Wednesday, March 28, 2012

Oh To Be Mentally Ill



We talk about the mentally ill as though they are a defined class of people.  The mentally ill need this or that...  The mentally ill live shorter lives.... need different resources...are dangerous...are not dangerous...smoke more...eat less chocolate... whatever....


So who are these mentally ill people?  And what do we mean when we speak of "the mentally ill?"  Community based studies showed many people-- I'm thinking the number is 56%- have a lifetime prevalence for psychiatric disorders, including anxiety disorders, phobias, and substance abuse disorders.  


If someone had a bad episode of depression that resolved years ago, are they mentally ill?  What if they remain well for years but only if they stay on medication? How sick do you have to be and for how long to enter the club? 


The NAMI website says:
Mental illnesses are medical conditions that disrupt a person's thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life.

Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible. 

I'm not so sure that does it for me.  I'll let you chime in.

41 comments:

rob lindeman said...

"Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions"

I'm positive that this doesn't do it for me.

ohtohavepeaceandquiet said...

Please explain the title of this post. Oh to be generally prefaces something aspirational so I am confused why you would go with "oh to be mentally ill". Definitions aside, you probably don't want to be depressed or alcoholic or manic depressive or schizophrenic or anything else that falls under some category, somewhere, of mentally ill.

If I wander over to a medical blog I'd be stunned to see a post :Oh to be diagnosed with cancer, or oh to be diabetic.

You can tell me to take a chill pill but I think that you are perhaps starting with the pot stirring??

Dinah said...

Rob...funny, I knew that you felt that way.
Oh To Be....let me think about this. Sometimes people do want to be mentally ill....it allows them to get entry into programs that may include housing or outreach services, and it allows some of them to get disability payments which may make it an aspired for status.

Liz said...

it definitely doesn't do it for me. not even close.

i'd rather see a definition of "mental health".

every psychiatrist i saw between the ages of twelve and twenty-five or so prescribed medication to treat my "mental illness."

and yet, only with therapy did i make any gains. and now, with dbt and NO MEDICATION, i am doing better than i ever have.

i think some people love talking about illness so much that they miss the big picture-- people learning new ways of thinking and behaving and gradually becoming happy and healthy, moving forward to lead rewarding lives.

if i meet zero of the criteria for bpd, do i still have bpd? i don't think so. in fact, in spite of my plethora of labels, i'd say i'm pretty damn mentally healthy.

ohtohavepeaceandquiet said...

Dinah,

Some people do want to be mentally ill. I know that. I have seen it. I have seen the people who come into hospital seeking to retreat from a world that expects them to take care of themselves. They are discharged and end up back in the hospital very quickly. While there, they are on Facebook half the day, order two desserts most days ,and seem to be about as well as the staff. It is baffling to see them admitted again and again. They are also in the minority of patients I have met on psychiatric wards.
As for disability, plenty of people would love to have a doctor's note saying they have disorder xyz so that they can claim for life. It's not so different than people who stage car accidents to collect insurance.
Whether they have a mental illness or personality disorder, or they are in full control and just very good scam artists is a question. I know about secondary gain but i don't think that addresses my question about your post title. You asked how sick a person has to be to join the club. That implies that you wanted some discussion of where to draw the lines and whether or not the current system does a good job ,as opposed to asking how to weed out malingerers.

Dinah said...

Ohtobe:

You're doing a great job with discussion here!

You know, I don't want to insult anyone with the titles I invent, nor the graphics I choose or the content of the blog posts. But we are pulling on 7 years here, and I like catchy titles, and so this popped in to my head and I ran with it. If anyone else writes in and is distressed by it, I'll change the title....2 is a quorum. By all means, suggest alternatives.

I actually wasn't thinking about malingering. A person can be mentally ill and disabled, and want the title so they can get benefits without any issue of scamming. It is so hard to get disability benefits these days, that it may well be an aspired for status by some very sick people.

Mostly, though, the title popped out of my head. Not everything that pops out of there is useful.

J said...

I don't care if you leave the title or not but I will say that it kind of leaves a bad taste in my mouth since.... you are not mentally ill. So what works for you or doesn't isn't really relevant.

I have MDD, severe, recurrent. A couple of hospitalizations over my life, decades of medications and shrinks. I'll likely never be off the latter two, though it's been more then 10 years since I was last hospitalized.

I also have a PhD and years of a successful career, family, life.

