Let's talk about mental illness

[Haggis_McMutton]

This was making the rounds on reddit this morning:

Source: http://anarchistsoccermom.blogspot.ca/2012/12/thinking-unthinkable.html?m=1

In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.

Three days before 20 year-old Adam Lanza killed his mother, then opened fire on a classroom full of Connecticut kindergartners, my 13-year old son Michael (name changed) missed his bus because he was wearing the wrong color pants.

“I can wear these pants,” he said, his tone increasingly belligerent, the black-hole pupils of his eyes swallowing the blue irises.

“They are navy blue,” I told him. “Your school’s dress code says black or khaki pants only.”

“They told me I could wear these,” he insisted. “You’re a stupid bitch. I can wear whatever pants I want to. This is America. I have rights!”

“You can’t wear whatever pants you want to,” I said, my tone affable, reasonable. “And you definitely cannot call me a stupid bitch. You’re grounded from electronics for the rest of the day. Now get in the car, and I will take you to school.”

I live with a son who is mentally ill. I love my son. But he terrifies me.

A few weeks ago, Michael pulled a knife and threatened to kill me and then himself after I asked him to return his overdue library books. His 7 and 9 year old siblings knew the safety plan—they ran to the car and locked the doors before I even asked them to. I managed to get the knife from Michael, then methodically collected all the sharp objects in the house into a single Tupperware container that now travels with me. Through it all, he continued to scream insults at me and threaten to kill or hurt me.

That conflict ended with three burly police officers and a paramedic wrestling my son onto a gurney for an expensive ambulance ride to the local emergency room. The mental hospital didn’t have any beds that day, and Michael calmed down nicely in the ER, so they sent us home with a prescription for Zyprexa and a follow-up visit with a local pediatric psychiatrist.

We still don’t know what’s wrong with Michael. Autism spectrum, ADHD, Oppositional Defiant or Intermittent Explosive Disorder have all been tossed around at various meetings with probation officers and social workers and counselors and teachers and school administrators. He’s been on a slew of antipsychotic and mood altering pharmaceuticals, a Russian novel of behavioral plans. Nothing seems to work.

At the start of seventh grade, Michael was accepted to an accelerated program for highly gifted math and science students. His IQ is off the charts. When he’s in a good mood, he will gladly bend your ear on subjects ranging from Greek mythology to the differences between Einsteinian and Newtonian physics to Doctor Who. He’s in a good mood most of the time. But when he’s not, watch out. And it’s impossible to predict what will set him off.

Several weeks into his new junior high school, Michael began exhibiting increasingly odd and threatening behaviors at school. We decided to transfer him to the district’s most restrictive behavioral program, a contained school environment where children who can’t function in normal classrooms can access their right to free public babysitting from 7:30-1:50 Monday through Friday until they turn 18.

The morning of the pants incident, Michael continued to argue with me on the drive. He would occasionally apologize and seem remorseful. Right before we turned into his school parking lot, he said, “Look, Mom, I’m really sorry. Can I have video games back today?”

“No way,” I told him. “You cannot act the way you acted this morning and think you can get your electronic privileges back that quickly.”

His face turned cold, and his eyes were full of calculated rage. “Then I’m going to kill myself,” he said. “I’m going to jump out of this car right now and kill myself.”

That was it. After the knife incident, I told him that if he ever said those words again, I would take him straight to the mental hospital, no ifs, ands, or buts. I did not respond, except to pull the car into the opposite lane, turning left instead of right.

“Where are you taking me?” he said, suddenly worried. “Where are we going?”

“You know where we are going,” I replied.

“No! You can’t do that to me! You’re sending me to hell! You’re sending me straight to hell!”

I pulled up in front of the hospital, frantically waiving for one of the clinicians who happened to be standing outside. “Call the police,” I said. “Hurry.”

Michael was in a full-blown fit by then, screaming and hitting. I hugged him close so he couldn’t escape from the car. He bit me several times and repeatedly jabbed his elbows into my rib cage. I’m still stronger than he is, but I won’t be for much longer.

The police came quickly and carried my son screaming and kicking into the bowels of the hospital. I started to shake, and tears filled my eyes as I filled out the paperwork—“Were there any difficulties with....at what age did your child....were there any problems with...has your child ever experienced...does your child have....”

