True, we love life, not because we are used to living, but because we are used to loving. There is always some madness in love, but there is also always some reason in madness. —Nietzsche

In the UK, mental ill health is recognized as the single largest cause of disability, contributing 23 per cent of the disease burden and costing over £117 billion a year in public services, lost productivity, and reduced quality of life. Every year in the EU, around 27 per cent of adults are affected by mental disorder of some kind. In the US, nearly one in two people will meet the criteria for a mental disorder at some time in their life. Data from the US National Health Interview Survey indicate that, in 2016, 13.5 per cent of children aged 12-17 had been diagnosed with attention deficit hyperactivity disorder (ADHD), up from 7.2 per cent in 1998.

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 really 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 seldom makes the headlines. Are we really to believe that God or nature did such a ramshackle job of designing the human brain that one in four 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, have more than doubled since 2008. 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 certain physical disorders such as hot flushes in menopausal women. In the UK, the SSRI fluoxetine is so commonly prescribed that trace amounts have been found in the water supply.

For all this apparent progress in diagnosis and treatment, people who meet the 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’.

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, as certain poets have claimed, 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, namely, personality disorders, schizophrenia, depression, bipolar disorder, and anxiety disorders, and the sixth, final chapter treats 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.

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

Begin your journey to peace and power of mind.

In my work as a psychiatrist, I help to treat mental disorder—and, I’m delighted to say, most of the people I see do get better. But why stop here? I believe that there is much more to mental health than the mere absence of mental disorder. Mental health is not just about surviving, but about thriving, about developing and expressing our highest, fullest potential as human beings.

Before Christianity, there were, of course, the pagan gods, Zeus and Jupiter and their ilk. But, especially for the high-minded, there were also a number of philosophical schools, the major ones being Cynicism, Stoicism, Skepticism, and Epicureanism. Although each with its own outlook and method, all four schools aimed at the attainment of mental mastery and tranquillity, or ataraxia—making them, in my view, much more similar than different.

Ataraxia [Greek, ‘lack of disturbance’] is also the guiding principle of this series, with each book, like each philosophy, adopting a distinct but complementary approach to peace of mind: exploring the deep origins of our distress in The Meaning of Madness; guarding against the demons of self-deception in Hide and Seek; refining our emotions in Heaven and Hell; regulating our relations with others in For Better For Worse; developing our thinking skills in Hypersanity; and, finally, redefining our concept of success in The Art of Failure.

Although the series is numbered, each book can happily stand on its own—meaning that you can read just one or all six, and in whichever order you like.

Ataraxia is closely linked with eudaimonia, which is often translated as ‘happiness’ but which is, in fact, a much deeper, fuller, and richer concept, sometimes articulated in terms of flourishing, or living a life that is worthwhile and fulfilling.

The stakes could not be higher.