Yet I do have a mental illness. Perhaps it is different to say mental illness rather then mentally ill; perhaps semantics. Perhaps not. Mental illness does not define me; it is a characteristic of who I am, all that shaped me into who I am. I doubt I'll ever go 5 years without a depressive episode - needing some tweak in the drugs and/or some extra support. Does that mean I am mentally ill when someone who has had no recurrence of illness for 20 years isn't? Maybe it does. What's so awful about that? We talk about remission in cancer, why not in other illness?

ohtohavepeaceandquiet said...

Dinah,

I find it fascinating that the label of mental illness is an aspired for status because it allows people to claim disability,which they could not do without the label and lots of paperwork. It is a very sad commentary on our society. What do we do with those unfortunate souls who grew up into trust fund money, or who manage to earn a living and support themselves in between hospitalizations every few years for mania or depression or whatever? To what status do they aspire? Are they less mentally ill on paper because they do not need any papers signed?
How about this: are those who are ineligible for disability due to immigration status, or due to the fact that they live in countries that do not provide disability at all ,any less prone to be diagnosed with mental illness? Perhaps. Maybe it is like breast cancer rates for women who immigrate from countries that do not know of McDonalds. I think there may still be a few.Their cancer rates grow to match those of American born women after x number of years of being exposed to the North American diet. Do mental illness rates increase as people learn the North American definitions of mental illness and/or imbibe in our "crazy" culture?
One more question: what do we do and how do we classify people who would be considered mentally ill by nay clinicians standards (okay, not Rob's) but who do not wish to claim that status and would rather live on the streets than collect disability or who are so disorganized in their thinking that it has never dawned on them to apply? I see these people on a regular basis, crouched in doorways, eating stale chips. I stop to talk to some of them. These people have had enough of the labels that put them into institutional before they were tossed out on the streets. Mentally ill today is not what it was years ago. It is almost a status symbol and yet the stigma remains. In our efforts to eradicate stigma we have chosen to define half or more of the population as mentally ill. It is a misguided, perhaps well intentioned ,move to normalize mental illness to the point that those with the mental illness equivalent of a cold and those whose illness is far more grave are huddled under one umbrella. From the point of view of service delivery, it makes no sense. It makes no sense, logically. I agree with Liz that we ought to be speaking more about mental health.That does not mean I do not believe in the concept of any mental illness. I have personally experienced times in my life of serious illness but do not identify as mentally ill. I have a thick file that details my illness down to the number of times I voided in a given day while hospitalized for manic depression. Many of us with that label have spectacularly long periods of wellness ,or relative freedom from acute symptoms. We should try not to forget that and we should also be wary of the explosion in the diagnosis of this "disease". I do not know if I have a disease or some strange temperament that makes me go crazy sometimes. I have had it for 30 years, before it became an accessory or a status to aspire to.

Jane said...

I'm actually getting a little bit disturbed by the labels that are being thrown out...especially with Asperger's Syndrome. Someone I know has a relative who was diagnosed with Asperger's (his parents elected not to tell him). His younger years were very socially awkward, but he is now popular in high school. Though he himself admits that he is very awkward..he is still very likable and down to earth. He is also very, very religious. He is a devout Catholic and was considering a priest for a while. However, because he is so awkward, he thought it might not be a good fit for him because he believes a priest should have superior social skills. My friend thought his concern was legitimate. Nevermind that I don't think young people should be sold short. That's the time to dream big...But I was really taken aback when she linked her nephew's knowledge of Catholicism to being an Aspie obsession. If dreaming of becoming a priest and learning everything under the sun about Catholicism is a symptom of Aspergers, then what is the difference between an Aspie and someone who is just really religious?

Not long ago, something similar happened, and that's why I wonder if people are looking for mental illness where it might not exist. My sister is dating a guy who thinks her kid, who is 12, has "mild Aspergers." I would have never thought that about him. Her boyfriend thinks he has Aspergers because he is messy, is amazing at math but struggles in english, and is obsessed with aliens and outerspace. He has memorized the names of planets, stars, constellations, and has an all around amazing knowledge of astronomy for a 12 year old. And he loves watching Ancient Aliens. That was his primary reason for thinking he has Aspergers (he is a messy astronomy buff who is obsessed with outer space). The boyfriend did mention that my nephew comes off as a little socially awkward, so I guess that would be the one detrimental Aspie symptom he saw. But I did ask the boyfriend, "What is the difference between an Aspie and someone who is just really driven to succeed?" If he grows up the be a famous astronaut would that make him less of an Aspie or more of an Aspie?