At least we have health insurance now. I recently accepted a position with a local college, giving up my freelance career because when you have a kid like this, you need benefits. You’ll do anything for benefits. No individual insurance plan will cover this kind of thing.

For days, my son insisted that I was lying—that I made the whole thing up so that I could get rid of him. The first day, when I called to check up on him, he said, “I hate you. And I’m going to get my revenge as soon as I get out of here.”

By day three, he was my calm, sweet boy again, all apologies and promises to get better. I’ve heard those promises for years. I don’t believe them anymore.

On the intake form, under the question, “What are your expectations for treatment?” I wrote, “I need help.”

And I do. This problem is too big for me to handle on my own. Sometimes there are no good options. So you just pray for grace and trust that in hindsight, it will all make sense.

I am sharing this story because I am Adam Lanza’s mother. I am Dylan Klebold’s and Eric Harris’s mother. I am Jason Holmes’s mother. I am Jared Loughner’s mother. I am Seung-Hui Cho’s mother. And these boys—and their mothers—need help. In the wake of another horrific national tragedy, it’s easy to talk about guns. But it’s time to talk about mental illness.

According to Mother Jones, since 1982, 61 mass murders involving firearms have occurred throughout the country. (http://www.motherjones.com/politics/201 ... otings-map). Of these, 43 of the killers were white males, and only one was a woman. Mother Jones focused on whether the killers obtained their guns legally (most did). But this highly visible sign of mental illness should lead us to consider how many people in the U.S. live in fear, like I do.

When I asked my son’s social worker about my options, he said that the only thing I could do was to get Michael charged with a crime. “If he’s back in the system, they’ll create a paper trail,” he said. “That’s the only way you’re ever going to get anything done. No one will pay attention to you unless you’ve got charges.”

I don’t believe my son belongs in jail. The chaotic environment exacerbates Michael’s sensitivity to sensory stimuli and doesn’t deal with the underlying pathology. But it seems like the United States is using prison as the solution of choice for mentally ill people. According to Human Rights Watch, the number of mentally ill inmates in U.S. prisons quadrupled from 2000 to 2006, and it continues to rise—in fact, the rate of inmate mental illness is five times greater (56 percent) than in the non-incarcerated population. (http://www.hrw.org/news/2006/09/05/us-n ... quadrupled)

With state-run treatment centers and hospitals shuttered, prison is now the last resort for the mentally ill—Rikers Island, the LA County Jail, and Cook County Jail in Illinois housed the nation’s largest treatment centers in 2011 (http://www.npr.org/2011/09/04/140167676 ... -prisoners)

No one wants to send a 13-year old genius who loves Harry Potter and his snuggle animal collection to jail. But our society, with its stigma on mental illness and its broken healthcare system, does not provide us with other options. Then another tortured soul shoots up a fast food restaurant. A mall. A kindergarten classroom. And we wring our hands and say, “Something must be done.”

I agree that something must be done. It’s time for a meaningful, nation-wide conversation about mental health. That’s the only way our nation can ever truly heal.

God help me. God help Michael. God help us all.

What should be done in situations such as this?
How should society handle people like Michael ?

[Johnny Rockets]

I have had mental health concerns, my children have/had mental health concerns, and it is crucial to detect, diagnose, and treat as early as possible to correct or at least improve the quality of life for the future of the individual and the supporting family.

Better trained teachers, care givers, and school nurses that can red flag kids with behavioral issues for assessment would help. Resources for parents who have little or no benefits including treatment options and support groups would help as well.

We should be investing in our children. In their health, training, fitness, education, and social development...as much as possible, and whenever possible. So many problems get addressed simply and cheaply when addressed in emergent stages then down the road. Crime drops, poverty drops, productivity increases, and a higher educated next generation benefits humanity.

Johnny Rockets

[john9blue]

this boy makes death threats to get what he wants because he believes that he knows better than his parents, and he might actually know better than his parents. i don't think he fits the profile of an irrational psychopath.

[Metsfanmax]

I despise the term "mental illness." A "mental illness" is not something like a physical illness because the latter is demonstrably a case of the human body not working as it is biologically designed to do. A "mental illness" is not the result of some actual disease or physiological lesion; it is a catchphrase we use to describe those whose brains operate differently from that of most people. A "mental illness" cannot be cured precisely because it is not actually an illness. We can sometimes use drugs to artificially change human behavior; but then we still have not "cured" a "disease," just as using a tranquilizer to stop convulsions from occurring does not cure whatever disease causes the convulsions.

