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I am glad to see that people find the issue of "can someone have a mental illness and not know it" as intriguing as I do. I think both Sasha and Vidya made some great comparisons in their interpretation of the question that shed light upon how we should look at it. For example, maybe having a mental illness is like having a tumor, or having scar tissue, and just not knowing it. I think these are very intuitive comparisons, but I can't help but wonder if we're leaving something very important out.

Vidya said,"Many mental illnesses have symptoms like mania which the patient would not recognize as mental illness.  Thus we are forced to tell a happy person that there is something wrong with him and perhaps to even push treatment on an unwilling person." Here, I do not interpret Vidya as meaning "wrong" in the strict, objective sense, but rather, at least, referring to our obligation to inform the patient that their symptoms fit criteria that we have of DSM illnesses. I think that is entirely fair; even if we are not entirely correct in what constitutes an "illness," we should let patients know our current medical opinion, in the same way we would inform someone about a tumor or scar tissue. But "push treatment on an unwilling person" is the point I want to consider. Does this truly follow from the prior statement (that we have an obligation to inform patients of the current medical paradigm)? I think there are a lot of implicit assumptions here, and ones that we no doubt make in the current medical world (just go to any involuntary psychiatric ward). But I wonder if these are the correct assumptions. If you discover a tumor or scar tissue in me, by all means, take them the hell out. But if you're telling me that, despite my harmlessness, my vivid reality is incorrect, that my feelings of euphoria are wrong, that my habits are abnormal, and that I have to take pills that will leave me feeling numb and apathetic, then I might say screw you. I'm not saying I entirely disagree with Sasha or Vidya, but I wonder if we can explore this a bit further before drawing such close comparisons to other physical but unknown illnesses: these importantly differ in how we *as patients* desire ourselves.