[D.A. Xue]

The term 'Mental Illness' suggests that the illnesses designated are to be distinguished by the concept of "mental." While the concept of "mental" has many meanings depending on whose expressing it and the circumstances in which it is expressed, the concept is frequently and tacitly used in lay parlance to distinguish such illnesses from the "physical" illnesses. However, my impression -- admittedly resting on anecdote -- is that such a classification not only distinguishes mental from physical illness but also identifies both illnesses as belonging to the same generic class: "illness." That is, there are two types of illness-things: the mental type and the physical type.

Focusing just on the mental-physical distinction, isn't such a distinction misleading and the ontology wrong? Why shouldn't mental illness be considered a kind of physical illness? After all, as members have frequently noted in other discussions, there are strong genetic preconditions for many mental illnesses, and those rogue-genetics lead, in part, to the types of neuro-chemical imbalances that cause the suffering. DNA and neuro-chemistry, however, are physical entities. Similarly, a person may have a genetic predisposition for cancer, M.S. or Parkinsons, but these diseases are also recognized as physical diseases. Why not, therefore, Bipolar, Schizophrenia as well as other "mental" illness? In other words, isn't it wrong to say there are two types of illness-things: the mental ones and the physical ones? Instead, shouldn't we say that there is only one type of illness, and it is physical illness?

To be sure, the current usage(s) of "mental illness" covers many types of disorders with varied causes. An Iraq War veteran may suffer profoundly from PTSD, and war-induced PTSD stems from the environment. (Perhaps "environment" here is best understood as physical? I don't know.) In contrast, other mental illnesses have more obvious physical causes. (Again, DNA and neurochemical imbalances.) So, if the term "mental illness" is to be meaningful at all, then perhaps it is as a term referring to physically caused illnesses whose most damaging effects are on a person's mental life -- but even this definition would be too broad for many users of the term as it would include the pain of numerous, so called, physical diseases. The excruciating pain of cancer, while stemming from physical causes, affects one's "mentality." Pain is an experience, and experience is "mental." I don't know about the rest of you, but excruciating and long-lasting pain certainly impacts my mentality. (Smile)

Am I picking-nits?

In the spirit of full disclosure -- and hopefully I am not breaking the forum's no-agenda rule - I have a scholarly interest in prejudice against persons with mental illness. Many of the prejudices manifest through misplaced blame. That is, all-too-often sufferers are treated as if they are blameworthy for their condition, which in turn leads to dehumanization and alienation from society. Life is just tough. We all have these days. Stop whining. Just get over it and of course the tenets of the anti-Psychiatry movement. The implication of such "advice" and "insight" is that those with mental illness are just weak-willed individuals who need simply to get their bleep together, or in the most extreme cases, there is no such thing as mental illness. However, how many of us would tell a cancer patient to stop whining or that we all have bad days? What such attitudes about mental illness belie is the pre-judgment that the symptoms of mental illness are simply "in the head." (Here in-the-head = fantasy/not-real and physical = real.) So, by asking for member's positions on whether the physical-mental distinction is bogus or tragically careless, the answer to the question has profound relevance to those struggling with mental illness -- to the day to day life of those so afflicted. Please know, though, that if you do argue the mental-physical distinction is legitimate, I am definitely not suggesting you are a mental health bigot. The bigotry I refer to flows from the careless assumptions often aligned with the distinction and not necessarily from the distinction itself. Simply put, I just want to unpack the distinction to see if stands up to critical analysis.

So, is the distinction between mental and physical illness legitimate?

[Turtle]

D.A. Xue, on 08 August 2011 - 09:42 AM, said:

...
So, is the distinction between mental and physical illness legitimate?

i think it's legitimate in the sense that it is utilitarian. if a patient describes pain in an arm then it wouldn't make much sense to immediately send them to a psychologist before doing a physical exam to see if there was a physical cause. likewise it wouldn't make sense to first send a patient complaining of lack of concentration or anxiety to an orthopedist.

the modern idea of mental function having locality is only around 150 years old, and with all the new imaging technology perhaps some new terminology will take hold. i know more than a few people who suffer from depression that when asked about "why" they have it they say the cause is a chemical imbalance. they say that because the doctors told them that and so i think the physical nature of mental illness is receiving recognition within medical practice. (note that i think the "chemical imbalance" line is over-simplified & over-used and often a smoke screen for selling drugs.)

anyway, no matter what name you give a "weakness", and whether it is real or just perceived, some people are going to take advantage of it. mean people suck.

so on to phineas gage. tragedy or happy accident?

phineas gage@wikipedia

wicker pariah said:

Phineas P. Gage (July 9?, 1823 – May 21, 1860)[n 2] was an American railroad construction foreman now remembered for surviving an accident in which a large iron rod was driven completely through his head, damaging much of his brain's left frontal lobe, and for that injury's reported effects on his personality and behavior – effects so profound that friends saw him as "no longer Gage".

Long called "the American Crowbar Case" – once termed "the case which more than all others is calculated to excite our wonder, impair the value of prognosis, and even to subvert our physiological doctrines"[1] – Phineas Gage influenced 19th-century discussion about the brain, particularly debate on cerebral localization,[2] and was perhaps the first case suggesting that damage to specific regions of the brain might affect personality and behavior.

