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Mental illness (or '''Emotional disability''' '''Cognitive dysfunction'''[http://bjp.rcpsych.org/cgi/content/abstract/174/6/539 ) is a diagnostic label applied to people whose Thinking and Feeling or Mood may affect their Ability To Relate To Others and/or their ability to work. The definition of mental illness is highly controversial, given that many people experience emotions or cognitions that may be classed as abnormal, yet live productive lives and are not commonly considered "mentally ill". For example, recent studies suggest that occasional auditory and visual hallucinations are not unusual in the general population (as was previously supposed) and are therefore not limited to those labelled schizophrenic. Mental illness is distinct from the legal concepts of Sanity and Insanity . Other terms used to describe aspects of mental illness and Mental Health include behavioral health, mental hygiene, mental wellness and behavioural dysfunction. CAUSES See Also: Causes of psychiatric disorder There are multiple Causes Of Mental Illness . Most mental disorders are proving to be caused by differences in functional brain structure as well as neurochemistry. Chemical imbalances associated with disorders often involve the neurotransmitters Dopamine , Norepinephrine , and Serotonin . Each disorder is likely to have its own Etiology , or causation. Treatment options include Psychiatric Medication , Psychotherapy , lifestyle adjustments, other supportive measures or a combination of these. Sufferers typically seek treatment only when psychiatric symptoms make it very difficult to function, but early treatment - when symptoms are mild or moderate - will generally lead to a better long-term outcome. While many mental disorders now appear to have physiological causes, these cannot yet be used for diagnosis. The diagnostic process is complex and requires the careful skills of a gifted medical detective. Diagnosis remains a subjective - albeit increasingly Evidence-based and scientific - art that includes careful and detailed assessment of Patient Histories and current and past symptoms. Psychiatric disorders vary from one individual to another and may be mild, severe, or anything in between. Even in one person, symptoms can vary over time from their most severe to complete remission and back. The individual or those around the individual may not understand that showing no symptoms does not mean the disorder is gone. These illnesses often are episodic, and "flare-ups" may be triggered by Stress and other factors. If one becomes ill again after a symptom-free period it is not due to a lack of willpower or self-control, but rather the natural waxing and waning of the illness. Appropriate treatment of the disease can help stabilize the course of the illness and reduce or eliminate the waxing and waning of symptoms. Regarding the major psychiatric disorders (e.g. bipolar disorder, schizophrenia, major depression, obsessive-compulsive disorder, ADHD) the Nature Versus Nurture debate has generally been settled. The answer is "both," with a significant emphasis on nature. The major psychiatric disorders all show strong evidence of Heritability . Using identical twins, one or both of whom had mental illness and who were reared apart (to control for environment), psychiatric researchers have shown high rates of heritability (significantly higher than for the population at large) for most mental illnesses, with bipolar disorder showing the highest inheritance and therefore strongest biological component. A small minority of individuals question whether mental illness is "real." This view is promoted by Scientologists and the Anti-psychiatry movement. PREVALENCE AND DIAGNOSIS According to the 2003 report of the U.S. President's New Freedom Commission On Mental Health , major mental illness, including Clinical Depression , Bipolar Disorder , Schizophrenia , and Obsessive-compulsive Disorder , when compared with all other diseases (such as cancer and heart disease), is the most common cause of Disability in the United States. According to National Alliance For The Mentally Ill ( NAMI ), an American advocacy organisation which accepts funding from the pharmaceutical industry, 23% of North American adults will suffer from a clinically diagnosable mental illness in a given year, but less than half of them will suffer symptoms severe enough to disrupt their daily functioning. Approximately 9% to 13% of children under the age of 18 experience serious emotional disturbance with substantial functional impairment; 5% to 9% have serious emotional disturbance with extreme functional impairment due to a mental illness. Many of these young people will recover from their illnesses before reaching adulthood, and go on to lead normal lives uncomplicated by illness. At the start of the 20th Century there were only a dozen recognized mental illnesses. By 1952 there were 192 and the Diagnostic And Statistical Manual Of Mental Disorder, Fourth Edition (DSM-IV) today lists 374. Depending on perspective, this could be seen as the result of one or more of:
CONTROVERSY Psychiatry remains somewhat controversial to some people. For example, over thirty years ago Homosexuality was considered a mental disorder in American psychiatry (see DSM-II ). So some of what psychiatry used to consider disorder or illness was likely the result of Cultural Norms Or Bias and this perception varies over time and place. Contemporary psychiatry, however, is guided by Evidence-based Medicine . Thus, it has becoming much more scientific and much less speculative than it once was. As mentioned above, neurochemical studies have revealed abnormalities in Neurotransmitter functioning among individuals with certain psychiatric diagnoses. Also, structural or neuroanatomical differences among brains of people with schizophrenia have been detected via Neuroimaging . Mental illness tends to run in families, and there have also been strongly suggestive, but not conclusive, links between certain Gene s and particular mental disorders. Some behaviors which are considered normal-variant, such as Homosexuality and Giftedness , are likely to have a neurobiological and genetic