Anyhow, just thought I'd share...Is every abnormality a mental illness? Because I was also thinking...if being obsessive about gaining knowledge on a specific is a symptom of Aspergers, then are all doctors at least partial Aspies? Don't you have to be kind of obsessive to get through med school and beat the curve and get As? Are all the most competent doctors, with an encyclopedic knowledge of their field, suffering from a symptom of mental illness? Something to think about...

Sideways Shrink said...

There certainly are remission episodes from all kinds of mental illnesses or I certainly would not be well enough to A) be a shrink or B) continue to treat patients without falling into existential despair. I did a stint in oncology and I found the medicine interesting but I am not made up that sort of inpatient oncology stuff: where everyone knows its all just going to end on death nearly every time. Psychiatry is all about treatment success and remission and "graduating" patients from more to less intensive psychotherapy. J, your situation is like that of most of my patients, except your shrink would have been working with you on laughing at some of this categorical crap for what it is--a bunch of words that don't have real power over us after we figure out what they mean to us.

Anonymous said...

I am bipolar, but I do not consider myself mentally ill. I personally think "mentally ill" is quite derogatory. I have a mood disorder.

girrl88 said...

I think the distinction needs to be made between situational conditions and chronic illnesses. Many people will experience a situational depression or something to that effect, IMHO this is mental illness. If you are unable to function normally (shower, eat, work, shop, OR are hallucinating, psychotic, delusional, etc.) then you are mentally ill. The real question is whether or not it is a permanent condition.

What I dislike about NAMI's wimpy definition is that it makes it sound like mental illness can be cured. That bit about "recovery is possible" is very misleading. If you are truely mentally ill then no, you cannot be cured. Your symptoms can be managed but your illness will never go away. There is no magic pill, no super-powered therapy.

The deaf separate themselves into two groups - little d and Big D. Little d means that you have some hearing, Big D means that you have no hearing at all. I think that mental illness should have similar distinctions. Those that have situational/temporary mental illnesses and those with chronic mental illnesses. I am not saying that one is more ill than the other, just that one has a chance of becoming better and living without medications and the other will most likely be on medications for the rest of their life. We also have to remember that medication alone is not the answer. I was always taught that it's a 40/60 balance. 40% medication and 60% therapy & you.

I do know that many of the mentally ill are good at hiding their illness. I know that several times i've seen patients in group settings behaving fairly normally even though they are experiencing issues at the time. These people aren't scam artists, just good at putting up a false front. It's something everyone has done, pretended things were okay when they weren't. Some of these people do it every time they leave the house.

Personally, I like the title. Had you gone on to bash the MI I could see how it might be offensive but when it leads to an intelligent open discussion, nah, it's fine.
And if it means anything, I'm bipolar.

Sideways Shrink said...

Using the deaf analogy is interesting in this context because my husband, an improvisational jazz musician, had a benign tumor in his right ear. He had lost hearing without knowing it. He was compensating for tinnitis (in his case a roaring sound) without realizing it. So can you guess than I'm heading for a spectrum of crazy argument? He has had 3 surgeries including having titanium (?)replacement bones and a new ear drum created from his ear canal. He now has a full spectrum of his hearing back in that ear and 95% of the "intensity" of the hearing. However, for 5 years it went up and down fairly wildy. For 2 and 1/2 of those years he didn't realize he was having hearing problems (like a person with no insight into their mental illness?)and with treatment it still fluctuated but he was getting help (like the agony of psychotic symptoms when you are on an in patient unit changing meds rapidly).
But those extremes aside, everyone is on the spectrum of well adjusted to bat shit crazy--although I have never met anyone who is well adjusted--unless those were the boring people at the cocktail party I skipped talking to and a lot of my friends are bat shit crazy but that isn't scary so I think it's all about perspective and stigmatization and creativity.
If 57% of us are this thing, it can't be a bad thing. I'm in the human race because I have no choice, but I do love us.

K said...

