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KIM TALIA PILLAY

STUDENT NUMBER: 215080580

PSYC706: PSYCHOPATHOLOGY

ASSIGNMENT 2: Critical Reflective Paper

DUE DATE: 28 September 2015

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DECLARATION

I, Kim Talia Pillay, hereby declare that this assignment submitted here is my original

work and has not been submitted before to any institution for academic purposes.

Furthermore, I have acknowledged all sources used and have cited these in the

reference section.

………………………….. ………………………………………..

SIGNATURE DATE

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Introduction

In today’s day and age, the burden of mental illnesses continues to grow globally with

significant impacts on social, physical, human rights and economic consequences. Among

society and specifically in South Africa, a country that accommodates diversity, there are

many differing impressions and perceptions about mental illness. It is evident that, what is

known about mental illnesses is most often misunderstood. In an attempt to make sense and

understand the purpose of this reflective piece, this essay will focus on “Perfect” by Pink.

This song tells the tale of a young girl who struggles with bullying, substance abuse and

loneliness, these experiences turn her into an angry, suicidal and manic depressant. When the

darkness lies over her head like a signal of impending doom in her life, she cuts all of her hair

off and turns to her solace, which can be somewhat of her childhood love that is, painting.

With this new release on life, the girl triumphs over all situations and reaches success in love

and life. This is inspiring and motivational to the twenty-first century individual, who seems

to be endlessly suffering from depression, often affecting them personally and their

relationships within society. This essay will focus on my introspection, in other words,

reflecting on my personal experiences as well as evaluating my thoughts and perceptions

about this mental illness. The essay will also make use of the lyrics of “Perfect” by Pink and

explain the characteristics of this disorder and simultaneously reflect on the experiences of

Pink, who penned these lyrics from personal experiences.

Individual introspection and perceptions of depression as a mental illness

I had a firsthand encounter with the mental illness depression while studying the content in

my Psychology Undergraduate Degree. As I began to acquire a greater knowledge and

understanding, I gained a better view on the struggles that one experiences due to this illness.

I began to view myself in a new light, undergoing a process of introspection, pondering on

my preconceived ideas about depression and coming to the realisation that my views on this

clinical disorder was limited to say the least. According to my view on depression, I

understood that a sufferer experiences low self-esteem, and a bleak outlook on life. It was not

a mental illness, in my opinion, that needed to be clinically dealt with, diagnosed or

warranted treatment. Due to my baffled and questioning mind, I never thought that a person

would need to see a specialist with regards to “sad” thoughts and be prescribed medication to

aid them to be rehabilitated in order to function normally in society.

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I grew up around people who did not have much knowledge of mental disorders, such as

depression. They seemed to have the similar perceptions as me, believing that depression was

not a form of mental illness and did not have specific criteria needed to diagnose an

individual and treated like other diseases. I did not feel it warranted hospitalisation or

counselling, in order for them to be rehabilitated and to lead a normal life. In society, many

people dare not mention issues regarding depression, due to lack of knowledge, stigma and

discrimination. From a social perspective, people are often discriminated, biased and

prejudiced against and society perceives those who have clinical conditions and get help,

assessed or tested, as damaged or social outcasts. They assume that these people are not able

to function normally in the community and should therefore be ostracized in society. Ethical

issues of testing stemmed from the past and still prevail today, from one ethnic group to

another, where many were and are still categorized and labelled and discriminated against.

They are labelled with a social difference rather than it being perceived as a person with a

differing lifestyle or condition and they are the ones who are disadvantaged and unfairly

denied in the workplace. They are looked down upon and passed over, for example, in job

opportunities and not accepted into Universities and colleges because of purported bias in

standardized tests.

Lastly, from a South African perspective, countless individuals would seek medical

assistance when suffering from physical illnesses, however in a case where a person portrays

an illness associated to mood, feelings, behaviour and present no signs of physical pain they

do not seek professional help. Many usually consider going to a spiritual healer also known

as a Sangoma, to aid in the expelling of such “demons”. According to them, symptoms of

depression indicate that other spirits are controlling and destroying their inner self and they

aim to mitigate these by potions or calling on their ancestors for aid. Individuals who suffer

from depression fear that others will view them as being weak, indifferent and cognitively

damaged. However, cultural norms are transitioning as individuals are becoming more aware

and assertive of the nature of depression as an illness and the negative impact it has on the

person’s well being.

