If physical illness was treated like mental illness..

Page 3 of 4 [ 56 posts ]  Go to page Previous  1, 2, 3, 4  Next

kraftiekortie
Veteran
Veteran

Joined: 4 Feb 2014
Gender: Male
Posts: 87,510
Location: Queens, NYC

14 Nov 2014, 7:44 pm

It's physiological, yet experienced as "emotional."

It has an "emotional" impact upon me.



B19
Veteran
Veteran

User avatar

Joined: 11 Jan 2013
Gender: Female
Posts: 9,993
Location: New Zealand

14 Nov 2014, 8:46 pm

At this stage, I'm thinking about two issues that are extremely relevant to this whole thread. The first of these is Reductionism. For those unfamiliar with this term, here's a simple example:

Patient X walks into a clinic looking miserable, is tearful and reports having been unhappy for days.
On this basis, a diagnosis of depression is made and assumed to be the sole cause.
Patient X walks out with a prescription for depression, a mental illness solely due to a misfunctioning of Patient X's defective brain.
Reductionism is basically "scientists wearing blinkers and jumping to a simplistic conclusion which they mistake as being scientifically explanatory".

What might have happened t if a non-reductionist been applied to Patient X's presentation: first, he was asked, what has been going on in your life in the past 3 months?

He discloses that it has been a very tough time. Patient X's loved mother recently died, he is under massive stress from managerial issues at work, the bank is going to foreclose on his mortgage, and as a result of these pressures he is unable to sleep, his angina is playing up. On examination it is found that his blood pressure has skyrocketed, his cortisol levels are so high that they are inducing typical secondary symptoms of depression, he is gaining weight because of his skyhigh cortisol levels, stress has raised his C-Reactive Protein levels to a point that it is causing arteries to narrow and blood flow through them to be less efficient, and for all of these reasons, which need identification, consideration and treatment, he is a mess. He is a prime candidate for an imminent heart attack and needs immediate intervention for that. He needs support and counsel from financial advisers on his financial problems. Grief counselling and support seems indicated. Intervention to manage and lower his stress levels is urgent, and he is referred to stress management providers. He needs to rest and restore normal sleep cycles. A full blood count and laboratory tests are indicated to assess his current physiological status before completing the treatment plan.

That's the core problem with psychiatry that deals with "mental" illness. It's reductionist, it leaps to simplistic assumptions, it confuses symptoms with causes, it blames every "mental" condition of a "malfunctioning brain disorder". Depression typically has wider roots in social components, personal components, situational components, cultural components, physical components, lifestyle components, emotional components and psychological components - the latter often stemming from unresolved abuse and abandonment in childhood. In every serious "depression" there is whole story behind it in many chapters. Psychiatry is uninterested in the story, in the personhood of the patient, uninterested in the stigmatising effect of their pronouncing such a person as "mentally ill". The multifactorial approach they almost never bother with takes time, care, respect, open-mindedness, diligence, sensitivity, and empathy. And the drug companies do not pay the high bonuses for that, only for the prescriptions of prozac et al.

You can call this stupidity, or short-sightedness, or self-interest, or even corruption - or none of these depending on your point of view. I think I have at least made mine pretty clear: in all areas of medicine, people presenting with "mental" symptoms are the most poorly treated, undertreated and it is no surprise that many make no profound recovery despite taking the SSRIs for years. Some just experience blankness. This makes them no further trouble to the medical profession who can then write repeat prescriptions in the smug knowledge that they are "helping" the patient "manage" his symptoms. The quality of life that the patient experiences is not a priority in such thinking.

Reductionism sucks, bigtime.



B19
Veteran
Veteran

User avatar

Joined: 11 Jan 2013
Gender: Female
Posts: 9,993
Location: New Zealand

14 Nov 2014, 8:51 pm

Another example of reductionist thinking that came up earlier in this thread the depressed just need to "take responsibility to get exercise and make lifestyle changes". That's heard so often that it has become the mantra of reductionist thinking applied to depressed people.

You might need to look at the cartoons again now, after all this heavy stuff..



androbot01
Veteran
Veteran

User avatar

Joined: 17 Sep 2014
Age: 53
Gender: Female
Posts: 6,746
Location: Kingston, Ontario, Canada

14 Nov 2014, 9:00 pm

B19 wrote:
Patient X walks into a clinic looking miserable, is tearful and reports having been unhappy for days.
On this basis, a diagnosis of depression is made and assumed to be the sole cause.

With this limited information, this doesn't seem an unreasonable diagnosis.

Quote:
What might have happened t if a non-reductionist been applied to Patient X's presentation: ...
He discloses that it has been a very tough time. Patient X's loved mother recently died, he is under massive stress from managerial issues at work, the bank is going to foreclose on his mortgage,...he is a mess. He is a prime candidate for an imminent heart attack and needs immediate intervention for that. ... Grief counselling and support seems indicated. Intervention to manage and lower his stress levels is urgent, and he is referred to stress management providers. He needs to rest and restore normal sleep cycles. A full blood count and laboratory tests are indicated to assess his current physiological status before completing the treatment plan.


Now there is a bigger picture, but the diagnosis would still be the same. Obviously the heart trouble needs attention, but I think all the things you've suggested would not be cost effective. Or necessary. It doesn't matter how one becomes depressed, once you are, you are. What you are saying is akin to suggesting that a patient with a broken leg will receive better treatment if he recounts the event and it's effect on him. Well this is probably true from his perspective, it is not really necessary. The doctor has to fix the leg effectively and efficiently.



B19
Veteran
Veteran

User avatar

Joined: 11 Jan 2013
Gender: Female
Posts: 9,993
Location: New Zealand

14 Nov 2014, 9:07 pm

No, you have misunderstood me, perhaps I did not sufficiently clarify the central point I was making:

Which is that all these important other issues would be completely missed by a reductionist approach, possibly with fatal consequences.

