A debate on mental sickness...

[ShivaFan]

I wrote a paper up for my University back in the 1970's, I visited and did some "one on ones", interviews, case study, with mental cases at a state mental "ward"/hospital.

While there are many causes for mental issues, I came to the conclusion that the majority of those in my case study had mental issues related to chemical imbalance, it is all about chemicals hitting the brain, imbalance and past exposure, parents who were drug abusers or heavy users of prescribed medicines or marijuana, parents who abused LSD or other drugs, mental issues related to exposure to heavy insecticides, etc... not the only cause, but a major cause.

 

[The Hammer]

Actually not even psychiatrists express this view in the literature anymore (ok, they do, but not in the way presented to the public). I wish, also, to add a caveat: yes mental illness as it is classified, categorized, and diagnosed is largely constructed from a switch from psychodynamic models to the biomedical model (motivated by such things as the view amongst medical doctors that psychiatrists were not doctors and relatedly a decline in medical students seeking careers as psychiatrists, the frustration of insurance companies being billed for sessions that were "medical" despite any medical diagnosis, etc.).

This does not mean the mental health issues are simply "in the mind" or that one can simply "snap out of it". Quite the contrary. Rather, diagnoses have no singular pathogenesis nor singular underlying pathology. This is to be expected quite apart from psychiatry given the paradigm switch from genetics to epigenetics and the realization that the nature/nurture dichotomy was inherently flawed. Models such as the biopsychosocial model of mental illness are far more supported by the evidence, and as there is no technology that can even test so-called "chemical imbalance" (hell, even in neuroimaging the idea of a base or resting state to which others may be compared is a discarded fantasy), this description is not only largely meaningless, but untestable.


Agreed.

While I agree that a chemical imbalance may not be the only cause of depression, considering human emotions are expressed on a spectrum and it is normal to be depressed for a period of days-months, and then be ok afterwards. The imbalance comes into play when someone has been depressed for a period of years, and their ability to function is being greatly reduced. A psychologist will not say you have a particular disorder until you feel it is interfering with your every day life.

I have a person very near to me who has been diagnosed with depression, and while it is more then likely a combination of things and not just a chemical imbalance, the symtoms that are listed in the DSM V, do fit the bill and so it is a good diagnostics model.

The reason they think it is a chemical imbalance is because when given an SSRI for a period of time, the Serotonin levels boost in the body, and the bodies ability to re-uptake the serotonin lessens some, which in many cases completely negates the issue of depression and removes said symptoms. So while this may not always be the case, and medication does not fix everyone (which is why all psychologists I have seen/talked to, do not recommend medication unless it is absolutely necessary). But all in all, a chemical imbalance is a very likely cause, just not the only cause.

 

[john2054]

Thankyou everyone for engaging with my posts in this constructive manner. I was fairly sure that i would recieve at least one piece of troll hate mail as a result (much like i got off the mental health forum website, b4 they banned me), but instead you have engaged in a creative and constructive way. I am also an expert on this field, having suffered from the condition for the last nine years, and researched it deeply in this time. Including reading several books on it, cover to cover. How many of you can claim this?

As for the chemical imbalance paradigm, whereas it is true that this is a working model, which seems to fit with a great majority of psychiatrists, it must be remembered that they are working as well. In fact it is a part of the etymology of the psychiatric illness/wellbeing model that they seek to cure these diseases/malnomers with drugs. Sure many of them will also look to other forms of treatment as part of their recovery model, they do these as well at least these days. However their first recourse is to the medicine, and the rest comes after i am afraid to say. And yes i do have insight over these nine years having spent a third of this as an inpatient, and the rest on the outside.

Life in hospitals, where the very defintion and creation of the term and concept and reality of 'madmen' happens, is nothing like the outside world. And it is very easy to step in to this environment and loose sight of the wood for the trees. As one above poster has already reffered to from her experience as a student. But i am living proof of someone who has both a. been diagnosed clinically mad and been refused escape from three separate medics and judges, and also got married, had a (step) daughter, and is close to finishing a degree, in this time. To be honest with you if the makeup of users of this site are anything like the general population of the west, the majority of you won't have degrees. And whereas i would expect to see the odd state of mild depression, i very much doubt i'll find someone else who has done three years plus in these places. For the simple reason that most don't make it out alive. I have lost many good friends along the way.

Please don't argue with what i am saying. Well you can argue and disagree, but ultimately the only person you are fooling is yourself. For whereas they constantly tell me that i have no insight in to my condition, as evidenced by me blaming my recent relapse of the whiskey i was drinking by the bottle at the time, for example. I would beg to differ!

