WHAT IS MENTAL ILLNESS
what exactly is a mental disease? The human brain controls and creates three types of activities-thinking, feeling (emotions), and behaviors. Because doctors cannot now do any kind of definitive diagnostic tests (for example a blood test) to diagnose any mental disorders, a different diagnostic approach is necessary, which is far from perfect. We now have to rely on an accurate history about symptom clusters. This involves asking detailed questions about the nature of abnormal thinking, the kinds of emotions being experienced, and about any unusual behavior. Someone who has experience talking with a wide spectrum of people, can be much more accurate than somebody using a checklist. As an experienced professional, I have had the privilege of listening to and questioning literally thousands of people about their deepest emotions, believes, and private behaviors. Only people in a few professions share that experience, for example ministers or priests. As a result of this unique experience, I have discovered that many people really don't know what normal is. Very commonly at the end of an evaluation, the person asks me, "and I crazy Doc". They are only partially kidding. I surmise this because I observe them to experience significant relief when I say “Of course not."
Many people will say, "we’re all a little crazy". That is not true. I've listened carefully to the way though word, “crazy” is used in normal conversations and when someone is "really crazy", it means that they are out of touch with reality in some way. Technically this is called psychotic. It is not normal for people to ongoingly have auditory hallucinations or false beliefs (delusions). It is not normal to be convinced that the television is transmitting messages to you alone, for example. When a person is psychotic, their brain is playing severe tricks on them. Most commonly this involves hearing voices or sounds which do not have an external source. An example is that people sometimes hear the phone ringing, where as someone else in the room knows that there has been no phone call. False beliefs can be of many different kinds, for example delusions about infidelity, persecution and being controlled by outside forces.
The situation is more complicated regarding problems with anxiety and depression. Of course everyone has been briefly sad, depressed, or anxious. However, that's definitely not the same as, day after day, week after week, month after month, dread or deep despair. The red, despair, hopelessness, and thoughts questioning whether or not life is worthwhile indicate clinical depression, not normal sadness. Many people "limp along" without getting professional help, even though they are functioning at a much lower level than they were before they got clinically depressed or anxious. If the disorder came on gradually, they may not really know how severe it is. Their reluctance to get professional help may be reinforced by ignorant and/or in sensitive friends or relatives who speak platitudes like, "you're only feeling sorry for yourself... snap out of it, etc.". Even worse many people stigmatize themselves as a result of their critical and harsh judgments about themselves.
A true mental illness must have abnormalities of thinking, on motions, and/or behavior. Often there are mixtures of dysfunction in more than one category. As I said before, experienced mental health providers can reach remarkable agreement about different diagnostic categories, even though their diagnoses are based upon symptom clusters. This method is far from ideal, but this diagnostic approach does identify disorders which can be treated successfully. We now have medications to treat each of the abnormal symptom categories; thinking, emotions, or behavior.
Treating doctors commonly tell their patients that they have a brain disease and require medication. That statement is only true in a limited sense. I believe these doctors mean well. They want the patience to look at the problem this way, so the patient or their loved ones won't blame them. A great deal of research has been done about chemicals in the brain called neurotransmitters. The amount of neurotransmitters is abnormal for certain mental disorders. However that does not prove that abnormal, neurotransmitter levels are causing the mental illness. The real question is what causes abnormalities in the amount of neurotransmitters in your brain. In this sense we don't understand the fundamental cause of mental disorders. Yet the situation is no different for cancer or high blood pressure to name just a couple examples.
My point may be more clear using an example from the rest of medicine. The bottom line problem with diabetes is deficient insulin production by the pancreas. However, there are many different things that can cause the pancreas to be unable to produce enough insulin. Consider the example of a person who is working long hours at a very busy job that they hate, is trapped in a marriage which is very unhappy, and has all is been down on themselves because of perfectionistic expectations. They will experience repeated failures because they don't live up to their unrealistic and harsh standards. They will be frequently judging themselves negatively. Living in such a situation is not going to result in normal brain chemistry in my opinion. The problem is the old, "chicken and the egg" controversy.