I agree with girrl88 - there is and should be acknowledged a distinction between an episode of mental illness that developed in response to life circumstances, and recurrent or chronic conditions that substantially interfere with one's ability to exist normally. There has been a significant attempt to destigmatize mental illness here in Australia over the last 5 years or so. The message is one of "be open about your condition, there is hope and treatment will help". However, I am a lot like J, I have a PhD, but I also have severe, treatment-resistant, chronic MDD. I am functioning well at the moment, but I am dependent on meds and the support of my psych. Miss a couple of doses of my short-acting MAOI and I am teetering at the edge of the black hole again. My circumstances are not the same as someone with girrl88's description of situational illness yet the popular assumption with the recent media campaigns, is "see a doc, you'll get over it" (that is progress from "just get over it!). I learnt the hard way that that is not the case for me. And it is hurtful if someone, even with the best intentions, suggests otherwise. There is almost the implication that I am doing something that prevents me from being well. That is offensive. It is a good thing to destigmatize mental illness, but it is a bad thing to bundle all mental illness together. If one has a chronic or recurrent condition, it is not understood by the general public that it may be something that is lived with rather than cured.

Anonymous said...

Posted for Sarebear:

Rob is doing an excellent job of making sure I'll never take him seriously.
The title bugs me, but I also think you get to put whatever you want on your blog.
During my process of trying to get disability, I was highly reluctant, thinking, "Who on EARTH would want a court to declare them disabled due to mental illness? Why would you WANT to be seen as disabled, that's just not something that I'd ever see as a good thing." The only reason I kept going was so I could access money for treatment to get better.
My claim was dismissed due to the judge (based partly on the casual dismissal of it by the psychologist there) dismissing a key piece of evidence from my family doc, seemingly because he's not a mental health professional.
Anyway, it bugs me that it may be easier for those trying to scam the system to get benefits than it was for me; I only went to the doc every 3-4 years for it sometimes, and they didn't like that there wasn't a big pattern either, even though I showed a pattern over time, it was just really really spread out due to being too poor or no insurance or both, to be able to go to the doctor.
Anyway. Then they said, give up your right to appeal and we'll consider giving you a trickle of SSI. I felt undue pressure, and don't make decisions well that way.
Anyway. I don't like the definition on there either it's too cold and it doesn't mention something I think it should mention that I'm reluctant or averse to mentioning. Yep, helpful that is, not.
Most of the time I don't know that I believe I'll ever get better, but I do see some improvement from time to time in therapy, in different things, despite it being really slow . . . or I wouldn't keep going.
No, I probably would because he's the only one who really understands me, and I don't know if I could live anymore knowing no one understands me. Too dependent yeah but at this point I'll take whatever I can that gives me any motivation whatsoever, because I have so little motivation it's practicalyl non-existent (did I smoke weed as a baby?)

oh said...

it is true that many people are capable of hiding their illness or putting on a mask every day. At the same time, it is not easy to get admitted to most psych wards. You have to be pretty sick or you will be sent home with the names of a support group or a social worker who may or may not see you. If a person has the capacity to sit on a psych ward and be on Facebook or equiv for half the day, they are taking up a bed that could be used for someone who is sick enough that they are well beyond hiding it. My long periods of wellness are the times I hide how I feel, no matter how awful that may be, because i am terrified that any sadness will be mistaken for suicidal depression and I am concerned that any overt display of happiness may be determined to be
the fist signs of mania, at which point I will told to double my dose. If I win the lottery, I will have to go collect my check with a wan smile lest anyone think I am on the verge of a full blown episode.
You know you are really sick when you cannot hide it no matter how hard you try.
I did not feel the title had much to do with the post. I do not really care what title you use. I like your explanation that not everything that pops into your head is useful.

rob lindeman said...

"Rob is doing an excellent job of making sure I'll never take him seriously."

And I have difficulty taking seriously expository writing full of paragraphs beginning with the word "Anyway."

In any case, my point, in case anyone hasn't got it yet, is this: Diabetes Mellitus, Type I, is a disease with a well-defined pathophysiology, pathology, treatment, and natural history. That makes it a disease. Mental illnesses are identified as diseases only by analogy to Diabetes Mellitus, Type I.

Whales have fins and swim in the water, but that don't make them fish.

oh... said...

