Mental illness.

[magicmiles]

This has come a bit in the thread featuring JuneBug, and I wanted to get your opinions specifically on the type of mental illness that comes about due to a chemical inbalance in the brain.

There is a very big distinction made between mental illness and brain injury (from external trauma). Is this distinction valid? Should a chemical inbalance be considered a physical injury, even though it comes about for no obvious reason?

I ask because I wonder, if no such distinction was made would there be less stigma attached to having this type of injury/illness?

[Tero]

Though mental illness is treated with drugs, it is a bit more complex than just a chemical imbalance. It can be a stepwise, long process.

[Nam]

Mental illness encompasses a wide range of things from being depressed or stressed out to more complex and detremental to one's psychosis. Some are treated by therapy and/or drugs and some aren't treated at all, or at least not more advent toward the more "profitable" disorders.

Everyone here can have mental disorders, illnesses, etc., 

Example: Sociopathy vs. Psychopathy (not interchangeable)

Sociopathy dealing more with social change, environmental conditions, and other things in relation. Psychopathy dealing more with genetics, chemical imbalances, and psychological illness caused by diseases and viruses.

I feel both have their own valid arguments but I don't take much stock in psychiatry.

-Nam

[LoriPinkAngel]

Traumatic Brain Injury may be irreversible in some cases depending on the extent and location of the injury.  A Chemical imbalance may be treatable with medication but may be resistant to treatment depending on how long it takes to diagnose before treatment is attempted and how long before appropriate treatment is found.  Adverse side effects from many psychotropic medications make compliance and effectiveness of those treatments problematic.  A chemical imbalance cannot be solved by any amount of psychobabble talk therapy.

[jdawg70]

This has come a bit in the thread featuring JuneBug, and I wanted to get your opinions specifically on the type of mental illness that comes about due to a chemical inbalance in the brain.

There is a very big distinction made between mental illness and brain injury (from external trauma). Is this distinction valid? Should a chemical inbalance be considered a physical injury, even though it comes about for no obvious reason?

I ask because I wonder, if no such distinction was made would there be less stigma attached to having this type of injury/illness?

In the same way that being born with one lung is the same injury as losing a lung - insofar as the current state of the person in question is "missing a lung" - then no, no distinction should be made between a mental illness caused by external trauma and mental illness caused by internal misfunction.  My iPod is broken in the same way whether I sever the cable on the hard drive or the manufacturer severed it.  The problem set is the same; the solutions for fixing the iPod in either case are all the same.  The origin of the malfunction is immaterial.

But I'm not sure that there would be a reduction in social stigma frankly.  There will still be people who think that the person is being 'punished' for some ill-defined reason; there will still be insensitive clods out there that simply shun abnormalities out of irrational fear; there will still be people who will refuse to treat someone with mental illness as a person, choosing instead to treat them as charity cases.  In short, I suspect (but do not know) that the number of people who stigmatize the mentally ill in accordance to how they acquired the illness is small.

[kindred]

Traumatic Brain Injury may be irreversible in some cases depending on the extent and location of the injury.  A Chemical imbalance may be treatable with medication but may be resistant to treatment depending on how long it takes to diagnose before treatment is attempted and how long before appropriate treatment is found.  Adverse side effects from many psychotropic medications make compliance and effectiveness of those treatments problematic.  A chemical imbalance cannot be solved by any amount of psychobabble talk therapy.

I don't understand. Isn't depression a mental illness caused by chemical imbalance and isn't it treatable by positive thoughts plus exercise?

Correct my understanding if I'm wrong but as far as I understand, any mental illness can be kept in checked through sheer force of will. Lots of historical geniuses suffered from mental illness and some of them eschewed treatment because it dampened their genius and opted to just use logic to combat the problems brought about by their illness.

[magicmiles]

Thanks for the replies. Appreciated.