So no, let's not talk about mental illness. What you are trying to talk about is how to get people who act abnormally, to act more normal.

[jj3044]

I despise the term "mental illness." A "mental illness" is not something like a physical illness because the latter is demonstrably a case of the human body not working as it is biologically designed to do. A "mental illness" is not the result of some actual disease or physiological lesion; it is a catchphrase we use to describe those whose brains operate differently from that of most people. A "mental illness" cannot be cured precisely because it is not actually an illness. We can sometimes use drugs to artificially change human behavior; but then we still have not "cured" a "disease," just as using a tranquilizer to stop convulsions from occurring does not cure whatever disease causes the convulsions.

So no, let's not talk about mental illness. What you are trying to talk about is how to get people who act abnormally, to act more normal.

I know many a health care professional that would disagree with your point.

How do you know a physical illness isn't "supposed" to be how the body operates? How do you know that diabetes isn't how the body is "supposed" to operate? Because a panel of healthcare professionals have decided this over the years due to testing, studies, etc. Mental health diseases are no different.

[chang50]

I despise the term "mental illness." A "mental illness" is not something like a physical illness because the latter is demonstrably a case of the human body not working as it is biologically designed to do. A "mental illness" is not the result of some actual disease or physiological lesion; it is a catchphrase we use to describe those whose brains operate differently from that of most people. A "mental illness" cannot be cured precisely because it is not actually an illness. We can sometimes use drugs to artificially change human behavior; but then we still have not "cured" a "disease," just as using a tranquilizer to stop convulsions from occurring does not cure whatever disease causes the convulsions.

So no, let's not talk about mental illness. What you are trying to talk about is how to get people who act abnormally, to act more normal.

So more accurately it is an orientation,I know Aspies (as people with Aspergers syndrome often call themselves)refer to their condition as such,even naming the sub-aspergers community as neurotypicals.Interesting..

[Metsfanmax]

I know many a health care professional that would disagree with your point.

Of course they would. Many a "health care professional's" job depends on "mental illness" being seen as synonymous with "physical illness." That doesn't make it scientifically or ethically justified.

How do you know a physical illness isn't "supposed" to be how the body operates? How do you know that diabetes isn't how the body is "supposed" to operate? Because a panel of healthcare professionals have decided this over the years due to testing, studies, etc. Mental health diseases are no different.

I know that diabetes is a disease not because a "panel of healthcare professionals" told me so, but because a proper insulin level is necessary for the adequate functioning of the human body, and without it adverse health effects occur. Mental health "diseases" are quite different, because the human body's biological functions are not affected by whether someone can "hear" voices in their head.

[Metsfanmax]

I despise the term "mental illness." A "mental illness" is not something like a physical illness because the latter is demonstrably a case of the human body not working as it is biologically designed to do. A "mental illness" is not the result of some actual disease or physiological lesion; it is a catchphrase we use to describe those whose brains operate differently from that of most people. A "mental illness" cannot be cured precisely because it is not actually an illness. We can sometimes use drugs to artificially change human behavior; but then we still have not "cured" a "disease," just as using a tranquilizer to stop convulsions from occurring does not cure whatever disease causes the convulsions.

So no, let's not talk about mental illness. What you are trying to talk about is how to get people who act abnormally, to act more normal.

So more accurately it is an orientation,I know Aspies (as people with Aspergers syndrome often call themselves)refer to their condition as such,even naming the sub-aspergers community as neurotypicals.Interesting..

To be precise, and maybe this will help explain to jj where I'm coming from, "mental illnesses" are not diagnosed based on objective, scientifically reproducible investigations but based on subjective investigations of behavior by psychologists. In other words, they are diagnosed based on behavior, and therefore there is no scientific backing for the term "mental illness" if it is meant to be analogous to a biological illness. The Rosenhan experiment is a simple demonstration of this: you cannot fake a heart attack to a trained scientist, but you can fake "mental illness" to a trained psychiatrist.

[john9blue]

mets is exactly right. psychiatry in its current state barely qualifies as a science. take it from someone with personal experience, lol.

[Lootifer]

The one topic that has the potential to make a difference and you guys crap on about fucking semantics?

f*ck this forum. Seriously.

