Bad Psychology II: The Myth of Mental Illness

[Dancing David]

(Now as a caveat i do want to say that I am against the political repression of dissent as used by some states in psychiatric admission.)

However I am very opposed to Thomas Szasz and his theory of "The Myth of mental Illness”, even at the time he published the book in 1961, the organic nature of mental illness was becoming rather noticeable. Granted the treatment of people with mental illness was appalling, which led to deinstitutionalization. (A good thing).

But Szasz was off base then and he is even more off base now. Mental illness is real, it is not a myth, it is not a social construct any more than diabetes is a social construct.

From:
http://en.wikipedia.org/wiki/Thomas_Szasz

While people behave and think in ways that are very disturbing, this does not mean they have a disease. To Szasz, people with mental illness have a "fake disease," and these "scientific categories" are in fact used for power controls. Schizophrenia is "the sacred symbol of psychiatry" and, according to Szasz, is not really an illness. To be a true disease, the entity must somehow be capable of being approached, measured, or tested in scientific fashion. According to Szasz, disease must be found on the autopsy table and meet pathological definition instead of being voted into existence by members of the American Psychiatric Association.

Schizophrenia is real, people who live with it are miserable, it is not a product of social conditioning or an imaginary disorder. People with bipolar disorder have real problems functioning when their symptoms are florid. As do people with major depression.

Now the treatment of people in institutions was appalling as is the stigma of mental illness today. But it is not imaginary that people with schizophrenia hear voices that distress them or that they kill themselves and can present a harm to others. People living with a mental illness are not lazy or suffering from a moral character defect.

It is an organic problem involving the brain. It is not imaginary in any way. It is real.

Szasz did a real dis-service to people like myself living with PSMI (Persistent and Severe Mental Illness)

 

[Sword_Of_Truth]

I've worked with the mentally ill. I've seen the damage that it causes and I've witnessed the pain and the frustration felt by those who suffer while they are in all too rare lucid states.

I hate schizophrenia especially. It's a very real and horrible condition. The openness and tolerance that society has shown to sufferers of AIDS as yet eludes the victims of schizophrenia. Their illness is exacerbated by their isolation and unlike AIDS or various other diseases, schizophrenics have no celebrity spokespersons advocating their cause. The closest they have is an ignorant wench whose professional experience consists entirely exposing her breasts and sticking out her tongue who is fearmongering and telling people not to use the most effective and reliable medical technology in existence.

For someone to claim that mental illness does not exist is the same kind of crass ignorance that it takes to deny the Holocaust.

 

[Denver]

I agree with everything you've all said. I have a brother who suffers from (at least) Bipolar with Psychosis. Years on meds. Years off meds. Years normal. Years of isolating himself, no job, no friends, lots of paranoia and beliefs which DISAPPEAR with the right treatment and medication, and come back when it is withdrawn.

For me, an additional issue is a sort of pendulum effect of deinstitutionalization. While I agree it was a good thing, now it seems almost impossible for me to get him help, since he has never been dangerous to himself or anyone around, but otherwise refuses treatment. There are books on this phenomenon that theorize why people like this have no insight into their illness and, therefore, refuse treatment.

I often wish there was a way I could slip medication into his food. It's unethical, and illegal, and wrong, and I'd probably attempt it if I could.

 

[Ivor the Engineer]

I think the problem is the very broad and fuzzy line between what is considered normal and what is considered illness in psychiatry.

 

[Careyp74]

I think he is giving disease a definition that suits his own beliefs, but even then, maybe someday we will find physical evidence causing mental illness. Perhaps there are visual differences in the brains of mental illness sufferers and those that don't suffer any illnesses.

 

[Safe-Keeper]

I've worked with the mentally ill. I've seen the damage that it causes and I've witnessed the pain and the frustration felt by those who suffer while they are in all too rare lucid states.

Aren't you being too generalizing here?

For someone to claim that mental illness does not exist is the same kind of crass ignorance that it takes to deny the Holocaust.

True. You might as well claim asthma is a myth and that all of its sufferers are just using it as an excuse to be lazy.

 

[Sword_Of_Truth]

Aren't you being too generalizing here?

How much generalizing is enough?

I remember a conversation I had with a patient while he was having a good day. He was medicated, lucid, aware of himself and his surroundings and of his condition, its effects and its consequences. He expressed to me his deep remorse at some of the things he had done while he was ill. He felt that he had offended people, frightened them, he even felt responsible for blaspheming his religion. I tried to assure him that he was not responsible for his actions, yet he felt that way anyway. He was a good man with a good heart. He couldn't hurt a fly even while severely ill. This wasn't someone I met during my volunteer work, he was in fact my roommate at the time and I attended church with him.

