Mental Illness: Two: People Are Strange

A follow up to Mental Illness: One. As before this post is not a thorough research based article. It is a mix of personal experience, discussions, made up things, fleeting thoughts and stuff I will just put in to wind people up.

To summarise my previous articles. Mental Illness exists, if for no other reason than society (legal, medical, general public [pdf]) says that it does. The term mental illness covers such a wide variety of problems and issues that it is effectively meaningless.

Mental Illnesses, however defined, are caused and influenced by a combination of factors. Genetic, environmental, birth trauma, head injury, drug usage, MI5 rays etc. Some have some kind of causal effect, some probably make things worse when someone is unwell.

The following posts and comments discuss these issues.

Mental Illness: One

Abuse: Society, The System and Sanity.

Secrets Are Lies Left Untold

Horrible Lives Make People Mad

I intend to discuss what Mental Illness is, irrespective of cause. Not a list of medical diagnoses, there are many sites that will give technical information.

I just had a passing thought about where learning disabilities should fit in. In short I have no idea. Any learning disability nurses want to get involved the comments section awaits.

Classically mental illness are divided into two types. Organic and Functional.

Organic Psychiatry

There is a field within psychiatry which looks specifically at illnesses of the brain and body that can have psychological and neurological symptoms - this is known as organic psychiatry.

In short mental illnesses caused by a known physical problem. The classic is probably dementia. Though I remember reading a Kitwood book (Dementia Reconsidered ?)stating that many people with a diagnosis of dementia were found to have nothing observable wrong with their brains when autopsied. Well apart from sitting under a microscope in a lab, that was very wrong.

Functional illnesses are everything else that falls under the mental illness brand. Schizophrenia, bipolar disorder, depression etc. The difference between them is probably somewhat arbitrary. Some of the current functional illnesses undoubtedly have physical causative factors. Changes in brain chemistry can affect the mind (my friend that smoked cannabis giggled and told that was true, my drunk friend was going to give me a logical rebuttal to my hypothesis but instead told me how she had been done wrong by her man). I would imagine their is some kind of feedback loop. Factors that strongly influence a persons state of mind over a period of time probably can have lasting effects on brain chemistry. This is unaffected by any theories of mind body separation an argument I am more than willing to have elsewhere (in the forums ?).

Anyway.

My theory for this post, is probably obvious to everyone else, is that most Mental Illness is just normalness gone to extremes.

Most of the diagnoses is the ICD-10 are just heading for groups of signs and symptoms that seem to clump together in potentially useful combinations. Useful for the writers of psychiatric textbooks that is. Think of a diagnosis as a little blog ring, facebook friends network or whatever. (Remember generally signs are the things we can see, symptoms are the things the client tells us about).

I was giving a lecture once and I said:

Mental: I can not think of many psychiatric problems that most ‘normal’ people do not suffer to a lesser extent sometimes.

Voice from Audience: Rubbish !

Mental: Did anyone else hear that ?

Audience: *much hilarity*

Actually there was no hilarity. I never got invited to give the talk again.

Next time stick to the party line Mental and do not put 5 minute gaps in your notes with the comment ‘make up something funny and interesting‘.

I am going to pick about half a dozen random signs and or symptoms from the ICD-10 and try to show how they are variations upon or extremes of normalcy.

All links from www.mentalhealth.com.

From Obsessive-Compulsive Disorder

Predominantly Compulsive Acts (Obsessional Rituals) : The majority of compulsive acts are concerned with cleaning (particularly hand-washing), repeated checking to ensure that a potentially dangerous situation has not been allowed to develop, or orderliness and tidiness. Underlying the overt behaviour is a fear, usually of danger either to or caused by the patient, and the ritual act is an ineffectual or symbolic attempt to avert that danger.

Of course all nurses are obsessive hand washers, we hear the voice of matron commanding us. Most people have rituals and like to check things. I have seen night nurses check the doors are locked.

• Step 1: Lock the door with key, turn handle, shake door, observe door not opening.
• Step 2: Repeat everything from turn handle, a bit harder.
• Step 3: Repeat Step 2, a bit harder again.
• Step 4: Step back, stare at door, see if it is going to open of own accord.

Parents are another good source of safety rituals relating to their children. And do not get me started about my mother. God bles her soul.

F60.3 Emotionally Unstable (Borderline) Personality Disorder - Borderline type:

… the patient’s own self-image, aims, and internal preferences (including sexual) are often unclear or disturbed. There are usually chronic feelings of emptiness. A liability to become involved in intense and unstable relationships may cause repeated emotional crises and may be associated with excessive efforts to avoid abandonment and a series of suicidal threats or acts of self-harm.

Well this covers some of my ex-partners. I am sure they would say the same about me People feel empty at times. People get involved in difficult relationships. Most people will try to avoid being abandoned. Self harm is tricky. Figures vary. Most of the things listed can be normal when not in excess.

Delusion Disorder

… group of disorders is characterized by the development either of a single delusion or of a set of related delusions which are usually persistent and sometimes lifelong. The delusions are highly variable in content.

This one is a bit tricky. Speaking as a God Bothering Christian ™ I know many of my beliefs are considered delusional by people I know. Or my belief that others think this is delusional, with a hint of paranoia. The belief is a huge left wing conspiracy is probably delusional. Sorry Daily Mail readers. The first thing that happens when you get two left wingers in a room together is an argument!

Remember the adverts for Switch Debit Cards. The huge billboards saying ‘No One Likes You‘ ? I know someone who was halfway convinced they were being deliberately put up just to annoy her. She knew they almost certainly were not, but she did wonder why she kept seeing them everywhere she went.

Schizoprenia

This is a big one. Too big. Quickly glancing over the criteria I suspect my theory is about to break down. But I will go where Angels fear to tread.

(e) persistent hallucinations in any modality, when accompanied either by fleeting or half-formed delusions without clear affective content, or by persistent over-valued ideas, or when occurring every day for weeks or months on end;

Most people do not have persistent hallucinations. I would suspect most people have had brief hallucinations. Stay up too long and you will see things. Over valued ideas are not uncommon, just find someone’s pet obsessive belief. What a dreams if not full blown hallucinatory experiences. Who walking down a dark street at night has not been convinced that someone is following ?

You get the idea.

Most of the other classic disorders are extremes of normal mood; depression, mania. All people have felt depressed at times, most have had little manic spells.

Must finish here. This has taken far longer than I expected and my manic spell is running low. Will post as is and expand in the comments as required.

Next in series will probably cover … treatment in some form or another. Either that or I will finally get round to my anti-anti-psychiatry rant.