My definition of health is not only the absence of infection and chronic conditions, but also represents a state of biological, cognitive, and social well-being. Likewise, illness is any affliction that causes deviation from a state of optimal living, whether it be a foreign organism, a congenital defect, or a physiological aberration in function or structure. My deciding factor for the manifestation of illness is the experience of distress or disorder in psychological, emotional, spiritual, and interpersonal realms.
These ideas originated both from Western biomedicine and my empirically-rooted background in science, and from my Culture, Health, and Illness course. I also think the resurgence of a movement towards natural and organic remedies in the media has perpetuated a more holistic, integrated perspective on health and wellness. This, in conjunction with the advent of germ theory and vaccinations to immunize against acute disease, has shifted emphasis from health as absence of pathogens to health as an all-encompassing, ideal state of physical, mental, religious and social harmony.
Accordingly, ADHD is classified as an illness, since it detracts from optimal performance by disrupting learning and attention. It can have disabling effects upon academic, occupational, and interpersonal aptitude. Moreover, it qualifies as an illness due to the implication of anatomical and neurotransmitter perturbations.
Similarly, HIV is an illness since it is a communicable retrovirus, which is intrusive upon biological, psychological, and social spheres. The decline in immunity leads to opportunistic pathogens and bodily degeneration; this compromises ability to remain employed, and diagnosis can cause stigma that affects emotional welfare and constrains relationships. In contrast, I think HIV is a disease and not an illness in its early stages, as a person that is asymptomatic while the virus is latent may be ignorant of their HIV-positivity and will not experience debility or negative social or psychological consequences.
However, I do not think sadness is an illness unless it is of sufficient duration, frequency, and severity to inhibit normal functioning in any of the realms discussed. Unlike clinical depression, sadness is a disposition on a spectrum of normative emotions, and would not be an illness unless it interfered with the person’s daily living, caused social alienation, or was perceived by the person to cause significant distress. Here, it is the person’s experience of being unwell and their illness narrative that determines whether their affective state can be considered an illness.