[LoriPinkAngel]

Traumatic Brain Injury may be irreversible in some cases depending on the extent and location of the injury.  A Chemical imbalance may be treatable with medication but may be resistant to treatment depending on how long it takes to diagnose before treatment is attempted and how long before appropriate treatment is found.  Adverse side effects from many psychotropic medications make compliance and effectiveness of those treatments problematic.  A chemical imbalance cannot be solved by any amount of psychobabble talk therapy.

I don't understand. Isn't depression a mental illness caused by chemical imbalance and isn't it treatable by positive thoughts plus exercise?

Correct my understanding if I'm wrong but as far as I understand, any mental illness can be kept in checked through sheer force of will. Lots of historical geniuses suffered from mental illness and some of them eschewed treatment because it dampened their genius and opted to just use logic to combat the problems brought about by their illness.

The misconception that mental illness can be treated by force of will, thus leading to the assumption that those who are unable to self treat their mental illness is a huge contributor to the stigma associated to mental illness.  Positive thoughts and exercise do not change the balance of neurotransmitters in the brain any more than prayer does.

[Mooby]

This has come a bit in the thread featuring JuneBug, and I wanted to get your opinions specifically on the type of mental illness that comes about due to a chemical inbalance in the brain.

There is a very big distinction made between mental illness and brain injury (from external trauma). Is this distinction valid? Should a chemical inbalance be considered a physical injury, even though it comes about for no obvious reason?

I ask because I wonder, if no such distinction was made would there be less stigma attached to having this type of injury/illness?

There's a big difference in medicine because the management is completely different. Neither should be stigmatized.

I don't understand. Isn't depression a mental illness caused by chemical imbalance and isn't it treatable by positive thoughts plus exercise?

Yes, depression is caused by a chemical imbalance.  Studies show that the most effective treatment is a combination of psychological therapies (such as cognitive-behavioral therapy) and antidepressant medication.  Therapy is generally aimed more at identifying and managing the underlying causes of the depression than it is "positive thoughts."  While exercise is one of many factors that can influence depression, it is not a cure.

Correct my understanding if I'm wrong but as far as I understand, any mental illness can be kept in checked through sheer force of will.

You're wrong.  In fact, quite the opposite is often true: many mentally ill people feel helpless to overcome their illnesses.

[Jag]

To the OP, specifically to the reference to the other thread: the distinction being drawn was between situational depression (circumstances, grief, loss, etc) and clinical depression. Situational could be called circumstantial just as easily; clinical is unrelated to one's life circumstances, although events can certainly influence it's impact to a degree.

Clinical depression is an ongoing mental health condition related to the presence or absence of chemicals in the brain, situational depression is (relatively) temporary and somewhat dependent on external factors. Both should be taken seriously (depression plays a large role in suicide statistics) but they aren't the same thing.

There's a lot of evidence that indicates that both diet and exercise can help manage depression (and the less extreme type of bi-polar disorder, cyclothymia (sp?)) but the best results appear to start with medical intervention to get the person leveled out emotionally, cognitive therapy of some sort, and a diet/exercise plan.

As I understand it, part of the difficulty in managing this kind of illness is in order to get the most benefit, the entire lifestyle generally needs some rearranging. It's very difficult to convince a deeply depressed person to get out of bed and take a shower - how can they be persuaded to go for a jog? That seems to be why a drug is most effective, at least in the beginning. Once a certain degree of stability is established with new habits in place, weaning off the drugs seems to work fairly well for some people; others will never be able to stop.

I remember reading about a study that had correlated long-term or ongoing situational depression to clinical depression - something about how the lower levels of ... serotonin? dopamine?... could become permanent? IIRC, the brain eventually reprograms itself to produce those chemicals at the new, decreased levels. Is anyone familiar with that? It was probably at least 5 years back.

[kindred]

Correct my understanding if I'm wrong but as far as I understand, any mental illness can be kept in checked through sheer force of will.

You're wrong.  In fact, quite the opposite is often true: many mentally ill people feel helpless to overcome their illnesses.

But it is possible, given the right strength of character, right? Audie Murphy(if addiction can be considered a mental illness), Nikolas Tesla, Isaac Newton etc.

