Mentally ill! Aren’t we all?

It seems that the debate over the new and improved DSM, diagnositic bible is continuing a pace and so it should. http://www.guardian.co.uk/society/2012/aug/14/grief-good-news-big-pharma The more radical changes will affect our younger generation far more than us adults and it seems that many see these changes as a reason to medicate rather than provision of any other type of treatment. But then what is mental illness? When are we mentally ill?

It can be defined as:

mental illness

n.

Any of various conditions characterized by impairment of an individual's normal cognitive, emotional, or behavioral functioning, and caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma. Also called emotional illness, mental disease, mental disorder.

http://www.thefreedictionary.com/mental+illness

but that really doesn’t explain in very good terms what you could expect from someone who is suffering from mental health problems and in part this is because of the descriptions of good mental,

Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. http://www.who.int/features/factfiles/mental_health/en/index.html

However the nature of mental health is that it is subjective and when someone may believe they are coping with life in the manor described above it really doesn’t mean that everyone else will. In part my concern here is about how the assumption of mental distress will lead to drug treatment something that I find intolerable and also a bit naive but then maybe not. I am appalled that everyone seems to consider that big pharma run the business of health, that despite so much emphasis being put onto talking therapies and the need for good healthy relationships as treatment for mental health prescriptions for anti anxieties, anti depressants, anti psychotics continue to rise. So is it me that is naive and should I start running around proclaiming death to the new definitions like many have. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960248-7/fulltext Lving with grief.

But I am not inclined to. It is not that fundamentally I disagree with the criticism but just how this will play out in terms of treatment with talking therapies/ access to counselling. (See my earlier post The new revised diagnostic bible).

So what do I feel about it?

I feel that in many ways the reasons why we have so many prescriptions for drug therapies is about how society and the medical profession think of and describe mental illness. Consider how many people will tell you that depression is a chemical imbalance in the brain and that the only way to reset the balance is to take the anti depressants. You think I’m joking! No I’m not.

Well what about this, that things will get better with time, but in the mean time why not get some help with these feelings by taking this...

Then there are many people who have done things that they cannot explain why and would wish to take back, having been told they have a mental disorder they have latched on to it, saying I’m ill and I can’t help myself, and it breeds a belief that some other force is making them do things that if they had full control they wouldn’t do. This other force is there illness and they live whole heartedly believing if they can get rid of it they would be the people they want to be. I have yet to work out if these people ever ask themselves what that force is but I’ve heard it enough to be thoroughly frustrated by it.

The fact is that I feel very much that what is being said is influencing how mental health is approached in practise and waiting lists are a big part of this. Big pharma have just taken up where opinion stopped, the medical profession wanted control of the behaviour, it did some research and found chemical imbalances in people who were suffering and tried to deliver what science was asking for. Control their method choice drug and it will always be drugs until people stop saying that that is what they want. Control by any means necessary!

Where do I see this going?

Well I guess that the main problem for me is in how people and the medical profession describe mental illness. It has led people to see it’s treatment in a certain way. I guess for me it is that people have no idea how they maintain their happiness or good mental health they don’t even think about it. They just expect it to happen, that bad stuff will pass, how they cope under stress, they don’t know how they do it or not. They believe things will come right and they never consider that that they won’t and the rest of it is just what they do. It is easy to convince people who believe this that taking the pill will solve the problem, because given time it will pass. They’ve never considered that they have to learn anything or in fact could learn anything about it. It seems they forget that actually it is how they feel and what they tell themselves as a consequence of what they feel that will always drive the physical body. If you have bad habits in your head, for instance you tell yourself how awful you are, how useless then you will suffer from low mood how badly will depend on who else is telling them how good they are or how valued etc.

The big picture is that we all learn from experience and therapy is about experience. Drugs are not! Drugs make you dependant on them to control. Now for some people it is extremely difficult to maintain good mental health because of their genetic makeup and for them drugs will give them some peace however talking therapy will give the participants lessons on themselves, an understanding of what makes them tick and help them experience normal emotional handling. The problem I find with advocating talking therapy is that it doesn’t really explain the entirety of what I’m trying to get at and that is that good mental health is about making changes that last a lifetime, it’s about thinking about your mental health throughout your life and making changes as you go to improve it. We all learn our emotional handling from our parents and it may well work for them but that doesn’t mean it will for us, we have to find out what does but often the attitude that it will just sort is engrained so people don’t do anything about it because that’s just life. Good mental health can be achieved for any one it just takes time, patience, bit of therapy and maybe some drugs to help it along.