Mental disorder
A mental illness is defined by the medical profession as a disorder of the brain that results in a disruption in a person's meaning Lisa's thinking, feeling, moods, and ability to relate to others and to work. Mental illness is distinct from the legal concepts of sanity and insanity.
Mental health, mental hygiene, behavioral health, and mental wellness are all terms used to describe the presence or absence of mental illness.
No single cause of mental illness can be considered as there is a wide range of disorders that are part of the category. Each disorder is likely to have its own etiology, however, many mental disorders are considered to have organic or neurochemical causes. Treatment options include psychiatric medication, psychotherapy, lifestyle adjustments and other supportive measures.
Due to many mental disorders having no defined physiological cause and the "nature" or "nurture" debate, some have questioned whether mental illnesses are real disorders, or are psychosomatic in nature. Additionally, advocacy organizations have been trying to change the stereotype of psychiatric disorders, which are often seen as being personally controllable, and therefore a sign of weakness. Some of these organizations would prefer that psychiatric disorders be viewed as natural (although not always functional or acceptable) variations in the neurology of individuals, and promote the acceptance of a neurologically diverse human population.
Prevalence and diagnosis
According to the 2003 report of the U.S. President's New Freedom Commission on Mental Health, major mental illness, including clinical depression, bipolar disorder, schizophrenia, and obsessive-compulsive disorder, when compared with all other diseases (such as cancer and heart disease), is the most common cause of disability in the United States. According to National Alliance for the Mentally Ill (NAMI), an American advocacy organisation which accepts funding from the pharmaceutical industry, 23% of North American adults will suffer from a clinically diagnosable mental illness in a given year, but less than half of them will suffer symptoms severe enough to disrupt their daily functioning. Approximately 9% to 13% of children under the age of 18 experience serious emotional disturbance with substantial functional impairment; 5% to 9% have serious emotional disturbance with extreme functional impairment due to a mental illness. Many of these young people will recover from their illnesses before reaching adulthood, and go on to lead normal lives uncomplicated by illness.
At the start of the 20th century there were only a dozen recognized mental illnesses. By 1952 there were 192 and the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-IV) today lists 374. Depending on perspective, this could be seen as the result of one or more of:
- More effective diagnosis and better characterization of mental illness, due to over a century of research in a new field of science and academia.
- A highly increased incidence of mental illness, due to some causative agent such as substances in the environment or in one's diet, or the ever-increasing stress of everyday life.
- An over-medicalisation of human thought processes, and an increasing tendency on the part of mental health experts to label individual "quirks and foibles" as illness.
- Increasing politicization of the DSM, perhaps due in part to the Peter principle, which may allow decision-makers with more discriminating, compartmentalizing thought processes to dominate the higher ranks of the medical establishment.
Controversy over its nature
The subject is profoundly controversial. For example, until the 1970s homosexuality was considered a mental illness in American psychiatry (see DSM-II), and this perception varies with culture, cultural bias and theory of conduct.
Neurochemical studies have revealed abnormalities in neurotransmitter functioning among individuals with certain psychiatric diagnoses. Also, some structural or neuroanatomical differences between brains of people with schizophrenia can be detected via neuroimaging. Mental illness tends to run in families, and there have also been strongly suggestive, but not conclusive, links between certain genes and particular mental disorders. Routine brain scans or neurochemical tests for these conditions are, however, not generally required for prescription of drugs, and are not always employed in law either.
It is not clear whether these differences in brain chemistry are the cause or the result of mental disorders. It is also not clear that differences in brain chemistry are pathological. Also, there is no clear proposal as to which neurological anomalies should be considered pathological and which should not. This is relevant given that behaviors which are considered normal-variant, such as homosexuality and giftedness, probably have a neurobiological and genetic basis as well.
Traumatic life experiences may exceed an individual's coping ability and result in lasting changes in brain chemistry. Patterns of learned behavior can also alter brain chemistry, for better or for worse. Cognitive behavior therapy focuses on changing patterns of thinking through learning, which may ultimately restore so-termed "healthy" brain chemistry.
