| The Scream
, the famous painting commonly thought of as depicting the experience of mental illness.
A mental illness is a psychiatric disorder that results in a disruption in a person's thinking, feeling, moods, and ability to relate to others. Mental illness is distinct from the legal concept of insanity.
Mental health, mental hygiene, behavioral health, and mental wellness are all terms used to describe the state or absence of mental illness.
Some psychiatrists attribute mental illness to organic/neurochemical causes that can be treated with psychiatric medication, psychotherapy, lifestyle adjustments and other supportive measures, but it is important to note that we really don't know what causes mental illness. The battle between "nature" and "nurture" goes on as it has for years. We still don't know enough about the working of the brain and the nature of mental illness to understand what might be inherited (a result of specific genes) and what is learned as a result of our unique environment.
Advocacy organizations have been trying to change the common perception of psychiatric disorders, which are frequently seen as signs of personal weakness and something to be ashamed of. Advocacy organizations instead liken psychiatric disorders to physical diseases like the measles.
Prevalence of and diagnosis of mental illness
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 NAMI (the National Alliance for the Mentally Ill (http://www.nami.org)) an American advocacy organisation, twenty-three percent 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 nine percent to 13 percent of children under the age of 18 experience a serious emotional disturbance with substantial functional impairment, and five percent to nine percent have a 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.
The treatment success rate for a first episode of schizophrenia is 60 percent, 65 percent to 70 percent for major depression, and 80 percent for bipolar disorder.
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 your perspective, this could be seen to be the result of one of 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 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.
Controversy over the nature of mental illness
The subject is profoundly controversial, e.g. homosexuality was once considered such an "illness" (see DSM-II), and this perception varies with cultural bias and theory of conduct.
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 labelling "mental illness" as such. "There is no such thing as mental illness" is not an uncommon statement at gatherings of therapists emphasizing patient care and self-control, often decrying labels as suitable only for pill salesmen. 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.
Neurochemical studies have proven that there are systemic lacks of certain neurotransmitters in the brains of certain individuals. Also, some structural differences between brains of people with behavioral differences can be detected in brain scans. Some mental illnesses tend to run in families, and there have also been strongly suggestive, but not conclusive, links between certain genes and particular mental disorders. Routine 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. Anti-psychiatrists argue that traumatic life experiences that exceed an individual's coping ability can 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 increasively effective treatments for schizophrenia. Anti-psychiatrists, however, argue that drugs merely mask the symptoms of mental suffering by physically crippling the brain's emotional response system. Studies have shown that many patient's symptoms return once drug treatment is ceased. Psychiatrists might reply that many physical conditions, such as diabetes, must also be controlled with use of medications for an indefinite period of time.
See the articles on anti-psychiatry and causes of mental illness for a fuller treatment of these topics.
Other arguments against psychiatry:
- Patients of mental illness are often placed 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.
- Electroshock therapy
Categorization of mental illness
In the United States, mental illnesses have been categorised 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 categories contain a myriad of illnesses and some with 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.
Symptoms of mental illness
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. Movies often portray a murderer as mentally ill. This makes a villain more emotional, interesting, and dramatic. In truth, mentally disturbed people commit fewer crimes than the elderly.
Cures of mental illness
People with mental illness almost always have thoughts that are too complicated, chaotic, or unorganized. This is called a 'complex'. The psychiatrist's job is to help the patient think in a simpler way, such as to focus on food, water, shelter, and physical warmth - basic human needs. Everything else is unimportant: stress from family, friends, work, love and other complex and difficult emotions and problems are ignored in favor of 'the basics'. This helps the patient focus on what is important in life. These basics are solid objects that are easier to understand and control. The patient relaxes because he/she no longer has the burden of complicated expectations and emotional stress. This is called 'shrinking the complex'. This is why psychiatrists are sometimes called 'shrinks'. Some psychiatrists are accused of making the patient's complex more complex, by focusing on relationships and asking the patient stressful questions.
Other cures are relaxation, a stress-free environment, soothing music, fun non-stress games, easy exercise, easy physical outdoor activities, coloring, 'brain food' (like fish), the sound and smell of water, and regression therapy.