 

[The Hammer]

Thankyou everyone for engaging with my posts in this constructive manner. I was fairly sure that i would recieve at least one piece of troll hate mail as a result (much like i got off the mental health forum website, b4 they banned me), but instead you have engaged in a creative and constructive way. I am also an expert on this field, having suffered from the condition for the last nine years, and researched it deeply in this time. Including reading several books on it, cover to cover. How many of you can claim this?

As for the chemical imbalance paradigm, whereas it is true that this is a working model, which seems to fit with a great majority of psychiatrists, it must be remembered that they are working as well. In fact it is a part of the etymology of the psychiatric illness/wellbeing model that they seek to cure these diseases/malnomers with drugs. Sure many of them will also look to other forms of treatment as part of their recovery model, they do these as well at least these days. However their first recourse is to the medicine, and the rest comes after i am afraid to say. And yes i do have insight over these nine years having spent a third of this as an inpatient, and the rest on the outside.

Life in hospitals, where the very defintion and creation of the term and concept and reality of 'madmen' happens, is nothing like the outside world. And it is very easy to step in to this environment and loose sight of the wood for the trees. As one above poster has already reffered to from her experience as a student. But i am living proof of someone who has both a. been diagnosed clinically mad and been refused escape from three separate medics and judges, and also got married, had a (step) daughter, and is close to finishing a degree, in this time. To be honest with you if the makeup of users of this site are anything like the general population of the west, the majority of you won't have degrees. And whereas i would expect to see the odd state of mild depression, i very much doubt i'll find someone else who has done three years plus in these places. For the simple reason that most don't make it out alive. I have lost many good friends along the way.

Please don't argue with what i am saying. Well you can argue and disagree, but ultimately the only person you are fooling is yourself. For whereas they constantly tell me that i have no insight in to my condition, as evidenced by me blaming my recent relapse of the whiskey i was drinking by the bottle at the time, for example. I would beg to differ!

As an alcoholic, and suffer of social anxiety/anxiety/and depression I understand the fact that it may seem like the doctors want to fill you with medicines before giving you "help", but that is only the case with certain conditions that need to be curbed chemically before a patient is willing to participate in other forms of treatment. I myself have been through an IOP program twice 5 weeks each time, and I have never been given a single drug. Instead I was introduced to a 1v1 therapy sessions, group sessions with others with the same conditions in varying states of the treatment process, and through the CBT model or treatment. So, I feel the drug recommendations are higher depending on the conditions that one has. Psychotic disorders and Schizophrenia are typically only able to be treated via medications first and then therapy second, because one has to be place on more stable ground before being treated therapeutically.

With that, having a disorder or a condition and spending time in facilities in care of those disorders (Even when coupled with reading books/research about it), in no way makes one an "expert" in any way shape or form. You are knowledgeable and informed, but you are not an expert. The over-quoting of the wrong Diagnostics and Statistic Manual is proof of that. (We are on the DSM V) The DSM III was published in 1980, and we haven't used the it (superseded) since 1994.

DSM: History of the Manual | psychiatry.org

 

[john2054]

With that, having a disorder or a condition and spending time in facilities in care of those disorders (Even when coupled with reading books/research about it), in no way makes one an "expert" in any way shape or form. You are knowledgeable and informed, but you are not an expert. The over-quoting of the wrong Diagnostics and Statistic Manual is proof of that. (We are on the DSM V) The DSM III was published in 1980, and we haven't used the it (superseded) since 1994.

Of course you are true, having a disorder and spending time inside does not make me an expert on it. What does that is the amount of time i have spent inside (two years was the last stint) and the amount of attention and thought i have given my treatments and discussions about these both inside and outside. i dont actually remember using the dsm 3, i was referring to the latest version in anything i said. in fact lay of the ad hominem attacks. i also said i am a father and a husband, and an under-graduate student. They are the accolades i have to my name, now what are yours? 'the hammer' pathetic handle btw!

 

[ChristineES]

Your doctor neither knows these levels nor the effects of such meds on them.This is absolutely known by any and all clinical researchers. It is also known that multiple drugs, particularly ecstasy, work similarly to SSRIs and such in that the vastly increase serotonin levels. In fact, there have been multiple clinical trials inidicating the efficacy of special K (the street drug ketamine). There is no neuroimaging data that can support any DSM or ICD diagnoses (which are constructed to begin with), and indeed not only strong evidence that differential diagnoses of mental illnesses are completely wrong, but an utter lack of any evidence whatsoever supporting the bio-medical model.
This does not in any way mean that mental issues are neither serious nor some clinical construct without basis. Far from it. But the fact that drugs work isn't evidence of anything. Take MDMA, and you'll fell happier. Take an SSRI, you'll feel less happy but you won't crash.