In essence, knowledge and understanding creates a different perspective, changes one’s

perception, and eliminates bias, prejudice, and discrimination in relation to mental illnesses.

Although there is awareness, there needs to be equipped professionals carrying out the

assessments and tests that determine an individual’s state of mind. Clinicians employed must

be competent which will benefit society and the tests which are carried out should provide

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accurate, valid and reliable results. Psychological assessments and testing has advanced in

leaps and bounds in South Africa over the years. The access and exposure of psychological

assessment has increased dramatically from the past to present day in South Africa. However,

a greater need for such psychological assessment and tests are required in the underprivileged

areas of South Africa. The only way to combat this is to equip more clinicians with

background, experience and knowledge to implement these assessments and tests and make it

more widely accessible to various factions of South African society, so that everyone may

contribute to society in order for it to grow and thrive in a developing country such as ours.

The definition and diagnosis of the depressive disorder as per the DSM-5

The feature that is common of all depressive disorders is the presence of emptiness, isolation

and an irritable demeanour, associated with cognitive and somatic changes that significantly

affect an individual’s ability to function (American Psychiatric Association, 2013). The

Depressive Disorders have no presence of mania or hypomania episodes (Tutorial letter 502:

Abnormal Behaviour and Mental Health, 2014). However, it is significant to note, that not

every individual who suffers from depression experiences every symptom. As per the DSM-

5, the symptoms are categorized according to cognitive, somatic, emotional, behavioural and

perceptual symptoms. Victims of this suffering often feel they are alone and ostracized,

which manifest into hopelessness, guilt as well as the manifestation of suicidal thoughts and

self-destructive acts (Beck, Brown, Berchick, Stewart and Steer, 1990).

The cognitive symptoms are observed when the patient thinks and feels about him or herself

in a negative manner. These skewed thought processes will possibly perpetuate the problem

as they make the person resistant to help or counselling, however as the state of depression

lifts one will be open to therapy and rehabilitation. Cognitive signs that should be visible are

difficult in coherent thoughts, as people with depression often have problems focusing,

concentrating and recalling. They often have a negative view on all aspects of life as they

associate themselves with negativity, perceiving their life, themselves and their world in a

pessimistic light. They feel worthless and guilty, obsessing over their failures and faults

resulting in them feeling blameworthy and deeming themselves valueless. They also express

a sense of helplessness and hopelessness, as they believe that they are incapable of

overcoming the obstacles they face, in order to rid themselves of this state of depression.

These feelings of isolation also creep in, especially if individuals are bullied and ostracized,

resulting in them becoming sensitive to slights from their peers, co-workers, and family

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members. Sufferers are prone to suicidal thoughts which linger in their subconscious, often

expressing these thoughts openly, plaguing their daily lives and preventing them from

functioning productively in society. Emotional symptoms include typical emotions or moods

experienced, such as sadness, turmoil, anxiety and loss of interest or pleasure. This then leads

them to lose interest in daily activities and life in general (Halgin and Whitbourne, 2003).

The individual may feel despondent and emotionally unstable, deeming them the title of a

“professional mourner”. Some may become withdrawn and hide their emotions from their

loved ones, leading to acts of self-mutilation and self-destruction. Others may also exhibit

irritable moods, anxiety and lash out in anger as a result of distress and an overwhelming

sense of depression.

Depression is not just an illness of the mind but leads to negative physical symptoms as well.

These include drastic weight loss, loss of appetite and a general lack of attention to ones

physical appearance. A person’s appetite will tend to wither away as an individual with a

healthy appetite may lose interest in eating due to their mind being pre-occupied with their

woes. Others may respond alternatively, by eating excessively in an attempt to distract

themselves from their troubles, in an attempt to fill the void and self-medicate their emotions.

