A New Reader posed a fascinating question, based on yesterday’s post.
“I guess I would like to ask you (and I am highly interested in your answer as someone with so much experience), what other term would you use instead (of 'mental')? Madness doesn't apply to all mental disorders, e.g. anxiety, depression. And yes there are grey areas and people diagnose everything under the sun now as mental disorders, but how about the real, palpable issue of mental health in Canada or world for that matter?
“I just think we can make the word ‘mental’ become a neutral word, like sinusitis, or myocardial infarction, etc., so that when someone says I have a mental disorder, we can understand that they are not to be discriminated against or treated as 'abnormal' just by the virtue of having a disease.
“Or if they are to be treated as ‘abnormal,’ it should be a part of a treatment protocol so this becomes routine and we recognize that we are treating them differently, and not ignoring the elephant in the room.”
Great question. I’m glad you asked it and I hope you don’t mind if I share it here.
I‘ll do my best to live up to your expectations and share some thoughts with you, but I don’t think there is any ONE answer. This is really a book!
It’s going to be in two parts. And if you don’t mind, I’m going to consult two far more experienced people than I, Tufts University psychiatrist and professor Dr. Ronald Pies and Harold A. Maio, another one of my sages.
In the meantime, here goes:
If you believe "mental illnesses" are diseases, you could use the word "psychiatric," instead of "mental."
But that’s not a very good solution because “psychiatry” is not seen in the world of medical science as real “science” since so much of psychiatry, like diagnostics, is very subjective.
No blood tests, X-rays, scans, urinalyses, or other concrete tests can yet definitively confirm a psychiatric diagnosis.
Many psychiatric patients, myself included, have had several different diagnoses, depending on who makes the diagnosis, when it was made and what the so-called “condition” is.
This can be true in physical medicine, too, but not to the same degree.
And that’s the point.
It’s “mental” versus “physical” medicine.
I do not believe that "mental illnesses" are caused only by "malfunctions of the brain structures/molecules."
What about emotional trauma? Childhood sexual, emotional and physical abuse? They can cause what look like “mental illnesses,” too. Can’t they?
What about genetics? What about other environmental issues? And personal experiences?
Cannot they also cause mental distress?
Also, I don't see mental illnesses as "diseases."
Are disorders and illnesses the same as diseases? Are they interchangeable? If so, then why aren't Bipolar Disorders — and there are several types — called Bipolar Disease? Or even Bipolar Disorders?
Cancer is Cancer, but any doctor will tell you that Cancer is 20,000 different diseases.
It's just not that simple.
Our minds are not organs, like hearts or kidneys. If they were, I'd ask for a transplant! Just kidding. I’ve grown accustomed to my mind. I rather like it, despite its “issues.” It’s mine and there’s no other quite like it. And isn’t that the point?
Is a broken leg like a broken mind?
Is a mental illness a brain disease? That’s an ongoing debate.
My psychiatrist, Dr. Bob, says neuropsychiatry may be making a comeback. It existed until 1948, when it was split into two different specialties —neurology and psychiatry. Organic and inorganic or ... ethereal?
Medicine and Psychoanalysis.
And where does Psychology fit into all this?
Some might say we’ve come a long way, but I’m not so sure.
I think this is not only a philosophical question but also a political one. The American Psychiatric Association, which is currently revising the Diagnostic and Statistical Manual of Mental Disorders, is a highly political organization.
Disorders and Diseases are not exactly the same. Would you say you have a "diseased mind?" I don’t think so.
Mental isn't really a noun. It just feels that way when someone says, "You're mental." Like you're a "Diabetic."
And that’s the classic comparison. But it doesn’t hold because the mind is a different paradigm than the physical body.
Like Mac computers that are on a different platform than PC's and rarely if ever catch “viruses.”
I believe this. And I don’t know if anyone can prove me wrong.
Mental Illnesses are not the same as Physical Illnesses.
I am not my mental illness. I do not believe that "mental illnesses" will be seen as neutral as long as universities teach doctors that there is a "stigma" around them that we have to get rid of because no one will ever take responsibility for any “stigma.”
The word "stigma" is a problem. It reinforces "stigma" and it's a linguistic problem.
Language is very powerful in creating and perpetuating our beliefs.
If people would erase the word "stigma" from our lexicon and instead talk about ignorance, fear, prejudice and discrimination, then society might take responsibility for its systemic ignorance, fears, prejudices and discrimination.
And do something about it. Using education. But first, people must be aware of their own fear and ignorance, discrimination and prejudice.
The answer is in education.
But the same old problem arises. People don’t know what they don’t know. So they blindly accept what they think is true.
And there are no absolute truths. Except that one!
I’ll stop here and continue next week!