Knowledge is power: the patient empowered by information resulting from a non-reductionist multifactorial approach can then use that power to make his or her choices about whether to engage in future treatment/interventions and if so to what extent.



androbot01
Veteran
Veteran

User avatar

Joined: 17 Sep 2014
Age: 53
Gender: Female
Posts: 6,746
Location: Kingston, Ontario, Canada

14 Nov 2014, 9:16 pm

B19 wrote:
...perhaps I did not sufficiently clarify the central point I was making:

Which is that all these important other issues would be completely missed by a reductionist approach, possibly with fatal consequences.


Well, I agree there ... all aspects of the person's health should be considered.



B19
Veteran
Veteran

User avatar

Joined: 11 Jan 2013
Gender: Female
Posts: 9,993
Location: New Zealand

14 Nov 2014, 11:09 pm

This important article on biomedical issues associated with ASD will be of interest to many I think, because again and again in forums there are threads asking "do you think this (physical issue) is related to ASD?"

This covers a number of those thread issues and provides very informative answers.

http://www.autismtreatment.org.uk/wp-co ... s-2013.pdf



Who_Am_I
Veteran
Veteran

User avatar

Joined: 27 Aug 2005
Age: 40
Gender: Female
Posts: 12,632
Location: Australia

15 Nov 2014, 1:51 am

kraftiekortie wrote:
One has to, at times, use one's cognition and intellect to overcome dysphoria.


Easier said than done. Depression doesn't respond to "be logical, you have no reason to feel bad".


_________________
Music Theory 101: Cadences.
Authentic cadence: V-I
Plagal cadence: IV-I
Deceptive cadence: V- ANYTHING BUT I ! !! !
Beethoven cadence: V-I-V-I-V-V-V-I-I-I-I-I-I-I-I-I-I-I
-I-I-I-I-I-I-I-I! I! I! I I I


B19
Veteran
Veteran

User avatar

Joined: 11 Jan 2013
Gender: Female
Posts: 9,993
Location: New Zealand

15 Nov 2014, 2:01 pm

Thanks for a very interesting discussion on this thread. Glad people enjoyed the cartoons.

To round it off, here is a clinical lecture about the mental symptoms of physical illnesses - a most cautionary tale... hope you find it interesting.

http://www.continuingedcourses.net/acti ... rse067.php



Aspiewordsmith
Veteran
Veteran

User avatar

Joined: 2 Nov 2008
Age: 57
Gender: Male
Posts: 564
Location: United Kingdom, England, Berkshire, Reading

14 Feb 2015, 2:16 pm

I often heard of people with mental health problems being told to snap out of it and people with a more visible condition being told to take it easy and is treated much better. Also a valid point is that a person with a camoufalges developmental disability such as autism especially one without a learning disability (having allistic level IQ over 70) is dehumanised where as a person with a physical condition for example cancer gets proper understanding and support especially because the latter is terminal. Allistic people say about autistic children they need more 'discipline' where as a child with cancer is told he or she needs a holiday to America to feel better and would be therapeutic. You could imagine the outrage that would be felt if childhood leukaemia was treated with the attitude that he or she needs more discipline etc. We all know people with physical conditions and disability can really milk the system for sympathy and that autistic people by the definition of autism/Asperger syndrome cannot and this is an issue which has angered me since 1974 and has led to me in the past for doing things that I am not proud of because I am and was so sick and tired of the lack of empathy from allistic people and they say we lack empathy.

The only sick childrens charity I will donate to is the Great Ormond Street Hospital in London where I was treated for Dravet syndrome in 1968. I'm not heartless I can show compassion to those that really need it in 1988 I used to let a woman with type 1 bipolar disorder cry on my shoulder because I realy felt for her at the time but she was allistic still and other people. I also at the time used to take the piss out so society's stigma against invisible conditions. I used to help my mum with her shopping when I was 14 years old because she at the time had slight agoraphobia when she went out and her friends at the time were worse than useless.

I refused one point to donate to a kids cancer charity by saying that children with autism are just abused and told all they needed was more discipline but the child with cancer gets wrapped up in cotton wool and treated with kid gloves even getting trips to theme parks in America or France where as the autistic child gets abuse and years later is expected to show compassion at every one else. Where is the outrage at treating autistic/Asperger syndrome children as malingerers, are they less than human? No



Joe90
Veteran
Veteran

User avatar

Joined: 23 Feb 2010
Gender: Female
Posts: 26,492
Location: UK

15 Feb 2015, 4:48 pm

Ah yes, this was the thread I was trying to bring up in a thread about empathy, but couldn't remember what the title of this thread was.

This is what really irks me when stuff about empathy gets brought up, and how so many NTs believe that Aspies lack empathy, and so many Aspies believe that themselves lack empathy. It just ticks me off. Not saying NTs don't have empathy, not saying that at all. But, I'm just saying, that if more people could put themselves into the shoes of people with mental illnesses, then....I can't think of the right words to finish that sentence, but you know where I'm coming from (sorry, my mind keeps going blank lately). So I don't know what the difference is between the empathy levels of NTs and Aspies. I believe I am very empathetic. I may not be that good at giving advice, but that does not mean I lack empathy. It just means that my mind goes blank often and I'm not knowledgeable enough to think of a good solution. Usually my ideas are dumb, like if somebody was telling me their problems about money, they might as well be trying to get advice from a 10-year-old of how to deal with their problems with money. I can empathise, imagine how they feel, understand, and be there for them, all that sort of thing, but to think of ways to actually be able to help them with their money....I just don't know what to offer there. Makes me sound dumb to other people I suppose.


_________________
Female