At some time you will have heard people with no history of mental illness make jokes about how crazy or mad they are, meaning that they are unconventional and unpredictable; in truth they’re merely very sociable or imaginative. For people who have known what crazy feels like – or looks like – it isn’t funny.

Being crazy, or more aptly, insane, means that a person doesn’t have a solid connection with reality. This doesn’t include beliefs about God or angels or extra-terrestrials (unless you believe you are one when in fact you aren’t) or even conspiracy theories. What we mean by reality is rather mundane: having an understanding of who we are and how the world works. A solid connection with reality means we won’t jump off a building expecting to fly, we won’t try to bring people back from death because we believe we’re Jesus, and we don’t expect our bathtowel to sing selections from La Triviata.

How far away from reality does a person to be before they are considered to be insane? Broadly speaking, if a person holds to a belief that is demonstrably false – such as the editorial staff at the Sydney Morning Herald are Patagonian toothfish – and refuse to accept that there is anything abnormal about their belief, despite the evidence of reason, experience and the testimony of others [1]. This type of mental illness is called a psychosis.

So is depression a type of insanity? No: depression is classified as a neurosis: people can acknowledge that they aren’t functioning as well as they used to, that their thinking may be irrational or illogical and that they need help to get better.

[1] The false belief is obvious: the Sydney Morning Herald doesn’t have an editorial staff.

copyright Troy Grisgonelle 2008