About a year after this conversation, I found myself in the position of having to talk him down after he informed me that the angels had called him to be a prophet and that he was going to take the pulpit in the middle of Sunday services and inform the congregation of his grand plans. I shudder to think what might have occurred had I not intercepted him before he carried out his intentions.

That's an extreme example, but I've heard similar thoughts from other sufferers while they are lucid.

There are books on this phenomenon that theorize why people like this have no insight into their illness and, therefore, refuse treatment.

Often times refusing treatment simple as the effects of anti-psychotic medications. These are the kind of mind altering drugs that no one would ever want to take. I was only a volunteer, not a doctor, so take my "technical" description with a grain of salt, but these medications suppress the malfunctioning parts of the brain by suppressing the whole shebang. They don't talk to the voices while medicated, but they shuffle about listlessly like the living dead and show the emotional range of robocop on downers. For some patients, they show no anger or hate but they show no joy or passion either while on meds.

It's heartbreaking to think that for some of them, this is as good as it gets.

 

[Dancing David]

I think the problem is the very broad and fuzzy line between what is considered normal and what is considered illness in psychiatry.

Care to substantiate that IVOR?

You speak from ingnorance. What do you think is fuzzy?

Your inability to know what the terms mean?

Show me where it is fuzzy IVOR. I dare you.

It will be your misinterpretation of words like 'significant' and 'marked'.

Are you telling me that sleep disturbance does not exist? Or that someone who doesn't sleep for 48 hours is 'vaguely' suffering from a sleep disturbance.

Please enlighten us IVOR, what is fuzzy in the DSM-IV-R or the ICD-10 when it comes to Schizophrenia, or Bipolar disorder or even major depression.

 

[Dancing David]

Aren't you being too generalizing here?

Excuse me, how many people with schizophrenia do YOU know?
I had a friend who developed it.

He was not happy with it.

I worked with over 70 adults living with schizophrenia. There was only one who did not 'suffer' from her symptoms.

What is yoru basis for your question?

 

[Dancing David]

I agree with everything you've all said. I have a brother who suffers from (at least) Bipolar with Psychosis. Years on meds. Years off meds. Years normal. Years of isolating himself, no job, no friends, lots of paranoia and beliefs which DISAPPEAR with the right treatment and medication, and come back when it is withdrawn.

For me, an additional issue is a sort of pendulum effect of deinstitutionalization. While I agree it was a good thing, now it seems almost impossible for me to get him help, since he has never been dangerous to himself or anyone around, but otherwise refuses treatment. There are books on this phenomenon that theorize why people like this have no insight into their illness and, therefore, refuse treatment.

I often wish there was a way I could slip medication into his food. It's unethical, and illegal, and wrong, and I'd probably attempt it if I could.

The best is to have a professional relationship with a trusted individual. I did that for 9 years, as someone who is not a family member people will often confide in you. As you develop trust then they divulge more. Now this does not work for all people, especially those with bipolar disorder. The main issue there being that they do often function well enough to not end up homeless.

But take care of yourself as well, do not give more to your brother than you can at any given moment.

 

[Ivor the Engineer]

Care to substantiate that IVOR?

You speak from ingnorance. What do you think is fuzzy?

Your inability to know what the terms mean?

Show me where it is fuzzy IVOR. I dare you.

It will be your misinterpretation of words like 'significant' and 'marked'.

Are you telling me that sleep disturbance does not exist? Or that someone who doesn't sleep for 48 hours is 'vaguely' suffering from a sleep disturbance.

Please enlighten us IVOR, what is fuzzy in the DSM-IV-R or the ICD-10 when it comes to Schizophrenia, or Bipolar disorder or even major depression.

I've been around here long enough to know that me enlightening other posters is not a realistic proposition. People believe what they want to and rarely give serious thought to what I have actually written. Thankyou for providing another example.

Now, carry on without me.

 

[kerikiwi]

I've been around here long enough to know that me enlightening other posters is not a realistic proposition. People believe what they want to and rarely give serious thought to what I have actually written. Thankyou for providing another example.

Serious thought being given to what you have written does not automatically lead to agreement.
So go on, enlighten us. What is the fuzziness?

