We should keep in mind one very basic fact. Among the very many people who present with a mental affliction, some are (almost certainly) suffering from a real illness, one that is understandable (in principle) like any other mental complaint. By the same token, others are (almost certainly) not. Mental suffering takes many forms, only some of which have roots in disease. The suffering of those who are not really ill in any meaningful medical sense can still be acute.2