Depressed individuals also suffer with insomnia, facing difficulty sleeping and staying asleep

once they eventually do. They usually wake up in the early hours of the morning or oversleep

throughout the day. They may also feel sluggish and agitated, as they react to daily task in a

delayed fashion. They may also be less sociable and active, as well as fidget due to being

unable to concentrate due to a general sense of restlessness. With regard to somatic

symptoms of depression, the physical manifestations of depression are also taken into

consideration as well. These symptoms include pains and aches, fatigue, insomnia or

excessive sleep during the day, weight gain or loss and loss of sexual desire (Tutorial letter

502: Abnormal Behaviour and Mental Health, 2014).

The behavioural symptoms consist of avoidance, withdrawal, clinging and demanding as well

as activities and excess. In addition, these people always express a need to be secluded from

others (Kaplan, Sadock, and Grebb, 1994). Individuals with depression may avoid enjoyable

activities and social gatherings with loved ones. They often withdraw from their immediate

social environment and the bedroom becomes their comfort and solace in order to escape

reality. They most likely become less dependent on personal relationships and manifest major

visible acts of insecurity and isolation. They appear to be closed off to the world, partaking

in acts of escaping reality, such as over eating, alcoholism, addiction to substances, video

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games, etc.(Tutorial letter 503: Abnormal Behaviour and Mental Health, 2014). Lastly,

according to the DSM-5, symptoms of hallucinations differ from individuals with psychotic

disorders such as schizophrenia. These hallucinations point out the perceptual symptoms

(Kaplan, Saddock and Grebb, 1994).

Analysis of the lyrics ‘Perfect” in relation to a clinical presentation of depression

As I listened to the song called “Perfect” by Pink, it transported me to my dark days of the

past. I went through a reflective timeline in my life and was surprised that I could too relate

to such a song. I came to the realisation that I am not the only one who experiences

depression; facing problems that consume and overwhelm me, overriding every achievement

and moment of happiness in my life. The lyrics depicted the various symptoms of depression

namely cognitive, behavioural, emotional and somatic as per the DSM-5. Depression is a

mood disorder which involves a person feeling worthless, losing interest in gratifying

activities and ones social environment (American Psychiatric Association, 2013). As a

teenager, Pink wrote lyrics as an outlet for her feelings and this is shown in the song “family

portrait” which helps one understand the reason for her pain behind the lyrics and which

paved the way for songs such as ‘perfect” which shows her personal experiences and

struggles as a child and teenager.

It was at an early age that Pink’s parents filed for a divorce. She never spoke out about her

strife or consciously realized how it negatively impacted her until years later. Pink began

acting out within a few years, although she had asthma, she began smoking when she was

nine years old, a habit she kept for many years demonstrating an act of self-destruction. Pink

got her first tattoo when she was twelve, acting out as a form of rebellion. When Pink was

fourteen, she was abusing drugs and running away from home on a regular basis. She was

also arrested on several occasions for her rebellious misdeeds. However, music remained her

solace and an integral part of her life. Pink lived with her mother after her parents separated,

but got kicked out when she was fifteen years old because of the lifestyle she was

leading(Encyclopaedia of World Biography, 2004).

I once viewed the television music channel “VH1: Behind the music: Pink” and gained

insight into Pink as a person and her back story. Pink admitted that she was a difficult and

wild teenager, constantly tormented by her demons. She never had a stable upbringing,

staying with friends, family, and later moved in with her father. Her mother commented

during the VH1: Behind the music: Pink, “her initial writings were always introspective.

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Some of it was very black, and very deep, almost worrisome…Oh my God, I didn’t know she

felt this way”. Pink the song writer and singer of “Perfect” stated in the lyrics that she was

once experiencing many negative feelings, but she eventually triumphed over all obstacles in

life. The girl who plays the role of Pink shows signs of suicidal tendencies by mutilating

herself and this supported the clinical symptom of depression, as she showed lingering

thoughts of death and self-mutilation.