Sarebear,

I live every day knowing that no one understands me. More people than you imagine live that way. I think it is part of the human condition and not so much to do with any illness or harsh life circumstances. Some people still manage acloseness of sorts with at least one other human, perhaps a partner or a child. Still, even these people will never trull understand the way that you may wish. They will never live inside your skin and you will never live inside their skin. You may try but you will never truly understand them the way they might wish to be understood. We cannot live in the hope that some medical professional will truly understand us. I don't believe that they do and they certainly have less investment in trying than the people in your "real life". Our doctors understand us from a lens that is different than what we may be hoping it were. That said, i am grateful for that fact because to be truly understood by someone I paid or who was paid to understand leaves the ever present understanding on my part that this "understanding" is fleeting and superficial. I probably did at some point in my life, but no longer wish to be understood. It is like wondering what happens to your "self" after death.

To Rob: I fail to appreciate the difference between "Anyway."and "In any case". A Harvard English prof would. For our purposes here, it is irrelevant.

rob lindeman said...

Good call. I got hoist by my own petard! There is a difference between the expressions, but the argument is the irrelevancy, not the choice of words. Stating that one doesn't take another comment-er seriously is merely another way of stating one doesn't agree.

I tried to edit out the first. I should have known the new edit system wouldn't let me dump and re-write!

p.s., I miss the word verications. Any chance of going back to them? The 'prove you're not a robot' thing is creepy

Oh... said...

Rob,
You have a petard? Lucky son of a gun. I wouldn't mind owning one of those but I think there are restrictions on what people diagnosed with a mental illness have the right to bear. I think we are only allowed grudges and I'd rather not keep a stock of those.

rob lindeman said...

Good points, Oh... said...,

I pretend to know a little about the constitution... But I'm not sure the second amendment supports the right to bear grudges, or to grind axes, if one has an axe to grind. It does, however, protect the right to arm bears: I saw it on a t-shirt.

Liz said...

girrl88--

i don't think there is a simple distinction between those that have short term and those that have long term mental illness. i think any sort of illness can be improved or exacerbated by the right or wrong form of treatment. i find the simplification of "those that can and those that can't get well" sort of alarming. and i think that a person believing that they CAN'T get well can be a huge hindrance to the healing process.

Oh... said...

Bare arms could get me locked up in certain parts of Brooklyn and a few other hot spots.

girrl88 said...

Liz - What would you prefer that I call it? Symptom management? -- There are some people that will only need symptom management for a short while as their symptoms will only last a short while. Other people will be plagued by their symptoms from the onset throughout their lives and will therefore need lifelong symptom management.

It's a half-full, half-empty thing Liz. It's all in how you read it. And just because one can't get well doesn't mean one can't get better. There is a huge difference between the two.

As far as science is concerned, mental illness is due to a chemical imbalance in the brain. Speaking only in terms of those that could definitely be considered the chronically mentally ill, (those that have had diagnosable Axis I mental illnesses for, let's say, 15 or more years) how are you expecting their brains to start producing the correct amount of chemicals when research has shown that it hardly ever happens? If one can't reasonably expect their brains to recover to what is considered a "normal" level of functioning then how can one tell them that they can expect to get well?

rob lindeman said...

"As far as science is concerned, mental illness is due to a chemical imbalance in the brain."

Actually, as far as science is concerned, no chemical imbalances have been detected.

Oh... said... Has Brooklyn ratified the constitution yet?

oh... said...

Rob,

B Park knows from the constitution?

Re: Chemical imbalance. I am not certain what causes what I have, but the chemicals I take make me better (or "weller") but mostly just well enough to blend in. I have had several med(chemical) holidays that ended very badly, as in my passport was confiscated at the border--(imagine the hospital psych ward as the entrance to a foreign country). It could be that the chemicals I ingest have caused damage to the parts of my brain that regulate chemicals and it could be mere coincidence that over a period of 30 years my wellness coincides with chemical use. That the chemicals keep me together does not absolutely prove that I started out with an imbalance, but unless you can provide me with a better explanation, I will remain okay with the fuzzy notion of a chemical imbalance. Sometimes it is not about being right or wrong. Not all of life is as black and white as that.

Simple Citizen said...

Mental Illness is kind of like pornography - “I know it when I see it.” Yes the DSM is faulty, yes the Monoamine theory was incomplete if not completely wrong. Any definition is going to perturb someone because mental illness is defined by the sufferer. It’s like asking people “what is normal?” In order to define mental illness you’d have to define mental health.

I know plenty of people who don’t have a DSM-IV diagnosis that certainly don’t meet my personal definition of mental health. That’s because I am not them. What feels like mental wellness to me is not even close to my neighbors definition.
Want to know a sad but often reliable way to identify mental illness?
Go to an ER and see which patients the ER doctors don’t want to deal with.

