I, as a good little webmistress, keep an eye on my web analytics. So yes, I know some things about my audience, and one of the things I know is what people are searching for when they find me. This sometimes influences what I write about, like today: What is the worst mental illness?

What is the Worst Mental Illness?

That depends on how you judge it. You could judge it by suicide rate, in which case:

  1. Anorexia is the worst with about a 20-25% suicide rate*
  2. Bipolar is second worst with about a 15% suicide rate^
  3. Schizophrenia is third worst with about a 10% suicide rate**

You could judge the worst mental illness based on disability rates in which case you would probably get:

  1. Schizophrenia as the worst
  2. Bipolar as second worst
  3. Depression as third worst (although more people with depression are on disability overall)

Perhaps schizophrenia is the worst as it’s associated with more psychosis (delusions and hallucination). Perhaps major depression is worst because of the number of treatment-resistant cases.

Or perhaps the answer is simply this: The worst mental illness is the one you have.

Psychological / Psychiatric Pain Scale

Bipolar Mood Rating Scales

I’ve had doctors want me to put my mood on a pain scale of 0 – 10 where 0 is practically dead and 10 is no pain. And I have done that appointment after appointment, as requested. I’d imagine many people have done this exercise.

But even if you consider yourself a “3” and I consider myself a “4” that doesn’t indicate that one disease is worse than another. It doesn’t even indicate who is in more pain. It just means that in our own heads that is our experience. Once you learn you can experience more pain than you ever thought possible, the scale shifts. Trust me.

But what does that matter. If half as much pain as you experience drives me to commit suicide, who the heck cares how we compared?

Mental Illnesses are Individual

What I’m saying is that my struggle with bipolar disorder is mine and unique to me. I have a unique set of symptoms, a unique set of challenges and a unique set of techniques that I find helpful. Bipolar disorder and all mental illness are heterogeneous that way.

But believe me when I tell you, no matter what the diagnosis, no matter what the illness, no matter what the pain scale, no matter what the statistics say, it doesn’t matter. Because when you’re on the floor of your kitchen with a razor blade in your hand, you know one thing for sure – your mental illness is surely the worst in the world for you at that moment. And you’re absolutely right.

* FYI, that’s a contentious number people argue over there. I suspect it includes all manner of anorexia-related death.

^ This is also a contentious number with some experts saying it’s closer to 6-10%.

** The number here may be lower than commonly accepted too at around 6%.