Drug therapies for severe mental illnesses such as bipolar disorder and clinical depression, which are consistent with biochemical models, have been remarkably effective, and there are reports of increasingly effective treatments for schizophrenia. Some argue that drugs merely mask the symptoms of mental suffering by physically crippling the brain's emotional response system. Others argue that the effectiveness of drugs does not imply that their use is safe or desirable; as an analogy, they say that it might be possible to "treat" homosexuality with drugs.
Studies have shown that many patients' symptoms return once drug treatment is ceased. Others reply that many physical conditions, such as diabetes, must also be controlled with use of medications for an indefinite period of time.
It is important to note that the existence of mental illness and the legitimacy of the psychiatric profession are not universally accepted. Some professionals, notably Doctor Thomas Szasz, Professor Emeritus of Psychiatry at Syracuse, are profoundly opposed to the practice of applying the label "mental illness." The anti-psychiatry movement often refers to what it considers to be the "myth of mental illness" and argues against a biological origin for mental disorders, or else suggests that all human experience has a biological origin and so no pattern of behavior can be classified as an illness per se.
Other arguments against psychiatry include controversial treatments, such as Electroconvulsive therapy, or the practice of placing patients in a mental institution with other mentally ill people. This does much to increase the emotional stress levels of the patient by influence of the other patients, causing the mental illness to worsen.
Some people currently diagnosed as mentally ill are also against the notion of a psychiatric disorder. For example, some autistic individuals have organized and formed the autistic rights movement. They claim that autism is a form of neurodiversity.
Categorization
In the United States, mental illnesses have been categorized into groups according to their common symptoms in the Diagnostic and Statistical Manual of Mental Disorders, compiled by the American Psychiatric Association. There are thirteen different categories, some containing a myriad of illnesses and others only a few. Selecting any of the Wikipedia categories in the table will allow you access to all the articles and subcategories in that category.
Many organizations do not view mental retardation as a mental illness. The Mental Health Association of Southeastern Pennsylvania states: 'Mental illness and mental retardation are not the same thing. People are born with mental retardation, a condition characterized by below-average intelligence throughout one's life. Mental illness, however, can affect anyone at any time. In fact, certain mental illnesses are more common among people with high intelligence and creativity.' However, people with developmental disabilities, such as mental retardation, are more likely to experience mental illness than those in the general community [1].
Symptoms
In addition to the categorized illnesses, there are many well-defined symptoms of mental illness, such as paranoia, that are not regarded as illnesses in themselves, but only as indicators of one of the illnesses belonging to one of the classes listed above.
Crime is not a symptom of mental illness; however, movies often portray murderers as being mentally ill. This makes a villain more emotional, interesting, and dramatic. In truth, mentally disturbed people commit fewer crimes than the elderly.
Treatment
Strictly speaking, there is no cure for mental illness. Many conditions, like schizophrenia, bipolar disorder, and depression, can be treated with medication, however. The function of the psychiatrist is in administering, monitoring, and managing the prescription of these medications and their effects on the patient.
Loosely speaking, there is a cure for some mental conditions in the same sense that there is a cure for cancer. That is, if a person has a mental illness, it can be treated until the symptoms disappear. The chances of the symptoms recurring will be affected by the number of episodes the patient has had in the past, the effectiveness of the treatment, as well as external factors. If the patient's symptoms never recur, he is said to be 'cured'. If they recur, it is the same concept as a cancer patient coming out of remission, i.e. the patient never was cured in the first place.
Since mental illness is at its base behavioral illness, most mentally ill patients also benefit from psychotherapy, either from a psychiatrist or some other qualified clinician, like a social worker or psychologist. The most basic treatment involves identifying maladaptive, self-destructive, or inappropriate behaviors and finding ways, with the patient, of coping with, eliminating, or altering those behaviors to promote overall mental health.
Often individuals with serious mental illness will engage in several different treatment modalities, all with specific goals. For example, a patient with chronic schizophrenia may be involved in treatment with a psychiatrist for medication, and he or she may also be engaged in psychotherapy to help manage their life-long condition, as well being engaged in case management (sometimes referred to as "service coordination") or a day treatment, vocational, or psychosocial rehabilitation program to help move them towards a more productive and independent role in the community.