Liz said...

girrl88-

i guess the biggest difference, to me, is that i believe that just about ANYONE can, with the right treatment (don't read "meds" here), has the potential to become emotionally healthy and psychologically well (and not needing medication). to me, the goal of complete and total recovery is very liberating and motivating.

i haven't seen any convincing evidence of the truth of the chemical imbalance theory, either in the research or in my personal experiences. i have had an axis 1 diagnosis for fifteen years and took ineffectual medication for much of that time, so it seems, according to your definition, i'm chronically mentally ill.

while my brain hasn't "suddenly" started producing different chemicals, i am not on any medication. i have, with the help of a psychologist and a counselor, started thinking and behaving differently, and that has helped me tremendously. i have several friends who are experiencing a similar benefit to group support, counseling, and healthier eating/more exercise, WITHOUT medication. i have other friends who are on medications, though, and that is a decision they make with their doctor and therapists.

i can get my blood sugar checked, to see if it is at a healthy level. i get my thyroid checked periodically to make sure it's doing it's holding up okay after all the lithium i took over the years. if someone can show me concrete evidence that supports the idea that people with depression or bipolar disorder or schizophrenia have a serotonin or dopamine or norepinephrine issue, i'll re-examine my beliefs.

until then, i'll try to stay as healthy and well as i can naturally (and maybe i'll even quit smoking someday!)

Anonymous said...

posted for Sarebear:

It's more than just disagreement, Rob, it's a statement that your incessant, repetitive, rigid adherance to a narrow (IMHO, mileage may vary) point of view, that at times almost feels like an automatic response to almost anything that is posted here on certain subjects, tends to reduce your credibility in my eyes. For the reasons I've already mentioned, and again, to reiterate, for emphasis, that it feels like it's always the SAME.

Repetition can be used for emphasis, as I've done here, and perhaps that is what you intend when you put forth your repetitive, exact, rigid views, but it feels (IMHO, etc.) more like a bludgeon as well as a like a record player, skipping back over the same loop of content. More reasons why your credibility isn't high, to me.

Stating that my ability to compose focused or less-focused comments depends on to what degree my mental illnesses are affecting me at that moment may be obvious to some people, but since you don't seem to believe in mental illness, I suspect it means nothing to you at all. Still, just because I may have varying levels of being able to focus more at some times than others, and thus may sometimes or even often not express myself as . . . efficiently or well as I may like, it doesn't mean that my opinion isn't as valid as another.

Your opinion is yours and you've the right to it, as anyone has to theirs. But I do judge how much and to what degree it has credibility for myself, and apparently I felt like expressing my dissatisfaction with your credibility when I posted before. It's just my opinion, about how I feel the way you present yourself and your opinions has affected how I receive what you put out there.

Sarebear said...

to "oh..." regarding my dependency on my therapist, or not wanting to live without having someone who understands me, I'd say the following:

I've lived that way before, so it follows that I'm capable of living that way again. However, dependency on the therapist is part of the process, and while I don't consciously seek dependency in any of my relationships, I'll accept it as a by-product of therapy, one that will not always be there as I gain more confidence in myself, as I gain more insight and replace self-destructive beliefs with more productive or healthier ones (not to imply that the therapeutic dependence is destructive).

See http://www.afterpsychotherapy.com/emotional-dependency-in-psychotherapy/ for a discussion of therapeutic dependence.

I do appreciate your concern that I may be harboring a worldview that could be healthier.

girrl88 said...

I apologize for the delay in my posting and most likely this will not be read but...

Simple Citizen - You just posted two of the stereotypical things that people think about the mentally ill. First - "I'd be able to tell" - How? Second - "Go to an ER and see which patients the ER doctors don’t want to deal with." - Please elaborate.

Liz - You are discussing two separate issues under the guise of one. The issue of treatment styles has nothing to do with the cause of mental illness.

If someone knows of a current widely accepted theory for the cause of mental illness that is not biochemical in nature then I am open to read it.

oh said...

Sarebear,

I am not telling you how to live your life or what to feel.
If you cannot help feeling dependent and feel that you need to feel to feel that way for now, I am not here to judge you. From my experience, it is not about it not being healthy, it is about it not being real and about it not ending very well. Personally, it works better for me not to depend on anyone or anything. I don't expect much and I am not disappointed. I guess that is part of growing older. Pass the prunes.