I think this is important because there are certainly can be excessive reliance on drug treatment some patients are very demanding that their doctors provide some kind of pill to a lemonade temporary discomfort. He can be easier for the doctor to comply then to try to explain to the patient that they need to cope with a temporary hard time, from an emotional standpoint. In my opinion corporate/capitalist drug companies are in fact partly motivated by harmful greed. I don't believe you are witnessing, "the truth, the whole truth, and nothing but the truth" when you watch drug company advertisements on TV. Some doctors are too quick to prescribe medications, as opposed to challenging their patients to change destructive behaviors like stopping drinking, putting a hateful job, or getting out of a destructive marriage. I have evaluated many patients who want me to give them medications, despite the fact that it is obvious to me that the combination of their negative behaviors is causing the unpleasant emotions that they are experiencing. Certainly it can be hard to change the circumstances of one's life, but giving medications when a person is totally unwilling to work toward change is essentially enabling them to remain in circumstances which are causing damage.
Don't get me wrong. Research by the pharmaceutical companies has resulted in a tremendous decrease in suffering for many people on a worldwide basis. These companies should make a profit, but all the shortcomings of our current corporate/capitalist mentality is causing what I consider to be widespread abuse. Despite that it doesn't mean that the psychiatric medications can't be helpful for certain patients.
What about so-called, "natural methods". Many people apply a double standard when they talk about Herbs versus medications. Herbs are a complex mixture of complicated chemicals. The composition is affected by the amount of sunlight, rain, and the composition of the soil, as well as the duration of storage. It's clearly not possible to control those factors. By way of contrast, the drugs sold in a drugstore are produced in such a way so that you can know that the same amount of the same chemical is present in each pill. In addition, herbs can sometimes have dangerous side effects, just like the drug company medications. For example you should check to be sure that herbs will not alter the amount of different medications that you may have to take that reach your bloodstream.
Another common concern in the minds of patients is the question about whether or not psychiatric medications are addictive. Antidepressants definitely are not! These drugs should more accurately be called anti-anxiety/antidepressant drugs, because they treat both types of symptoms. If you have been taking an antidepressant regularly, and you discontinue it suddenly, you will not harm yourself. You might experience mild flulike symptoms for a couple of days. If your symptoms recur, it does not mean that you became addicted. Rather it shows you that your medication was doing something, and you may still need to take it or do something else in order to deal with your problem. In effect your problem has been uncovered again. The drugs called tranquilizers, on the other hand, can be biologically addicting, if not used correctly. However, remember that alcohol, nicotine, and caffeine are also addicting and many of these drugs are being used to sell for Medicaid. Such people proudly tell themselves that they aren't relying on any medications, which is obviously not strictly true. I recommend that you be totally honest with yourself and inform yourself about the pluses and minuses of which drugs you choose to ingest.
At the bottom line I consider myself to be a pragmatist. If a treatment method is moral (always) and legal (usually), I recommend doing an experiment to see whether or not your choices about your treatment are effective. Just try to be completely honest about the results of your experiments.Regarding legal I say , “usually”, because of arguments about medical marijuana, etc. Certainly good nutrition, regular exercise, regular sleeping hours, and regular involvement in the recreation are appropriate or even an essential to maximize mental health. However, people with significant anxiety and depression commonly have a hard time maintaining these healthy behaviors. If you are a loved one or support person for someone seriously depressed, please don't lay a trip on them. If you think you know what it feels like for them, just because you have temporarily been depressed in your life, you are probably being arrogant and ignorant. I'm not saying that you are an arrogant or ignorant person, in general.
Good luck with your choices. More detailed information can be found online at web sites for the NATIONAL INSTITUTE of MENTAL HEALTH or the NATIONAL INSTITUTE of HEALTH.