Or maybe the right term here is "deal" with mental illness. Because as far as I know, they never got rid of their illness just dealt with them in such a manner that they could function.

Basically, I'm curious about the new norms arising around mental illness. When I got diagnosed with mild autism there was no rush to try and treat it. The pediatrician essentially said, if he can't adapt take him to a specialist if he can, don't.

Nowadays, it feels like there's a whole lot more panic. I dunno  how to articulate this thought. It feels like people now know more about mental illness but not enough to actually be of help but enough to get themselves paranoid or even worsen the situation.

[Azdgari]

Kindred, you could make the same claim about "strength of character" being able to overcome cancer.  You've no evidence of cause and effect.

[Mooby]

But it is possible, given the right strength of character, right? Audie Murphy(if addiction can be considered a mental illness), Nikolas Tesla, Isaac Newton etc.

Or maybe the right term here is "deal" with mental illness. Because as far as I know, they never got rid of their illness just dealt with them in such a manner that they could function.

All of them had very different issues.  Some, like Murphy's addiction, does indeed involve willpower in the treatment.  It's hard to say exactly what people like Tesla, Newton, or Poe had because we're just guessing at the diagnoses, and these people has to attempt to their illnesses because there was no other option.

Certainly, there are people who stand out in history.  John Forbes Nash Jr. (A Beautiful Mind) famously went long stretches managing his schizophrenia without any medications.  People like him are the exception that prove the rule, however, as schizophrenia is a lifelong illness that normally cannot be self-managed, especially considering that many schizophrenics lack insight into their own illness.

Magicmiles' claim is akin to claiming that any infection can be cured through sheer force of will.  While it's possible to recover from a bacterial infection without antibiotics, there's a reason antibiotics are considered one of the most important inventions of all time.

Basically, I'm curious about the new norms arising around mental illness. When I got diagnosed with mild autism there was no rush to try and treat it. The pediatrician essentially said, if he can't adapt take him to a specialist if he can, don't.

That's because there's no cure for autism spectrum disorders.  Treatment is focused towards helping ASD patients adapt better to social norms and to manage other symptoms like seizures or anxiety.  So yes, it makes sense for your pediatrician to say that if you couldn't adapt you would need to seek interventions that would help you adapt.

Nowadays, it feels like there's a whole lot more panic. I dunno  how to articulate this thought. It feels like people now know more about mental illness but not enough to actually be of help but enough to get themselves paranoid or even worsen the situation.

Correct.  We've reached the stage where the public is more aware of mental illnesses but they are not educated on them.  Thus there is still a lot of stigma, misinformation, and panic attached to them.

Which is why I recommend staying away from the Internet for anything related to mental health (or health in general, even.)  If you're concerned about your own or someone else's mental health, see someone who is qualified to assess it, like a doctor or a professional YouTube commenter.

[Nam]

I think Junebug and Andrew have brain damage. Maybe they should hook up.

-Nam

[Mrjason]

I remember reading about a study that had correlated long-term or ongoing situational depression to clinical depression - something about how the lower levels of ... serotonin? dopamine?... could become permanent? IIRC, the brain eventually reprograms itself to produce those chemicals at the new, decreased levels. Is anyone familiar with that? It was probably at least 5 years back.

There's this one - http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030240

[Jag]

Magicmiles' claim is akin to claiming that any infection can be cured through sheer force of will. 

I just want to point out that mm never claimed that.

Correct.  We've reached the stage where the public is more aware of mental illnesses but they are not educated on them.  Thus there is still a lot of stigma, misinformation, and panic attached to them.

I think this is a very accurate assessment. People do seem to know just enough to be somewhat dangerous in their attempts to address mental illnesses.

Mooby, if I remember correctly, you're a ...doctor? A medical student? It's just an impression, based on I-don't-remember-what.

[Jag]

I remember reading about a study that had correlated long-term or ongoing situational depression to clinical depression - something about how the lower levels of ... serotonin? dopamine?... could become permanent? IIRC, the brain eventually reprograms itself to produce those chemicals at the new, decreased levels. Is anyone familiar with that? It was probably at least 5 years back.