It is extremely inaccurate, but that isn't your fault and it isn't ignorance or bias on your part. It is the result mainly of dynamics that produced the DSM-III, the relatively incredible efficacy of the introduction of anti-psychotics when the state hospitals were over-flowing with patients, and the well-intentioned push towards community based programs like half-way houses and group homes rather than state hospitals. Hence prisons have become the default mental health providers for the US, all for noble reasons that has resulted in tragedy.

Why did you ignore the majority of my post and the link I got the information from?

 

[ShivaFan]

I would like to add two more items regarding my concern for those who have some degree of mental illness (or whatever the current trending in terminology is used).

One of them will strike some as a bizarre off subject and trending to the "fringe" side of this discussion. I will state it as of the "other consideration" category, and I admit it is not common (today) because it is relatively a "new" dynamic to this and part of how somethings could be mis-diagnosed as "mental illness" while at the same time a contributing factor.

In the early 1970's, we started to first become aware in a big way with what was to become known as Lyme disease, a deer tick transmitted disease. In 1981 the link between infected deer tick bite and transmission of a spirochete that causes the disease was confirmed - double-membrane bacteria passed to humans via infected tick causing severe symptoms many years after transmission. Further analysis came forward linking the spread of a number of "emerging diseases" to various other ticks and transmission of bacterias. It seemed this was a relatively new phenomenon even though it was probably endemic in certain areas for a century or more. In the case of Lyme, it spread from Connecticut in the 1970's all the way to California where it became a very real issue.

Why do I mention this in conjunction to mental "disturbance"?

Because, I have witnessed the effect of these "emerging" tick born diseases first hand ... I had a Supervisor who came down with Lyme, keep in mind you can be infected, undergo initial flu-like symptoms, develop a "bulls eye" shaped rash or in some cases no rash at all, the symptoms go away like a typical "flu" and you dismiss it.

The bad reactions can come 10, 20 even 40 years later. The symptoms can in some cases mimic what we commonly call "mental illness" - in fact this was the case with this supervisor. She started to have severe depression, then odd behavior patterns, suddenly talking out loud for no real reason or even shouting with no particular sequence to explain the anger and outburst. Then one day she lays down right in front of others, curls up in fetal position to "take a nap" right on the floor before other managers and employees.

Her husband naturally freaked out, the long short of it she was then going through the mill of psychiatrists and doctors and was diagnosed as having depression and mental unstability. Many were unfamiliar with Lyme disease, but as it made more press somehow they eventually linked all of it to a tick born bacteria.

Even today there is still a lot of lack of knowledge regarding this, inclusive of mis-diagnosis sometimes as "severe depression" and "mental anxiety".

So f.y.i...

Another point is, there may be a link - seems very probable to me - of lack of sleep over extended periods of time, perhaps due to high stress or having to work night shifts, and symptomatic depression, anxiety, mental instability, and yes hallucinations and a state sometimes called "dreaming while wide awake". Lack of quality sleep time can be a very real issue. Some acts committed by those who have extreme cases of sleep deprivation and "dreaming while awake" and yet acting in a limited capacity even while awake can and has been labeled "mental illness".

Not to get off subject but sometimes diagnosis of "mental" isn't that at all.

 

[ChristineES]

Your doctor neither knows these levels nor the effects of such meds on them.This is absolutely known by any and all clinical researchers. It is also known that multiple drugs, particularly ecstasy, work similarly to SSRIs and such in that the vastly increase serotonin levels. In fact, there have been multiple clinical trials inidicating the efficacy of special K (the street drug ketamine). There is no neuroimaging data that can support any DSM or ICD diagnoses (which are constructed to begin with), and indeed not only strong evidence that differential diagnoses of mental illnesses are completely wrong, but an utter lack of any evidence whatsoever supporting the bio-medical model.
This does not in any way mean that mental issues are neither serious nor some clinical construct without basis. Far from it. But the fact that drugs work isn't evidence of anything. Take MDMA, and you'll fell happier. Take an SSRI, you'll feel less happy but you won't crash.