In art and literature
Books
- One Flew Over The Cuckoo's Nest by Ken Kesey
- Woman on the Edge of Time by Marge Piercy
- The Catcher in the Rye by J. D. Salinger
- The Curious Incident of the Dog in the Night-time by Mark Haddon
- The Bell Jar by Sylvia Plath
- Of Mice and Men by John Steinbeck
- Girl, Interrupted by Susanna Kaysen
- The Green Mile by Stephen King
- She's Come Undoneby Wally Lamb
Motion Pictures
Many motion pictures portray mental illness in inaccurate ways leading to misunderstanding and heightened stigma. Some movies, however, are lauded for dispelling stereotypes and providing insight into mental illness. In a study by George Gerbner, it was determined that 5 percent of 'normal' television characters are murderers while 20% of 'mentally ill' characters are murderers. 40% of normal characters are violent while 70% of mentally ill characters are violent. Contrary to what is portrayed in films and television, Henry Steadman and his colleagues found that, overall, former mental patients did not have a higher rate of violence than their control group of people who were not formal mental health patients. In both groups, however, substance abuse was linked to a higher rate of violence. (Hockenbury and Hockenbury 2004)
See List of films featuring mental illness.
See also
- Anti-psychiatry
- Automatism
- Causes of mental illness
- Chemical imbalance theory
- Electroconvulsive therapy
- Evidence-based medicine
- God complex
- History of mental illness
- International Center for the Study of Psychiatry and Psychology
- Medical algorithm
- Mental Health Act 1983
- Alphabetic list of mental illnesses
- Mindfreedom.org
- New Freedom Commission on Mental Health
- Outpatient commitment
- Patch Adams
- Psychiatric survivors movement
- Psychopathology
- Reality
- Sally Satel
- Sectioning
- Psychiatric hospital
- Texas Medication Algorithm Project
WikiBooks
External links
Government sites
- MentalHealthCommission.gov - 'Interim Report of the President's New Freedom Commission on Mental Health' (United States)
- NIMH.NIH.gov - 'Working to improve mental health through biomedical research on mind, brain, and behavior', National Institute of Mental Health (United States)
- NIMHE.org.uk - 'Responsible for supporting the implementation of positive change in mental health and mental health services', National Institute for Mental Health (United Kingdom)
- NIMHE.org.uk - 'Joined up knowledge sharing for mental health service improvement', NIMH (UK)
History and professional specialties
- CaSlater.freeservers.com - 'From Idiocy to Intellectual Impairment - 1000AD-2000AD: A history of people who have been described over the years as fools and intellectually impaired, mentally retarded and developmentally delayed, mentally handicapped and learning disabled' Catherine Slater, M.A.
- EricDigests.org - 'Mental Health Counseling: Identity and Distinctiveness'
- EricDigests.org - 'Mental Health and the Adult Refugee: The Role of the ESL Teacher'
- EricDigests.org - 'Mental Health Counseling Assessment: Broadening One's Understanding of the Client and the Clients Presenting Concerns'
- OhioU.edu - 'The History of Mental Illness' Ohio University, The Ridges
- Plato.stanford.edu - 'Mental Illness', Stanford Encyclopedia of Philosophy
Media coverage
- News-Medical.net - 'Globalisation affecting children's mental health around the world' (July 4, 2005)
- PublicIntegrity.org - 'Pushing Prescriptions: Drug Lobby Second to None: How the pharmaceutical industry gets its way in Washington', M. Asif Ismail (July 7, 2005)
Compiled mental health news and resources
- Mental Health News
- FreeWebs.com - 'Gambling Help'
- Mental-Health-Matters.com - 'Mental Health, Self Help & Psychology Information and Resources'
- NAMI.org - 'In The News', National Alliance for the Mentally Ill (NAMI California)
- PsychCentral.com - 'Dr. Grohol's Psych Central Mental Health Symptoms, Treatments and Resources'
- SeeMeScotland.org - 'Latest News and Events' (Scotland)
Online support groups
- About Mental Health - 'About Mental Health & Eating Disorders Support'
- PsychForums.com - 'Mental Health Support Community'
- Psych Central - 'Psych Central's Self-Help Support Forums'
Stories of Recovery from Mental Illness
- Recovery Stories - From MemoryWiki.
References
- Hockenbury, Don and Sandy (2004). Discovering Psychology. Worth Publishers. ISBN 0-7167-5704-4.
- Roy Porter, Madness. A Brief History, Oxford University Press 2003