...

[CraigD]

Welcome to hypography, D.A.

D.A. Xue, on 08 August 2011 - 09:42 AM, said:

In the spirit of full disclosure -- and hopefully I am not breaking the forum's no-agenda rule - I have a scholarly interest in prejudice against persons with mental illness.

Our “no agenda” rule here at hypography proscribes only the refusal to discuss your ideas, including any flaws people may perceive in them. Most importantly, you should to the best of your ability support your ideas with objective scientific – in this case, clinical – data.

I, and I think most of my fellow hypographers, agree with your opposition to prejudice against people with mental illness, so will perceive your “agenda” less as an agenda, and more an orthodoxy.

D.A. Xue, on 08 August 2011 - 09:42 AM, said:

So, is the distinction between mental and physical illness legitimate?

Turtle, on 08 August 2011 - 01:29 PM, said:

i think it's legitimate in the sense that it is utilitarian.

Ditto that, and kudos for your spot-on scholarship, Turtle.

All I can add to D.A’s and Turtle’s points are a few of my own of a practical and holistic nature.

I’m a medical information system computer programmer for a very integrated health care delivery enterprise, so while not a clinician, have a long acquaintance with the difficulties of delivering effective mental health care. Sadly, many of these difficulties are financial. Helping people with psychiatric problems, whether via a neurophysiological or traditional “talk theraphy” approach, costs money, money which must come from individuals, companies, and governments. In the interest of saving money, these payers often seek to exclude services they perceive as “luxuries”, of which mental health care is often one. Even if a good health care system can “sell” the idea that mental health care is a necessary part of an effective, integrated whole person health care system, it’s then faced with the challenge of delivering that care effectively on a limited budget. Even if met effectively, we must overcome prejudices against our approaches, which are often seen as “assembly line”, and over-reliant on the prescribing of psychotherapeutic drugs.

I think it’s also important to expand the quest to improve or whole population’s mental health to the public, political domain, as our societies’ laws and traditions affect our sense of happiness, well-being, and self-worth. When diagnosing mental illness, clinicians and patients tend to take the stresses due to our laws and traditions as necessary and unchangeable. I think that, in many cases, mental illness in individuals is a symptom of a disorder of our society, for which the most effective treatment is social change.

[Deepwater6]

I agree with all three of you. I sometimes try and think when watching the history channel about famous people in the past, and if they were mentally ill, just misunderstood, or both. I'm sure down through history many mentally ill people have been put to death by so called "sane" people. I can imagine someone having a mental illness during the Salem witch trials. They would surely be designated as being possessed by the devil. Like many other ideas man doesn't understand, the solution is burn them at the stake.

[Ken]

There is another way to look at the issue.

First differentiate between disorders that can be shown to have a physiological fundation from those that are physiological. There are a large number of behavioral disorders that respond to pharmaceutical treatment, and others that are precipitated by chemical stimulation, rather than call them examples of Mental Disease they should just be called Disease with behavioral symptomology.

Second, there are a number of behavioral disorders that are clearly initiated by (social) environmental factors without any physiological substrate.

Most behavioral Psychologists prefer to define behavior disorders in a functional sense and avoid the use of "Mental Illness" instead talking about Maladaptive Behavior, i.e., behavior that is harmful to the individual or to others. Certainly the situation is fluid. If research indicates that a previously considered environmental (social environment) initiator is found to have a physiological basis then the description can change to medical illness.

The big problem is finding an Operational Definition for "Mental". Strictly speaking it is impossible to directly observe or measure "mental" activity, all that one can see are neurological events that may, or may not, have any relationship to actual cognitive functions. The occurence of neurological activity and behavioral activity may be correlated, but correlation can never establish causal relationships.

[random]

Scientists in Finland have found metabolic abnormalities in schizophrenia.
http://www.scienceda...10405084302.htm

And another study showing brain abnormalities in schizophrenia
http://www.scienceda...10511104519.htm

There are physical brain differences in major depressive disorder.
http://www.scienceda...90505071039.htm
http://www.scienceda...80730140932.htm

And physical deterioration involved in bipolar:
http://www.scienceda...10216083131.htm

(Science daily ROCKS!!! )

[paigetheoracle]

Well the way I see it, the mind affects the body. I have migraines as some people here know and it is kick started, physically, by an emotional reaction - rage. Obviously physical illness disables the body but may allow us clear thought - mental illness disables the mind but not necessarily the body. Depression I think is fairly easily to see as an attitude towards life, where you give up all effort but hallucinatory diseases are like 'fevers,'where you are in conflict with something inside yourself i.e. a bug. Disintegration of the personality is conflict with sub personalities or war within. I posted about this some time back. A dutch psychiatrist or psychotherapist has found that those hearing voices, can be helped through reintegrating these disparate part of themselves back into the whole, like creating dialogue/ a peace treaty, to end wars in the outside world. Another analogy is my body the car. Some people run theirs into the ground, others let it rust and others treat it with respect. All cars eventually die but their treatment decides how long they exist and what goes wrong within them.