[chang50]

The one topic that has the potential to make a difference and you guys crap on about fucking semantics?

f*ck this forum. Seriously.

Nothing written in this forum makes any worthwhile difference to anything sadly..

[Lootifer]

The one topic that has the potential to make a difference and you guys crap on about fucking semantics?

f*ck this forum. Seriously.

Nothing written in this forum makes any worthwhile difference to anything sadly..

I disagree. Neocons vs Libtards arguing about which gun law kills more children, sure, that aint up to f*ck all; but if every one takes the time to read the OP then debate about mental illness/abnormal individual behaviour/crazy fuckers being crazy then people might learn something.

(based on the fact that people on this board are extremely unlikely to have any kind of knowledge on the topic and thus are likely to learn something, to me thats making a difference - hell you can learn something from the OP).

[Metsfanmax]

I don't support "education" of people on this forum if that education consists of indoctrinating more people into the idea that there is something wrong with those deemed "mentally ill." That does nothing to actually help solve the real problems we are talking about; it just masks them, and justifies horrors like involuntary commitment. If we want to really solve the problem of being who are abnormal enough to kill two dozen people, we have to take it as it is -- there are people who, because of how their brain operates and because of their environmental pressures, are capable of doing this as what they see as normal behavior.

I think the issue is worth discussing, but I don't think that means we should try to whitewash it by suggesting that we need more money to help "cure" the "ill." That is a complete misunderstanding of the issue, and I'm surely not going to keep silent just because it might make you feel better to talk about it this way.

[jj3044]

How do you know a physical illness isn't "supposed" to be how the body operates? How do you know that diabetes isn't how the body is "supposed" to operate? Because a panel of healthcare professionals have decided this over the years due to testing, studies, etc. Mental health diseases are no different.

I know that diabetes is a disease not because a "panel of healthcare professionals" told me so, but because a proper insulin level is necessary for the adequate functioning of the human body, and without it adverse health effects occur. Mental health "diseases" are quite different, because the human body's biological functions are not affected by whether someone can "hear" voices in their head.

How do you know what, exactly, is a proper insulin level? Panel of healthcare experts come to a consensus using data from studies.

How do you know what is considered proper cognitive functioning? Panel of healthcare experts come to a consensus using data from studies.

The process is the same. The testing is what I believe you are getting hung up on. You are saying that a fasting glucose test (or PSA, or mammogram, or CT scan, or any other "objective" lab test) is better than a validated questionnaire. There isn't a test in the whole realm of medicine that has a 100% track record of being perfect. There are many false-positives and false-negatives in science and medicine.

Edit: and to your second point, if someone can hear voices in their head, they could become a recluse, lose their job, stop eating because they think their food is being poisoned, buy a gun to try to kill their spouse who is "poisoning" them, etc. At what point, exactly, does it become a life threatening condition to themselves or others?

[Lootifer]

@ Mets:

I agree with your principle completely, just caution you to stay in touch with the wider argument (im not suggesting you dont, but ive observed it in other areas such as gay rights where they focus on trying to turn gay into a positive adjective; their efforts would be better spent elseware).

What I mean is no matter what you call it, society is going to think of it negatively; society views the results and assumes accordingly.

No its not an illness, but it is something that needs time and effort spent on it in order to improve life for the individual. You can avoid calling it treatment, but at the end of the day that's what it is (and treatment comes in many forms, and yes, a lot of it is pseudoscience as j9b suggests).

What we have to try and get accross is that "treatment" (seeking/getting help) is not something we should view negatively.

[Metsfanmax]

The process is the same. The testing is what I believe you are getting hung up on. You are saying that a fasting glucose test (or PSA, or mammogram, or CT scan, or any other "objective" lab test) is better than a validated questionnaire. There isn't a test in the whole realm of medicine that has a 100% track record of being perfect. There are many false-positives and false-negatives in science and medicine.

Sure, they are not perfect. What is important is that they are objective and reproducible, so that what physicians do can properly be called scientific in nature. A psychiatric evaluation is based on observed behaviors, which is not reproducible (because different people asking the same questions can yield different results) and not objective (because where one person might see a serious "mental illness," another might see a malingerer).

Edit: and to your second point, if someone can hear voices in their head, they could become a recluse, lose their job, stop eating because they think their food is being poisoned, buy a gun to try to kill their spouse who is "poisoning" them, etc. At what point, exactly, does it become a life threatening condition to themselves or others?

