A thoughtful reader concerned about backlash against the mentally ill asked me to write a piece basically saying that not all mentally ill people were homicidal maniacs. 

It's a fair request, but in this case it's counterproductive.  Here's what I mean: you want to say that "not all mentally ill people are violent."  You want counterexamples to Cho's example.  But that's a defensive posture, unnecessary because... Cho wasn't mentally ill.  He was a sad, bad man who killed people because his life wasn't validated.  There was no psychosis, there was no cognitive impairment, there was no psychiatric impairment in insight in judgment.  There was a lack of sex, but that's not yet in the DSM.

Not to reduce his life down to a soundbite, but he was a guy who thought he deserved better by virtue of his intelligence and suffering; found himself in a sea of mediocrity but couldn't understand why he couldn't therefore excel; and, worst of all, found that all the things he thought he deserved eluded him-- especially hot chicks, who not only dismissed him and found him creepy, but, worse, chose to be with the very men he thought were obviously inferior to him.  It's Columbine all over again.  It's almost even the same day.

Forget the Prozac, forget the involuntary commitment (where he was found by the court to be "a danger to himself and others"-- that's standard boilerplate, it is clinically meaningless).  Those are  red herrings.  You may as well blame wearing black t-shirts.  He's not mentally ill; he's an adolescent.

The difference, the single difference, between us and him is that when we were sulking in high school, we listened to Pink Floyd or U2.  He watched Oldboy.  We had a battered copy of a Playboy down at the creek under a rock, that was so creased we had to infer the boobs.  He had the internet.  Maybe we bought a pocket knife, or-- wow-- a butterfly knife.  He bought two Glocks.

In other words, the difference is this: he decided to shoot 30 people, and you didn't.  That's it.  I know it's not a satisfying answer, I know we want explanations, but there aren't any.  Forget genes, forget DSM.  He chose to do something bad,  he knew it was bad, but he did it anyway.

Don't worry about the mentally ill.  Worry about the nut politicians and media outlets who will look to the easy and convenient excuse of mental illness, rather than have to do the hard work of figuring out why our society is melting.

Older posts on Cho here, here, and here.