Jane said...

...In reading the comments between Oh Said and Sarebear I have mixed feelings. Nobody really likes to be dependent or having to rely on someone else. But I actually think that NOT depending on your therapist would defeat the whole point of therapy. You are there to depend on the therapist's good judgment. If you cannot depend on your therapist to have an accurate perception of you, give good guidance, and teach you how to lead a better and more productive life, well then there is no point to the therapeutic relationship. If your therapist doesn't understand you then it's time to get a new one. We all have to depend on different people. We rely on our hair stylist to keep our hair looking good. We rely on the Pharmas to keep producing medicine to treat our illnesses. We rely on our coworkers to do their jobs so that we can do ours. Etc, etc, and so forth. Our whole lives are spent relying on people. No one is totally self sufficient.

oh said...

Jane,

In an ideal world, you are not wrong. Ideally we should be able to rely on a therapist to understand us and on our hair stylist to figure out how to make us look our best. These are all just people and people screw up and let us down for lots of reasons. They also move away, burn out and die. No one ever wakes up thinking their husband or wife is going to die in a car crash on the way home from work that day. Children depend on their parents. Even the best parents can drop dead of sudden heart attacks. Life can be devastating, but you already know that.

Jane said...

I think maybe I wasn't clear. I wasn't saying that there are people that are perfect and can be depended on 100% of the time. My point was that we do depend on people all the time, and it is a given that people are fallible. The only thing that is 100% reliable is death and whatever infallible God/s/ess/esses people believe in. I'm saying that people tend to rely on other people with the full knowledge that we will be let down eventually but not all the time. People get let down in therapy. But for the most part, the therapist should be dependable (unless that therapist is getting fired).

oh said...

Jane,

You were clear. Maybe that works for you. Maybe it work for most people. it probably does.I rely on the grocer to carry to produce that won't poison me. I don't rely on anyone to understand me. That has never worked and I am fine with that after years of experiences that have taught me I am better off keeping myself to myself. I can be self sufficient unless I need an organ transplant. i couldn't do that by myself. I'd probably also need a lift to the hospital.

Sophia said...

My definition: "The mind is connected to the body in the same way the feet are connected to the legs. Much like the bones in the feet can break and make it difficult to do that normal stuff people talk about, the brain can break as well. Sometimes it's temporary. Sometimes it's not. Sometimes it hangs out in the back of your mind and you get skilled in telling it to shut up. Whatever it is, it sucks and you really need to get it checked out. That goes for kids, too. Kids can have broken brains. Kind of like how you can have a broken arm. It, like, happens. And yeah, it might be your fault. Hey, nobody's perfect. There are worse things. But be more careful with those kids, man.

In the wise words of my DBT therapist, 'Teenagers are all personality disordered.' Try to save the Zyprexa for those times they think the TV is telling them to kill themselves. The side effects suck and they might spit them out for that reason. Who wants to gain fifty pounds, sleep 12 hours a day, and have cavities from dry mouth? And Zyprexa is spendy, and your insurance company will fight tooth and nail to not cover it for a minor. You, the therapist, the teachers, and the doctors will tell your kid to suck it up in terms of med side effects, as surely it can't be any worse than taking a Benadryl. Good luck with that, man.

Seriously, though, medication is a useful tool in the recovery bit for many people. The four dollar lists at pharmacies are awesome. Don't forget to do some yoga or something, though.

It's not all doom and gloom. Heck, your therapist might very well be on medication just like you. And that nurse who takes your blood pressure at the psychiatrist's office? Xanax is his/her friend. I know this because all of my nurse friends tell me about their coworkers.

In short, life's a bitch and sometimes your brain breaks. Chances are pretty good it has nothing to do with you being lazy or having a soul that needs to be returned to the creator because it's defective. Sometimes you gotta roll with it. And not be afraid to be feisty when some jerk discriminates you for the mental disorder(s). They're in denial. Laugh at them and walk away." The end.

Not the best definition, but it's more or less what I tell my family about the folks I work with and what I do.

Anonymous said...

I watched a film a while ago called God Grew Tired of Us. It is about a group of boys who went through hell I think its also called the Lost boys of Sudan - it follows their journey and how loving and supportive they are too each other and others when they arrive in the USA. One of the main difficulties they had in adjusting to US/Western life is the isolation involved. One of them ends up in a mental institute as he cannot handle living the isolated life style of the west. I recommend watching it for anyone who doesnt understand mental health issues - I do believe the numbers of people suffering with mental health issues are more in the West due to our lack of community, trust and support of each other.

thedistinctone said...