Well, being a "danger" to yourself should never be considered something for the law to be concerned with. People with advanced AIDS or late-stage cancer have many of the same issues that you describe (may become bedridden and reclusive, lose their job, be unable to eat, etc.) but we do not lock them up for their own good if they refuse treatment. We generally agree that this is their right; the same ought to be true of the "mentally ill." As for whether someone is a threat to others, there is a disturbing double standard. We are perfectly willing to defend the rights of people who have not committed a crime, even if there are some signs that they could be dangerous, except in the case of a psychiatrist labeling them "mentally ill." Once that label has been applied, people get seen in a completely different light; but this is not a justification for treating them any differently under the law. If they voluntarily seek treatment for their condition, from people who claim that they can alter or subdue their natural behavior, that again is their right. But the double standard is the problem, and it is a disturbing threat to the idea of liberty and personal responsibility.

[Metsfanmax]

No its not an illness, but it is something that needs time and effort spent on it in order to improve life for the individual. You can avoid calling it treatment, but at the end of the day that's what it is (and treatment comes in many forms, and yes, a lot of it is pseudoscience as j9b suggests).

What we have to try and get accross is that "treatment" (seeking/getting help) is not something we should view negatively.

I believe that we should invest time and effort into ensuring that there are trained individuals ready to help anyone who seeks treatment to adjust their behavior, as long as we can be sure that such people are not coerced into this. So I agree that we should be actively convincing such people to take us up on treatment, as this is in the best interests of society as a whole (I don't think anyone witnessing what happened in CT can deny this). But we must not coerce an innocent individual into treatment that they do not desire -- that is antithetical to liberty.

[Lootifer]

No its not an illness, but it is something that needs time and effort spent on it in order to improve life for the individual. You can avoid calling it treatment, but at the end of the day that's what it is (and treatment comes in many forms, and yes, a lot of it is pseudoscience as j9b suggests).

What we have to try and get accross is that "treatment" (seeking/getting help) is not something we should view negatively.

I believe that we should invest time and effort into ensuring that there are trained individuals ready to help anyone who seeks treatment to adjust their behavior, as long as we can be sure that such people are not coerced into this. So I agree that we should be actively convincing such people to take us up on treatment, as this is in the best interests of society as a whole (I don't think anyone witnessing what happened in CT can deny this). But we must not coerce an innocent individual into treatment that they do not desire -- that is antithetical to liberty.

What if their abnormalaties is preventative of them realising they need assistance/help? (like in a genuine case, eg the case in the OP).

[Metsfanmax]

No its not an illness, but it is something that needs time and effort spent on it in order to improve life for the individual. You can avoid calling it treatment, but at the end of the day that's what it is (and treatment comes in many forms, and yes, a lot of it is pseudoscience as j9b suggests).

What we have to try and get accross is that "treatment" (seeking/getting help) is not something we should view negatively.

I believe that we should invest time and effort into ensuring that there are trained individuals ready to help anyone who seeks treatment to adjust their behavior, as long as we can be sure that such people are not coerced into this. So I agree that we should be actively convincing such people to take us up on treatment, as this is in the best interests of society as a whole (I don't think anyone witnessing what happened in CT can deny this). But we must not coerce an innocent individual into treatment that they do not desire -- that is antithetical to liberty.

What if their abnormalaties is preventative of them realising they need assistance/help? (like in a genuine case, eg the case in the OP).

This is a serious question, and I don't know that it has a clear-cut answer. I will say that however you answer it, you had better be prepared to treat patients with Parkinson's disease the same way that you treat people with behavioral abnormalities that apparently affect cognitive functioning to the point of being unable to desire help. If you would coerce the latter into treatment, why not the former?

[jj3044]

The process is the same. The testing is what I believe you are getting hung up on. You are saying that a fasting glucose test (or PSA, or mammogram, or CT scan, or any other "objective" lab test) is better than a validated questionnaire. There isn't a test in the whole realm of medicine that has a 100% track record of being perfect. There are many false-positives and false-negatives in science and medicine.

Sure, they are not perfect. What is important is that they are objective and reproducible, so that what physicians do can properly be called scientific in nature. A psychiatric evaluation is based on observed behaviors, which is not reproducible (because different people asking the same questions can yield different results) and not objective (because where one person might see a serious "mental illness," another might see a malingerer).

