What is mental illness?

SLUSK

How do you properly define mental illness, there are some who say that there is no such thing as mental illness. Some might argue that any mental illnesses are defined in the DSM(Diagnostic and Statistical Manual of Mental Disorders), but as you all know not long ago homosexuality was classified as a mental illness, so how do the psychiatrist decide what goes into the new revisions of the DSM or not? When someone has cancer you can make a proper clinical diagnosis of this disease,as far as I know there are no proper clinical tests to define if someone is suffering from a specific mental illness. Can you tell me how to define mental illness in a way that is not arbitrary?

Pete4779

SLUSK wrote: »

How do you properly define mental illness, there are some who say that there is no such thing as mental illness. Some might argue that any mental illnesses are defined in the DSM(Diagnostic and Statistical Manual of Mental Disorders), but as you all know not long ago homosexuality was classified as a mental illness, so how do the psychiatrist decide what goes into the new revisions of the DSM or not? When someone has cancer you can make a proper clinical diagnosis of this disease,as far as I know there are no proper clinical tests to define if someone is suffering from a specific mental illness. Can you tell me how to define mental illness in a way that is not arbitrary?

Well define any illness and you have your answer. The term "mental" illness predates around the past 20 years of progress, and both ICD-10 and DSM-IV date from the early 90s so the knowledge will be from late-80s at best.

Pick your actual condition. For example, you say cancer. At one stage, people just died. Cancer didnt exist. 100 years ago, people with diabetes were horrendously ill, died when really young and a number of treatments would have been tried. Fast forward and now basic clinical tests can be done to indicate a certain illness.

Terms like mental illness which means nothing really, like saying "bowel illness" when you have duodenal carcinoma and like saying "walking illness" when you have a broken foot. This is where confusion arises, as the term mental illness predates PET, fMRI, etc., .

In a big centre in UK or Germany, you can get fMRI done to demonstrate depression's effects and responses to treatments, the funtional impact of different areas of the brain in ADHD, etc., . This is like the modern laparoscopic surgery vs 1850s palpating the abdomen for appendicitis. In Ireland, it is the bottom of the psychiatric technology foodchain which is where a lot of misinformation arises.

You start with the word "illness" and then take your specific condition. In reality, there is no such thing as mental illness because that is a collective term that includes a huge range of biological and neurological developmental abnormalities, so of course it does not accurately describe the condition. Likewise, DSM or ICD in no circumstances explain the origins or causes of conditions because that would be like including all of Pubmed in every edition. They simply describe a presentation of a pattern of behaviours and emotional descriptions; because they do not discuss causes, people think erroneously that "there are no causes". For those, you need to go through the 100s of thousands of research papers on them.

The result is that many psychiatrists don't need to know e.g., the exact origins of each brain receptor and so on, but they will need to know what it looks like when it's being described to them so that it can be treated. Likewise, your surgeon doesn't need to know minute detail and physicology of the development of the appendix and what you had for dinner each day your whole life, but he needs to know how to solve the presenting problem.

(There are no clinical tests done for many conditions, like chest infections - but you start treatment anyway based on the clinical symptoms presenting. GPs do this without ever doing a CT scan, etc., because it's unneccessary. The advent of technology means advanced scans in big neuroscience centres and the results can be available to all doctors so they can be sure of x drug working in y situation).

SLUSK

Take any kind of mental illness, some kids get labeled with adhd while other psychiatrists label them as bipolar watching the same symptoms. Do psychiatrists have any idea what they are doing?

I watch a documentary about so called mentally ill children who have been labeled with various mental illnesses like adhd, bipolar and so on. This documentary was called the medicated child and the psychiatrists seemed to medicate kids based on the latest fads in the psychiatric community. Lots of these kids where over medicated. It was very sad to watch.

sam34

SLUSK wrote: »

Take any kind of mental illness, some kids get labeled with adhd while other psychiatrists label them as bipolar watching the same symptoms. Do psychiatrists have any idea what they are doing?

no, they havent a clue.
they spend 6 years in medical school, a minimun of three years in basic specialist training, pass teh membership exams of the Royal College of Psychiatrists, spend a further 3 or 4 years in higher specialist training, participate in lifelong Continuing Professional Development and education, but you're right, they have no idea what theyre doing and throw meds at people based on fads.:rolleyes:

SLUSK

You seem to be impressed by diplomas from prestigious universities, if you watched the documentary The medicated child you would see psychiatrists admitting to that there are no proper clinical tests for making a diagnosis on a lot of mental illnesses and that there is a big element of trial and error to medicating people. Would you want you own children to be medicated based on trial and error?

sam34

SLUSK wrote: »

You seem to be impressed by diplomas from prestigious universities, if you watched the documentary The medicated child you would see psychiatrists admitting to that there are no proper clinical tests for making a diagnosis on a lot of mental illnesses and that there is a big element of trial and error to medicating people. Would you want you own children to be medicated based on trial and error?

if i needed a solicitor, i would want one who is fully qualified. likewise, i want anyone who is prescribing to be fully qualified to do so. i want people who are making diagnoses and treatment decisions to be fully trained to do so, and i want them to keep up their education, which is what is ensured by medical degrees, membership of the royal college of psychiatrists and CME/CPD (without which the medical council wont register someone).

i do not base my opinions solely on one documentary, when i do not know who was behing it and what their agenda was. documentaries are not always objective.

just because there is not a laboratory test for mental illnesses, does not mean that trained professionals cannot recognise the signs and symptoms of those illnesses.

Re "trial and error" prescribing - thats the way in lots of illnesses. not every medication works for every person. sure if that was the case, we'd only need one in every class of meds, one anti-diabetic agent, one anti-epileptic, one anti-hypertensive etc. for various reasons, depending on their own pharmacokinetics and other factors, people will repsond differently to the same drug. "trial and error" is not unique to psychiatry, and d oes not mean that the prescriber is any less competent than any colleague.

Valmont

Rather than simply lambasting a common public misconception regarding psychiatric diagnosis, it may do some good to read about how such an inaccurate idea has arisen to begin with. It's an interesting enough article.

Sciutto M.J., & Eisenberg M. (2007). Evaluating the evidence for and against the overdiagnosis of ADHD. Journal of Attention Disorders, 11(2), 106-113.

This may also be of some interest:

Cormier, E. (2008). Attention deficit/hyperactivity disorder: a review and update. Journal of Pediatric Nursing, 23(5), 345-357.

Torakx

does anyone here not feel that "mental illness" is a disfunctional mind created by past experiences and sometimes genes/dna or foriegn chemicals put into our bodies?

when i suffered a nervous breakdown i decided before i would attempt any suidcide i would ask for help and procedded to get myself on anti depressants.
that was about 4-6 years ago and now i wouldnt touch them.

i think alot of cases is very dependant on experiences and also the illness or malfunction in question.
in my case i believe it was my super ego or ego that had alot of things it wanted to tell me and i refused to listen infact i couldnt even hear him.

forward a couple of years and i have a sudden realisation almost an awakening.my depression just went.prety much gone as i released those feeling trapped inside.

i guess now i feel somepeople may need a crutch for a broken leg. but if you dont take the crutch off you might find that leg never really strengthened and you now rely on the crutch.

sometimes doctors are told people need a crutch for a broken arm when maybe they need a sling or some other form of support until they gain strength and recover there true self within.
i think you cant say there is no mental illness because it is defined ussually as someones mental or concious/subconcious ability to act or coherently think the same as the majority.so some forms of it may not be illness just a different way of thinking and others can be detremental to the person.


or maybe i have no idea what im on about lol
anyway this is my form of therapy in a way too so its all good.