From my experience mental health treatment is just a methodology of waylaying the inevitable! It like a polyp of disambiguation to perform systematic motions that evolve into a higher understanding. I think people should open their eyes and see that people aren't like light bulbs for shedding light on their unamorous lives! Grow up for goodness sake!

Anonymous said...

Is not "medical condition" rather defined as something outside of the norm?
If 56% of people have "a propensity toward" mental illness, then it follows that mental illness (or at least a propensity toward) is normal.
With that little % mark, we have entered the magical world of statistic-speak, wherein nearly anything can be both "proved" and "disproved" with various pseudo- representative number sets, and accompanying choice interpretations of data.
Attempt to put that 56% propensity into a simple bell
shaped curve to define the parameter called normal. Recall that "normal" must include, not exclude, a few outlier points. Here normal is too broad, bell becomes too flattened to be called a bell, and normal cannot be defined at all. Thus if 56% tend toward mental illness, then tendency toward mental illness becomes normal. If the majority of population tends toward mental illness, then mental illness must be a normal part of life.

Tell me, has anyone ever been sent away from your place of business with the assurance that they are not mentally diseased, but rather "normal" and therefore do
not need your services?
It happens in other medical specialty offices, when tests show results within the range of normal, and/or MRI/CT/ultrasound/xray show nothing abnormal.
But psyche-normal is not so easily objectively tested, and being subjectively defined, perhaps psyche-normal does not even exist.

If I go to my physician suspecting diabetes, and tests show I do not have diabetes, I will be told that, in this particular, I am normal.
If I go to my physician suspecting a mental illness, I will automatically be given a Dx of mental illness, because
there are no such tests. I will never be told that in this particular, I am normal.
ie:suspecting mental illness IS mental illness. Suspecting diabetes is not diabetes.

If there is mentally abnormal, mentally normal must exist. Define either with the concise definitions used for diabetes and then you can reasonably compare mental illness to diabetes. Otherwise I hear only apples-to-oranges psychobabble.

So, if "oh to be mentally ill" implies a wish on your part not to be mentally normal, then by definition (or rather by non-definition) your wish is granted. Your chances of being mentally ill are likely better than 55%. ;)

Anonymous said...

Is not "medical condition" rather defined as something outside of the norm?
If 56% of people have "a propensity toward" mental illness, then it follows that mental illness (or at least a propensity toward) is normal.
With that little % mark, we have entered the magical world of statistic-speak, wherein nearly anything can be both "proved" and "disproved" with various pseudo- representative number sets, and accompanying choice interpretations of data.
Attempt to put that 56% propensity into a simple bell
shaped curve to define the parameter called normal. Recall that "normal" must include, not exclude, a few outlier points. Here normal is too broad, bell becomes too flattened to be called a bell, and normal cannot be defined at all. Thus if 56% tend toward mental illness, then tendency toward mental illness becomes normal. If the majority of population tends toward mental illness,
then mental illness must be a normal part of life.

Tell me, has anyone ever been sent away from your place of business with the assurance that they are not mentally diseased, but rather "normal" and therefore do
not need your services?
It happens in other medical specialty offices, when tests show results within the range of normal, and/or MRI/CT/ultrasound/xray show nothing abnormal.
But psyche-normal is not so easily objectively tested, and being subjectively defined, perhaps psyche-normal does not even exist.
If I go to my physician suspecting diabetes, and tests show I do not have diabetes, I will be told that, in this particular, I am normal.
If I go to my physician suspecting a mental illness, I will automatically be given a Dx of mental illness, because
there are no such tests. I will never be told that in this particular, I am normal.
ie:suspecting mental illness IS mental illness.
Suspecting diabetes is not diabetes.

If there is mentally abnormal, mentally normal must exist. Define either with the concise definitions used for
diabetes and then you can reasonably compare mental illness to diabetes. Otherwise I hear only apples-to-oranges psychobabble.

So, if "oh to be mentally ill" implies a wish on your part not to be mentally normal, then by definition (or rather by non-definition) your wish is granted. Your chances of being mentally ill are likely better than 55%, while your chances of being mentally normal are exactly the same.
Mentally ill (at 56% of population) IS mentally normal.