Edit: and to your second point, if someone can hear voices in their head, they could become a recluse, lose their job, stop eating because they think their food is being poisoned, buy a gun to try to kill their spouse who is "poisoning" them, etc. At what point, exactly, does it become a life threatening condition to themselves or others?

Well, being a "danger" to yourself should never be considered something for the law to be concerned with. People with advanced AIDS or late-stage cancer have many of the same issues that you describe (may become bedridden and reclusive, lose their job, be unable to eat, etc.) but we do not lock them up for their own good if they refuse treatment. We generally agree that this is their right; the same ought to be true of the "mentally ill." As for whether someone is a threat to others, there is a disturbing double standard. We are perfectly willing to defend the rights of people who have not committed a crime, even if there are some signs that they could be dangerous, except in the case of a psychiatrist labeling them "mentally ill." Once that label has been applied, people get seen in a completely different light; but this is not a justification for treating them any differently under the law. If they voluntarily seek treatment for their condition, from people who claim that they can alter or subdue their natural behavior, that again is their right. But the double standard is the problem, and it is a disturbing threat to the idea of liberty and personal responsibility.

If you have cancer and refuse treatment, that is a personal choice, because you KNOW you have a condition. If you have a mental (condition, illness, disease, whatever you would like to call it), most of the time you would not know you have it, so you never seek treatment.

I am not speculating here, or being a devil's advocate. I am personally dealing with a situation with someone in the family who is going through EXACTLY what I described above (just not to the level of the gun part). The entire family has been trying to convince this person to get help, but they will not do it, because they "know" that these things are actually happening, because they "overhear" conversations... people with these conditions are not rational, and no amount of rational argument can convince them. This is the truly scary part... not being able to help a family member who we see deteriorating significantly, which if untreated means an inability to financially be able to support themselves or their immediate family because they will lose their job, most likely a divorce breaking up the family...etc.

I apologize for the diatribe but you definitely hit a chord.

[Metsfanmax]

I am not speculating here, or being a devil's advocate. I am personally dealing with a situation with someone in the family who is going through EXACTLY what I described above (just not to the level of the gun part). The entire family has been trying to convince this person to get help, but they will not do it, because they "know" that these things are actually happening, because they "overhear" conversations... people with these conditions are not rational, and no amount of rational argument can convince them. This is the truly scary part... not being able to help a family member who we see deteriorating significantly, which if untreated means an inability to financially be able to support themselves or their immediate family because they will lose their job, most likely a divorce breaking up the family...etc.

I apologize for the diatribe but you definitely hit a chord.

I don't intend to demean anyone's personal experiences. I am not suggesting that the issues described by the term "mental illness" are not real and do not affect real people; they surely do, and I hope that your family is able to make it through this difficult time without too much anguish.

I think this is the sort of situation where you as a family have a right to do something about the problem, because you are in the position to speak for this person in your family. Would this person have, knowing what was coming to them, asked for treatment if they knew it would come to a point where they were unable to understand what was happening to them? If this person had a degenerative nervous system disease that caused the same thing, there would be a strong argument for the family's right to seek treatment for this person. If it is something purely behavioral, as you seem to be indicating, then people see the problem differently. I really don't know how to approach this problem in any surefire manner; it has never happened to me and I don't know what I would do if it did.

[Lootifer]

This is a serious question, and I don't know that it has a clear-cut answer. I will say that however you answer it, you had better be prepared to treat patients with Parkinson's disease the same way that you treat people with behavioral abnormalities that apparently affect cognitive functioning to the point of being unable to desire help. If you would coerce the latter into treatment, why not the former?

Its a very hard question; but I would set my ethical benchmark at those with an abnormality that either impacts others negatively, or has a high likelihood that it will impact others negatively then they should probably be pushed into treatment - however this treatment should still focus on helping the individual, not helping society get rid of a problem.

[InkL0sed]

I despise the term "mental illness." A "mental illness" is not something like a physical illness because the latter is demonstrably a case of the human body not working as it is biologically designed to do. A "mental illness" is not the result of some actual disease or physiological lesion; it is a catchphrase we use to describe those whose brains operate differently from that of most people. A "mental illness" cannot be cured precisely because it is not actually an illness. We can sometimes use drugs to artificially change human behavior; but then we still have not "cured" a "disease," just as using a tranquilizer to stop convulsions from occurring does not cure whatever disease causes the convulsions.