It is extremely inaccurate, but that isn't your fault and it isn't ignorance or bias on your part. It is the result mainly of dynamics that produced the DSM-III, the relatively incredible efficacy of the introduction of anti-psychotics when the state hospitals were over-flowing with patients, and the well-intentioned push towards community based programs like half-way houses and group homes rather than state hospitals. Hence prisons have become the default mental health providers for the US, all for noble reasons that has resulted in tragedy.

While I agree that a chemical imbalance may not be the only cause of depression, considering human emotions are expressed on a spectrum and it is normal to be depressed for a period of days-months, and then be ok afterwards. The imbalance comes into play when someone has been depressed for a period of years, and their ability to function is being greatly reduced. A psychologist will not say you have a particular disorder until you feel it is interfering with your every day life.

I have a person very near to me who has been diagnosed with depression, and while it is more then likely a combination of things and not just a chemical imbalance, the symtoms that are listed in the DSM V, do fit the bill and so it is a good diagnostics model.

The reason they think it is a chemical imbalance is because when given an SSRI for a period of time, the Serotonin levels boost in the body, and the bodies ability to re-uptake the serotonin lessens some, which in many cases completely negates the issue of depression and removes said symptoms. So while this may not always be the case, and medication does not fix everyone (which is why all psychologists I have seen/talked to, do not recommend medication unless it is absolutely necessary). But all in all, a chemical imbalance is a very likely cause, just not the only cause.

The fact remains is that a psychiatrist told me it was a chemical imbalance. He would not have gone into the complexities of the disorder with me. A medical doctor will give treatment for different disorders, but he or she will not go into great detail of what it entails.
But I do know that my depression and anxiety is a medical problem and not an emotional problem.

 

[dgirl1986]

Mental Illness is something that is not as unusual as we like to think. There are varying degrees, varying types and different types of treatments to help assist with mental health issues.

I do not see what basis one would have for a debate on it unless you were in the field of psychology or psychiatry.

 

[Drolefille]

Thankyou everyone for engaging with my posts in this constructive manner. I was fairly sure that i would recieve at least one piece of troll hate mail as a result (much like i got off the mental health forum website, b4 they banned me), but instead you have engaged in a creative and constructive way. I am also an expert on this field, having suffered from the condition for the last nine years, and researched it deeply in this time. Including reading several books on it, cover to cover. How many of you can claim this?

Hi, I have read MANY books on mental illness, as well as peer-reviewed articles, received my MA in the field of Counseling and my BA in the field of Psychology, worked in Mental health and with individuals with serious to moderate mental health problems to this day. I have dealt with my own mental health issues to differing degrees all my life.

Why would you go on about getting "hate mail." If this occurs please notify staff here, but the passive-aggressiveness of "People will hate me for this, but..." doesn't do you favors.

To be honest with you if the makeup of users of this site are anything like the general population of the west, the majority of you won't have degrees.
Please don't argue with what i am saying. Well you can argue and disagree, but ultimately the only person you are fooling is yourself.

Why go out of your way to try to put people down? Even among people who experience schizophrenia, or any mental illness, accounts vary, opinions vary, and what has or hasn't worked for people varies quite widely.

Of course you are true, having a disorder and spending time inside does not make me an expert on it. What does that is the amount of time i have spent inside (two years was the last stint) and the amount of attention and thought i have given my treatments and discussions about these both inside and outside. i dont actually remember using the dsm 3, i was referring to the latest version in anything i said. in fact lay of the ad hominem attacks. i also said i am a father and a husband, and an under-graduate student. They are the accolades i have to my name, now what are yours? 'the hammer' pathetic handle btw!

And now you're just out right insulting? You admit that having a disorder and spending time in an institution doesn't make you an expert, and then state that because you thought really hard while having a disorder and spending time in an institution you're actually the expert. That isn't logic.

 

[metis]

My son has bipolar disorder and tried to commit suicide twice when in his teens. He's now 42, off of meds, owns his own company, but still struggles with his "demons" periodically. If anyone here saw "Silver-Linings Playbook", that movie well captures how my son is.

 

[dgirl1986]

My son has bipolar disorder and tried to commit suicide twice when in his teens. He's now 42, off of meds, owns his own company, but still struggles with his "demons" periodically. If anyone here saw "Silver-Linings Playbook", that movie well captures how my son is.

That is awesome and really uplifting to hear!

 

[psychoslice]

I have schizophrenia and it can be very frightening sometimes, but to debate it, what are you going to debate, are you going to label it a another name ?.

