The boundaries of mental illness

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Isn’t everyone a little mentally ill? This seems to be the prevailing idea on my FB feed via memes. One of these memes says, ” relax…we’re all crazy, its not a competition”. When I see this I feel annoyed but at the same time I wonder is there a clear boundary between normal and abnormal? As someone who has experienced psychotic depression, OCD and Dysthymia I’m annoyed because that large of a spectrum invalidates my difficulty to a large degree. I think these people mean well because they are trying to include me as normal but on the other hand  saying that I don’t have much to complain about. Continue reading “The boundaries of mental illness”

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Distinguishing low mood from major depression

 

I think there is still much confusion between depression(normal mood) and major depression and so I thought I would share my thoughts on how I distinguish one from the other. How I distinguish normal moods from major depression:copy-download.jpg

  • Normal moods usually last a fairly short time and are less severe– often less than a day. Major depression is a moderate to severe depressed mood for at minimum two weeks. Moderate to severe often means thinking about suicide quite a bit.
  • With a normal mood one can often tie it to something that has happened or a given thought
  •  The mood within major depression is often connected to the circadian rhythms. Often people feel worse in the morning(often suicidal) and their mood improves in the evening
  • Distraction will often work with normal moods but not with major depression
  • The depressed mood in major depression is often accompanied with severe fatigue(bedridden), lack of motivation, disrupted appetite, lack of pleasure, cognitive problems, and excessive sleepiness/insomnia
  • Major depression affects your ability to function on a basic level. Good hygiene seems optional for people who normal have good hygiene

Antipsychiatrists who could be referred to as “lumpers” don’t make the above distinctions. They believe everyone experiences depression which is true but not everyone experiences moderate to severe depression that lasts more than two weeks and is accompanied by other symptoms. They also argue that the criteria that distinguish major depression are arbitrary which is also true but many distinctions in life are to a degree arbitrary and yet are still respected. I , a “splitter”, sometimes wish that they would come up with a new name for major depression so it wouldn’t constantly be confused with a normal low mood.

My arguments against antipsychiatry

My experience deviates from the experience of the depressed and psychotic people in Anatomy of an Epidemic. I would argue against Robert Whitaker (antipsychiatrists) by making the following points:

  • Robert Whitaker said that depression used to be thought of as cyclic and a limiting illness. My experience is that it is moreBobWhitaker chronic and that chronicity wasn’t due to medications . My depression was chronic for about eleven years prior to taking any medication. They don’t acknowledge atypical depression which is more chronic and less severe.
  • Whitaker believes that medication causes a more severe type of illness. This isn’t the case with me. The way depression expresses itself has changed over the years but I would necessarily say that medications made it more severe. Depression tends to be more atypical in younger people and more typical in older individuals.
  • Whitaker believes that psychosis is a fairly limited condition and consequently can be dealt with without medication. I experienced psychosis about four years ago and didn’t take medication until about a year ago. The psychotic episode didn’t seem to be resolving on it’s own.
  • Whitaker believes that most mental illness is resolved by time and alternative medicine such as diet, exercise and psychotherapy. Prior to experimenting with antidepressants and antipsychotics I tried quite a few natural therapies without much luck.
  • He believes that mental illness isn’t real, much like Thomas Szasz, due to a lack of pathology. There isn’t any test that doctors can run to diagnose someone as “mentally ill”. While this is true migraines don’t have any particular pathology either and yet are accepted as quite real. Why do antipsychiatrists assume that scientists know everything there is to know regarding mental illness. Antipsychiatrists seem to exist just in the present.
  • In many of his comparisons of nonmedicated vs medicated patients he never seems to discuss why the nonmedicated patients were nonmedicated. Did they possibly have a more limited illness or a less severe one?
  • Whitaker believes that medication interferes with people taking responsibility for their “illness”. Why is there a need to blame the patient with mental illness. Whitaker would like to take us back to the middle ages where mental illness was seen in the context of religion. It was seen primarily as a moral failing and not a physical one.

I agree with Whitaker that antidepressants aren’t particularly effective and many people are diagnosed incorrectly however there is still much that I don’t agree with him on.

Anatomy of an Epidemic

 

In this astonishing and startling book, award-winning science and history writer Robert Whitaker investigates a medical mystery: Why has the number of disabled mentally ill in the United States tripledover the past two decades? Every day, 1,100 adults and children are added to the government disability rolls because they have become newly disabled by mental illness, with this epidemic spreading most rapidly among our nation’s children. What is going on?

I recently finished Anatomy of an Epidemic. The author,Robert Whitaker, seems to believe the pharmaceutical companies scamdownload (6) the public with regard to psychotropic medicines. He thinks  that many drugs are either ineffective or produce numerous side effects. Although many are effective in the short run a large percentage of people appear to do worse over a long period on some of these drugs. Illnesses that used to be cyclic and limited are now more chronic.

One thing that I noticed though was that Whitaker never seemed to specify the degree of illness throughout his many comparisons of people who were medicated vs. those non medicated over a long period of time. It occurred to me that many of the non medicated people could have had either a less severe illness or a more limited one.

Another point that Whitaker tried to make is that the epidemic was due mainly to psychotropics. Someone pointed out though that there are  more people  than ever on blood pressure medications. Did the blood pressure medications cause this epidemic of blood pressure?

A third criticism of the reviewers on amazon was that Whitaker cherry picked his studies and consequently didn’t do a thorough review of the studies. It is hard to know if this is true since most people aren’t inclined to do an extensive review similar to his or even look at the many studies he referenced.

After doing a brief search for critics of Anatomy of an Epidemic, I found three links that were fairly good. One was by Dr. Torrey, the second by Jaffe, and the third by Carlat. Generally the criticism was that Whitaker didn’t consider all of the variables that were involved in the studies.