There's this one - http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030240

Thank you Mrjason - this isn't the study I recall, but it almost poses the same argument from the other direction. This one seems to say that medical intervention is the wrong approach, for the reasons that the study I'm trying to recall says it's the right one. Both are discussing the consequences of artificially altering the chemistry of someone's brain.

I can get kind of geeky about this stuff. Neuro-anything interests me, and human behavior is almost compulsively fascinating to me. The idea of altering my own brain chemistry kind of freaks me out, but the whole "come be part of the 'borg collective" freaks me out for the same reasons - I'm very attached to my understood boundaries of my self. I've worked hard to make sense of me to me, and am in no hurry to start all over 

[Mrjason]

NP Jag 

As I understand it mental health is a continuum rather than a fixed state and we all meander between the 2 extremes.
It only becomes a problem when we get too close to the bat sh!t crazy end of the continuum and start to exhibit damaging/antisocial behaviour.
I alter my brain chemistry most weekends in the pub but only on a small scale and it wears off pretty quickly too 

I'm also pretty freaked out by changing it too much and follow debates on psychoactive drugs particularly the ones about whether they should be freely available very closely.

Is "reefer madness" real?
Maybe, I suppose it depends on where you are on the mental health continuum to start with.

[Jag]

The older I get, the more I understand that I'm not a very good drinker. It doesn't stop me from practicing, but I'm just not very good at it (and it's not a lack of effort - I used to try all the time!). One or two beers and I'm probably fine; much more than that and I'm likely to say or do something I would otherwise not say or do. I'm somewhat ...tightly wound under the best of circumstances, relaxation is not my natural state 

My personal opinion on marijuana is that the US political position on it is both poorly thought out and expensive beyond any benefit - and somewhat hypocritical in light of alcohol being legal and regulated. I'm a member of NORML, and occasionally get involved in activism on legalization, although this isn't a matter I get deeply involved in. However, since I do expect the laws to change in the next decade at the most, I'm planning to take a couple of horticulture classes to satisfy my science requirements when I transfer to a bigger college in the fall.

I'm an ordained minister, and my retirement plan is to operate a business under the umbrella of the Church of Cannabis Cultivation. Tax free and government be damned!

[Mooby]

Magicmiles' claim is akin to claiming that any infection can be cured through sheer force of will. 

I just want to point out that mm never claimed that.

Oh my! It was kindred who suggested that. I hope I didn't brain my damage!

I think this is a very accurate assessment. People do seem to know just enough to be somewhat dangerous in their attempts to address mental illnesses.

Mooby, if I remember correctly, you're a ...doctor? A medical student? It's just an impression, based on I-don't-remember-what.

Resident, which is a doctor who is out of med school but still training for a specialty. 

[Jag]

Thanks Mooby, that's what I thought. Can I ask what specialty you are pursuing? No real reason, I'm just nosy and curious about people.

[jdawg70]

I just want to point out that mm never claimed that.

Oh my! It was kindred who suggested that. I hope I didn't brain my damage!

I think this is a very accurate assessment. People do seem to know just enough to be somewhat dangerous in their attempts to address mental illnesses.

Mooby, if I remember correctly, you're a ...doctor? A medical student? It's just an impression, based on I-don't-remember-what.

Resident, which is a doctor who is out of med school but still training for a specialty.

My suspicion is that your brain-fart was due to the 4 hours of sleep you've gotten in the past 3 weeks?

[Mooby]

Thanks Mooby, that's what I thought. Can I ask what specialty you are pursuing? No real reason, I'm just nosy and curious about people.

Family Medicine

My suspicion is that your brain-fart was due to the 4 hours of sleep you've gotten in the past 3 weeks?

Pfft, no. I've been doing outpatient stuff the past couple months. Hooray for 40 hour work weeks!

Though that post was made right before bed.