Pink’s lyrics also showed an unstable psyche, which was characterized by depressive

episodes, evident when she penned the words “mistreated, misplaced, misunderstood …

mistaken, always second guessing, underestimated, look I’m still around” (Pink, Martin &

Shellback, 2010). This showed that she often felt that she was treated

unfairly ,misunderstood, lost and interpreted incorrectly, which allowed for feelings of

emptiness and isolation to weave itself and consume her completely. The song “Perfect” is

filled with melancholy, for instance in the song she mentions being done waiting for the

critics because they are everywhere. In other words, she means that she will not conform to

the world of critics because to herself she is perfect. She says “change the voices in your

head…make them like you…”(Pink, Martin & Shellback, 2010).She is expressing that you

should possess a elevated sense of worth because how others perceive or judge you does not

matter and the only thing that matters is that you are content and accept yourself for who you

are regardless of your flaws. Pink also states the world is afraid so she swallows the fear and

the world is afraid of its appearance and the thing she should only be drinking is an ice cold

beer, as that is what she enjoys and she will not conform to the world’s standards and norms.

Pink has depth in her lyrics, exposing the human condition of always searching for perfection

and thus never being satisfied or content with one’s life, as perfection is an ideal that can

never truly be reached. Pink states that we should be happy with who we are as each person is

already perfect in their own way, evident in her chorus, “pretty pretty please, don’t you ever,

ever feel like you nothing, less than perfect…if you ever, ever feel like you nothing, less than

perfect, you are perfect to me” (Pink, Martin & Shellback, 2010) which somehow reassures

me and rids me of the negative self-concept I possess.

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Conclusion

I have gained a wider knowledge and understanding of the depression disorder as this task

was experiential and allowed me to go through a process of introspection about my own

childhood and adolescent years. I believe that it is pertinent that individuals who may think

they suffer from depression seek professional help and advice, as depression is a dark and

lonely state of being. It can be challenging to change ones attitudes, behaviours and thought

processes associated with depression, however therapy and a willing attitude can rehabilitate

a sufferer into a productive member of society with a much healthier outlook on life. There

are various types of treatments for depression and finding the correct treatment or

combinations of treatments are especially important with depression (Papakostas and Fava,

2008).

To conclude, people who suffer from mental illnesses and depression in particular should not

be totally disregarded and made inferior but rather steps should be implemented to include

them instead of casting them out and refusing to accept them. They are valuable and a

productive part within the community and in this ever diversifying society we are all a part

of. This essay focused on my introspection, in other words, reflecting on my personal

experiences as well as evaluating my thoughts and perceptions about depression as a mental

illness. The essay also made use of the lyrics of the song “Perfect” by Pink and explained the

characteristics of this disorder and simultaneously, reflected on the experiences of Pink, who

wrote the pertinent lyrics that led to my self-realisation and assisted me in feeling better about

myself and to remain positive amidst my obstacles.

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References:

American Psychiatric Association.(2013). Diagnostic and statistical manual of mental

disorders. Washington, DC: American Psychiatric Association.

Beck, A. T., Brown, G., Berchick, R. J, Stewart, B. L. & Steer, R. A.(1990).Relationship

between hopelessness and ultimate suicide. A replication with psychiatric

outpatients.American Journal of Psychiatry, 147,190-195.

Encyclopedia of World Biography.(2004).Pink Biography. Gale Group. United States,

Farmington Hills, Michigan.http://www.notablebiographies.com/newsmakers2/2004-

Ko-Pr/Pink.html

Halgin, R. P. & Whitbourne, S. K.(2003). Abnormal Psychology: Clinical perspectives on

psychological disorders. New York: McGraw-Hill.

Kaplan, H. I., Sadock, B. J. & Grebb, J. A.(1994).Behavioural Disorders.Behavioral

Psyciatry,160, 601-620.

Papakostas, G.I & Fava, M.(2008).Predictors, moderators, and mediators (correlates) of

treatment outcome in major depressive disorder. Dialogues in Clinical Neuroscience,

10, 439-451.

Pink, Martin, M & Shellback.(2010). “Perfect”. LaFace.RCA.Woodshed Recording, Malibu,

California.

Tutorial letter: Abnormal Behaviour and Mental Health.(2014). Second Study Guide for

PYC3702. University of South Africa. Muckleneuk, Pretoria.