 

[wackyvorlon]

I suffer from difficulties with depression and ADD, and I have a friend who is bipolar. Mental illness is very real. He believes some crazy things when he's not on his medication, things that are obviously not rational. He is has been suicidal many times, and even made attempts, although fortunately that is a field for which he has no competence.

On his medication, he does have very real and very difficult side effects. The lithium gives him tremors, and he has troubles with weight gain. But, he is no longer suicidal. He is rational and able to function far better.

 

[paximperium]

I've been around here long enough to know that me enlightening other posters is not a realistic proposition. People believe what they want to and rarely give serious thought to what I have actually written. Thankyou for providing another example.

Now, carry on without me.

Oh, very enlightening indeed.

 

[Skeptiquette]

that's a bit ironic,

I just started to read a 25 page review entitled "Immunological Aetiology of Major Psychiatric Disorders: Evidence and Therapeutic Implications" then I decided to see what was going on at the JREF forum.

It is interesting to think that people can still be living with a mindset from about 50 years ago. Fortunately, for those interested there is literally volumes of information avaible which address the genetic, biochemical, and immunological basis of psychiatric disorders.

I have quite a few very informative journal articles related to the immunological aspects of schizophrenia, depression, autism, etc.

Just off the top of my head (read it yesterday) is this one:

"Immune Involvement in Schizophrenia and Autism: Etiology, Pathology, and Animal Models" Behavioural Brain Research 2009 Article In Press.

If you would like more info or related journal articles, Just Ask!!

Skeptiquette

 

[wackyvorlon]

There is a psychiatrist in town here who beleives that anything added to the DSM in the past 30 years is a fiction. This extends to depression, as well.

His diagnosis for me, in particular, was that I was malingering and a narcissist. I disagreed.

 

[Slimething]

His diagnosis for me, in particular, was that I was malingering and a narcissist. I disagreed.

You only disagreed because your a narcissist!

Seriously, I have a sister with full-blown schizophrenia (beautiful-mind stuff). Off her meds (which happens all too often), she sees people put stuff in her food and hears voices. On her meds, the hallucinations go away but she's still very unsure of us.

Both my kids have ADHD and one also has Asberger's and would have been kicked out of school were in not for the meds that keep them attentive and non-destructive.

I've had serious problems with anxiety and depression and didn't realize it until someone at work told me I should try counseling "even though you probably don't need it". May have saved my life.

My point is that, without recognition of human frailty and what can go wrong with the brain, the effort to develop medications that make all the difference would not have been undertaken. Instead, my sister would be locked up somewhere, my kids (if I had had them) would be ostraziced or expelled and I might be ashes now.

Perhaps the problem is that there are no structural affects in the brain that we can detect with our present knowledge such that a final, unequivocal diagnosis can be made. However, if the diseases are based on neurotransmitter imbalance, how would a physical anmaly form? I can understand the human tendency to reject other's infirmities when there is no palpable evidence so that some may deny that people with psychatric needs are just going through phases or malingering. However, a view that people who are suffering should not be helped by any available method is just plain mean and ignorant.

Just a layman's two cents.

 

[portlandatheist]

Mental illness can be very debilitating. I have never had this problem before, but now I am suffering from Chronic Tax Anxiety Syndrome(CTAS) which seemed to be triggered by an IRS audit. Unfortunately, I am suffering this mental illness without the benefit of medication, federal assistance, or even accommodation at my workplace.
I don't think the IRS can find me responsible though, as the reason for the audit is my Chronic Disorganization Syndrome.

 

[wackyvorlon]

With depression in particular, I have found that if you have never suffered from it, you have no idea what it's like. It's an inscrutable enigma. It's easy to deny, because they cannot conceive of how someone could still feel miserable in spite of having the best day of their life.

 

[Dancing David]

I've been around here long enough to know that me enlightening other posters is not a realistic proposition. People believe what they want to and rarely give serious thought to what I have actually written. Thankyou for providing another example.

Now, carry on without me.

Nope you said that the criteria are vague, I asked you specifics, and I know what I am talking about. If the criteria are used by trained professionals, they are very useful and valid.

Now you say that you can't substantiate your claim?

Have you ever met a person who is very psychotic Ivor?
Or in a manic phase?

You may think the descriptive labels are vague, but the behaviors are real.

So why not just admit you don't have a way of saying why you think the criteria are vague?

Thanks Ivor, you just made your own argument look much worse.

It was not a request to enlightenm me, it was a request to show what you thought was vague about the DSM or ICD criteria for schizophrenia, bipolar or major depression.