[Tonus]

Some brain damage is physical, isn't it?  Such as Chronic traumatic encephalopathy (CTE) which describes the damage to the brain from repeated head injuries, including relatively minor ones like mild concussions.  Athletes who have CTE often suffer from dementia-like symptoms, deep depression and suicidal impulses.

[Jag]

^^^I can't swear to this, but I think the symptoms are dependent on the region of the brain that sustained the damage. I'll research it a bit later and see if I can find the study I'm thinking of (and see if I'm recalling it correctly as well!). I HAVE to go do some homework...

[Mooby]

Some brain damage is physical, isn't it?

Yes.  Severe trauma to the head can cause permanent damage to the brain.  So can something like a bleed or stroke.  And since the brain has pretty limited capabilities for regeneration, this is generally irreversible.

^^^I can't swear to this, but I think the symptoms are dependent on the region of the brain that sustained the damage. I'll research it a bit later and see if I can find the study I'm thinking of (and see if I'm recalling it correctly as well!). I HAVE to go do some homework...

Yes, different regions of the brain do different things. 

For instance, speech uses multiple areas of the brain and depending on what you injure, you might have difficulty forming words, or you might think of the words but speak gibberish, or you might have trouble understanding the words, or something mixed (these are some of the types of "aphasia" - interesting reading.)

There are also sensory and motor sectors of the brain, and they work based off a map of the body called a "homunculus."  (Google Image that one.)  Damage to one section of the homunculus shuts off that part of the body; that's why strokes tend to take out entire regions of one side of the body.

Of course, when we're comparing to mental illness we're thinking more of behavioral stuffs.  Some brain damage can mimic ADHD as it prevents people from filtering information.  Or, there can be emotional disturbances and personality changes - Google "Phineas Gage" for a super interesting case.  And, of course, damage to the memory areas (even just mild damage like concussion) can cause some memory loss.

Lastly, some changes can outright cause psychosis, such as brain damage from chronic alcoholism (Wernicke-Korsakoff syndrome).  Or withdrawal from certain drugs, particularly alcohol (delerium tremens.)  Or rare medical conditions, especially those that prevent the body from correctly filtering excess trace elements from the body (like having too much copper in the blood in Wilson disease.)

Basically, there are a lot of medical reasons why someone might be having psychiatric symptoms.

[LoriPinkAngel]

For instance, speech uses multiple areas of the brain and depending on what you injure, you might have difficulty forming words, or you might think of the words but speak gibberish, or you might have trouble understanding the words, or something mixed (these are some of the types of "aphasia" - interesting reading.)

I once had an elderly patient with dementia who had aphasia.  Sometimes she would make up a word to replace a word she could not remember.  But once she kept saying a word that for some reason didn't seem made up to me.  The nurse (I was a CNA at the time) said she was speaking gibberish again, but it finally hit me.  She was speaking Yiddish.   I asked her if that word was Yiddish & she replied yes & she told me what it meant in English.

[Mooby]

I once had an elderly patient with dementia who had aphasia.  Sometimes she would make up a word to replace a word she could not remember.  But once she kept saying a word that for some reason didn't seem made up to me.  The nurse (I was a CNA at the time) said she was speaking gibberish again, but it finally hit me.  She was speaking Yiddish.   I asked her if that word was Yiddish & she replied yes & she told me what it meant in English.

The brain is an odd thing, isn't it?

[magicmiles]

It sure is, Mooby.

I always found this an interesting read:

Supposing there was no intelligence behind the universe, no creative mind. In that case, nobody designed my brain for the purpose of thinking. It is merely that when the atoms inside my skull happen, for physical or chemical reasons, to arrange themselves in a certain way, this gives me, as a by-product, the sensation I call thought. But, if so, how can I trust my own thinking to be true? It's like upsetting a milk jug and hoping that the way it splashes itself will give you a map of London. But if I can't trust my own thinking, of course I can't trust the arguments leading to Atheism, and therefore have no reason to be an Atheist, or anything else. Unless I believe in God, I cannot believe in thought: so I can never use thought to disbelieve in God.

Attributed to C.S Lewis, but I think I saw it elsewhere also, attributed to someone else.