transition
  • Trouble with school
  • Divorce and relationship issues
  • Infertility

If you are unsure whether your psychological distress is causing a 3 or a 7 on your scale of mental well-being, make a check list of these symptoms to share with your doctor:

  • Sudden outbursts of anger
  • Intrusive thoughts that will not go away
  • Weight gain or weight loss
  • Audio or visual hallucinations
  • Lack of sleep or too much sleep
  • Delusions
  • Reckless acts
  • Impulsive behavior
  • Feeling as if your thoughts are not your own
  • Decreased sex drive
  • Suicidal ideations or daydreaming

The scale for testing mental health is not perfect. Although we can usually figure out what happiness means to us, this may be particularly difficult for a teenager or a child that is receiving mental health treatment. Everything from commercials on TV to marketing on Facebook, tells us that we should be happy. America focuses on happiness as much as it does consumerism and some people believe they are tied together. It’s important to express expectations openly while keeping them in line with the current reality of life. Before starting a session with a doctor, make sure both of you are on the same page. What does he/she think about the scale? What types of behaviors, feelings, and sensations would he/she consider a 4 or an 8 and more importantly, how do you define your own normal?