 

[methylatedghosts]

They are the accolades i have to my name, now what are yours? 'the hammer' pathetic handle btw!

Lol. relevance = 0

 

[The Hammer]

Of course you are true, having a disorder and spending time inside does not make me an expert on it. What does that is the amount of time i have spent inside (two years was the last stint) and the amount of attention and thought i have given my treatments and discussions about these both inside and outside. i dont actually remember using the dsm 3, i was referring to the latest version in anything i said. in fact lay of the ad hominem attacks. i also said i am a father and a husband, and an under-graduate student. They are the accolades i have to my name, now what are yours? 'the hammer' pathetic handle btw!

Sorry, John2054, but saying that you are "knowledgeable and informed, but in no way an expert" does not constitute an ad-hominem attack. I did not attack your character, or lob insults.

Expert (Noun): a person who has a comprehensive and authoritative knowledge of or skill in a particular area.

Being a husband, a father, an under-graduate, and a sufferer of mental conditions does not equate to "comprehensive and authoritative knowledge".

As for my "handle", it matters not if you or anyone else likes it, it is mine, and I like it. That would be like me telling someone their first name was pathetic. Who cares? So I will kindly ask you to stop with the ad-hominem remarks, thank you.

 

[LegionOnomaMoi]

While I agree that a chemical imbalance may not be the only cause of depression

I realize now there is a perhaps very simple way to express (or address) one aspect about my criticisms not of the idea that each and every diagnoses in the DSM or ICD corresponds to a unique disease with a particular, specific pathogenesis, but of this "chemical imbalance" notion which plagues common media reports and other sources of information (from TV shows to magazine ads). Something simpler than an inability to find some base state in an fMRI study. What would it mean to be "chemically balanced"?

 

[LegionOnomaMoi]

I have scanned and uploaded a paper:
Glasser, W. (2005). Warning: Psychiatry can be hazardous to your mental health. in R. H. Wright & N. A Cummings (Eds.) Destructive Trends in Mental Health: The Well Intentioned Path to Harm (pp. 113-128).Routledge. It was the best source I could provide that fit my criteria
1) Was written by an expert in an academic publication
2) Was accessible to the layperson
3) Was short (compared to e.g., one of the monographs, doctoral theses, or accessible academic books on the subject I have).

That said, I need to issue a caveat: the views expressed are more extreme than I believe warranted (true, the paper is infinitely better than Szasz' nonsense and probably his scientifically-oriented double Breggin), but too much is simplified and too little is addressed concerning certain regularities among persons diagnosed that are biological and suggestive of some underlying pathology (albeit not the biomedical model, which such findings are evidence against, but for something like the biopsychosocial model), etc. Also, it is oriented far more for mood disorders and those that are co-morbid with them (not, e.g., autism spectrum disorder or schizophrenia). However, there is no perfect source that can address all the nuances and technicalities in a way accessible to the layperson and that isn't a 10+ volume set.

There do exist more technical papers that are still somewhat accessible (I believe) to the layperson on our evidence (both the lack thereof and that against) for the view that psychiatric diagnoses correspond to distinct "diseases" that I would be happy to provide for those who wish something a little more technical that isn't some study filled with regression models and correlation values as well among technical jargon.

 

[Storm]

I haven't heard mental illnesses referred to as "diseases" before either. I thought that language was reserved for something that is actually... well... communicable?

Actually, the term has been common for several years now.

 

[Storm]

Tell that all to my doctor.

Gladly.

The biomedical model has been elevated from a model to a doctrine in the service of lazy profit, not health. That's why I was disabled for a decade by one incorrect diagnosis from a psychiatrist who spent less than 30 minutes of my 4 hour psychological evaluation actually talking to me.

Better yet, get yourself a copy of Saving Normal. It was written by the man who oversaw the creation of the DSM IV, explaining (and apologizing when appropriate) how we got to the point that that's actually a common story. The included guide to spotting suspicious diagnoses is what gave me the confidence to finally challenge it all after 10 years of being told I couldn't rely on my own thoughts.

It's not my place to question your diagnosis or treatment, but it is yours. It's not right to expect people suffering depression - be it neuropsychiatric, caused by inappropriate medication, or anything in between - to "be your own advocate," as I know all too well. But I don't want to see anyone else lose all I lost.

 

[Storm]

With that said, I'm no anti-psychiatry extremist. These diseases are real, and debilitating... But so is the epidemic of overdiagnosis and inappropriate medication.