So no, let's not talk about mental illness. What you are trying to talk about is how to get people who act abnormally, to act more normal.

If by "more normal", you mean "able to function at the same level as everyone else", then yes. That is in fact what the goal is.

There's actually a huge stigma attached to mental illness where most of society doesn't understand that it's an illness. My inner circle of friends, between them, deal with various forms of depression, bipolar disorder, dissociative identity disorder, severe migraine, ADHD, Tourette's, and probably other things too.

When my friend had a major depressive episode last year, she wasn't staying in bed, not doing schoolwork or seeing people because she was exercising her liberty. She was ill, and needed medical attention. Telling her to just "get over it" would have been one of the worst things you could have done.

Likewise for the various illnesses I listed above.

And, actually, you CAN cure some of these things. For instance, watch this TED talk: http://www.ted.com/talks/sherwin_nuland ... erapy.html

How can you possibly say this guy wasn't ill at the time he describes? And wouldn't you say he's more or less been treated successfully?

Granted, it's very rare that you're cured of a lot of these things. Personality disorders are considered entirely untreatable. But that's also the case of a lot of chronic diseases.

Look, this is an extremely complex issue. You can't just try to reduce it in the way you are trying to – and that is exactly what you're trying to do when you're trying to "tell it straight", or not "whitewash".

[Metsfanmax]

There's actually a huge stigma attached to mental illness where most of society doesn't understand that it's an illness. My inner circle of friends, between them, deal with various forms of depression, bipolar disorder, dissociative identity disorder, severe migraine, ADHD, Tourette's, and probably other things too.

What does it mean to say that your friend "has bipolar disorder?" It means that someone shows a range of behaviors that are subjectively similar to others observed by the psychiatrist(s) that diagnosed your friend. Reducing it to a label is exactly what I take exception to, because it suggests that a unique person with unique behaviors is part of some sort of nebulous "group." If you believe that it is a complex issue, then you should surely object to saying "my friend is depressed" and hoping that will explain to me exactly what you think of your friend.

When my friend had a major depressive episode last year, she wasn't staying in bed, not doing schoolwork or seeing people because she was exercising her liberty. She was ill, and needed medical attention. Telling her to just "get over it" would have been one of the worst things you could have done.

In that situation you were probably right to urge your friend to seek treatment from a therapist, if that's what you did. As I said above, I'm not saying that these behavioral issues are not real. If when you say "she was ill" you mean that she needed treatment in the same way that someone suffering from a heart attack needs treatment, I would object to that. You wanted this person to alter their behavior because you thought her behavior was not good.

And, actually, you CAN cure some of these things. For instance, watch this TED talk: http://www.ted.com/talks/sherwin_nuland ... erapy.html

How can you possibly say this guy wasn't ill at the time he describes? And wouldn't you say he's more or less been treated successfully?

Granted, it's very rare that you're cured of a lot of these things. Personality disorders are considered entirely untreatable. But that's also the case of a lot of chronic diseases.

Again, I'm not saying you cannot successfully alter someone's behavioral patterns. You surely can, as the fact that psychiatrists still get paid is a testament to (although they are so inefficient at this form of treatment, for most "mental illnesses," that it is a wonder more people don't question their methods). But then describe it as it is -- you are using a coercive treatment in an attempt to change someone's behavior. You haven't "cured" anything because there was no "illness." There was just behavior that you thought was inappropriate.

[InkL0sed]

They are disorders because there is some sort of mechanism in the brain that isn't functioning the way they should.

It isn't a personality quirk. It is a dysfunction. It impairs people's ability to operate normally. Maybe it won't kill them directly, but neither will other chronic diseases necessarily directly kill the sufferer if mistreated. Then again, maybe diabetes will kill the diabetic. And maybe depression will cause a person to commit suicide.

If someone had malfunctioning kidneys that caused them to urinate extremely often, you wouldn't call it a "different behavior" just because it caused them to run to the bathroom all the time, or be terrified of going outside because they could never be sure a bathroom will be nearby. You'd call that an illness, and treat it if you could.

You're still trying to reduce a complex issue by saying "it isn't an illness." Just repeating "it isn't an illness, it's just a behavior" isn't effective. So far, you haven't given me any reason to brush off your opinion as not only being just an opinion, but factually incorrect.