basis as well. Traumatic life experiences that exceed an individual's coping ability and may result in lasting changes in brain chemistry. Patterns of learned behavior can also alter brain chemistry, for better or for worse. Cognitive Behavior Therapy focuses on changing patterns of thinking through learning, which relieve anxiety disorders, depressive disorders and to some extent bipolar disorders (accompanied by medication). Drug therapies for severe mental illnesses such as Schizophrenia , Bipolar Disorder and Clinical Depression , consistent with biochemical models, are remarkably effective. Some argue that drugs mask symptoms of mental suffering by crippling the brain's emotional response system. An example of the latter being that an anti-psychotic medication may make it more difficult for the patient to think or feel at all, or a person may seem outwardly fine but inwardly be deeply depressed and unable to show it in their face or general demeanour. On the other hand, people with these illnesses who receive good treatment understand the difference between being over-medicated and optimally-treated. Psychiatrists who "cripple" their patient's brain response system are actually over-medicating their patients; and patients who allow themselves to be over-medicated aren't discussing the problem with their psychiatrist. Others argue that the effectiveness of drugs does not imply that their use is safe or desirable. However, discussion with one's doctor of a certain drugs safety/side effects profile and intended effect on one's symptoms and disorder is one adaptive alternative to not using medications altogether. Psychiatrists make the analogy that many physical conditions, such as diabetes, must also be controlled with use of medications throughout the individuals lifetime. Moreover, in mental illness, studies show that patients' symptoms return once drug treatment is stopped. It is important to note that the existence of mental illness and the legitimacy of the psychiatric profession have not been universally accepted by some individuals and groups, although this view is changing rapidly. Some professionals, notably Thomas Szasz , Professor Emeritus of Psychiatry at Syracuse, are profoundly opposed to the practice of applying the label "mental illness." Szasz argueably took this view too far. In 1986 Dr. Szasz was found guilty of medical malpractice when he told one of his patients with bipolar disorder to go off of his mood stabilizers because Szasz believed the man didn't have a mental illness. The man subsequently hanged himself in his garage; Szasz lost his license to practice medicine. The Anti-psychiatry movement often refers to what it considers to be the "myth of mental illness" and argues against a biological origin for mental disorders, pointing out that the differences in levels of neurotransmitter, or even in size of brain structures, cannot be taken as indications of illness. Or else it suggests that all human experience has a biological origin and so no pattern of behavior can be classified as an ''illness'' per se. This is an interesting philosophical viewpoint, but for many individuals suffering the realities of major depression, bipolar disorder, schizophrenia and other illnesses, it remains only philosophy. Against this must be set the fact that a disproportionate number of famous writers, artists, inventors and politicians as said to have experienced the mood swings characteristic of bipolar disorder, suggesting that genetic susceptibility may be at the root of the matter, and that some with increased susceptibilities find themselves unable to cope with the pressures of civilised life, while others get labelled as 'geniuses' or eccentrics. Other arguments against psychiatry include the view that Electroconvulsive Therapy damages the person. This view, however, is no longer controversial and can be life-saving in many circumstances. Long-term institutionalization, for mental illness no longer exists, but hospitalization for acute psychiatric illness still does. Hospitalization is usually very short (some would argue too short to effectively stabilize the patient) due to the realities imposed by Managed Care . Some people currently diagnosed with autism are against the notion of a psychiatric disorder. For example, some Autistic individuals have organized and formed the Autistic Rights Movement . They claim that autism is a form of Neurodiversity . We are all neurodiverse. That is why we have different personalities, strengths and talents. Untreated mental disorders can get in the way of our expressing our Signature Strengths . CATEGORIZATION In the United States, mental illnesses have been categorized into groups according to their common symptoms in the Diagnostic And Statistical Manual Of Mental Disorders , compiled by the American Psychiatric Association . One important caveat is that all the DSMs have shortcomings. Very often consumer groups or clincal researchers have different criteria for their diagnosis of a disorder. The DSM V due out in 2011 will hopefully address these differences. There are thirteen different categories, some containing a myriad of illnesses and others only a few. Selecting any of the Wikipedia categories in the table will allow you access to all the articles and subcategories in that category. Many organizations do not view mental retardation as a mental illness. The Mental Health Association of Southeastern Pennsylvania states: 'Mental illness and mental retardation are not the same thing. Some people are born with mental retardation, a condition characterized by below-average intelligence throughout one's life. Mental illness, however, can affect anyone at any time. In fact, certain mental illnesses are more common among people with high intelligence and creativity.' However, people with developmental disabilities, such as mental retardation, are more likely to experience mental illness than those in the general community [http://www.intellectualdisability.info/mental_phys_health/classification_ac.html]. ''Italic text'' SYMPTOMS In addition to the categorized illnesses, there are many well-defined symptoms of mental illness, such as Paranoia , that are not regarded as illnesses in themselves, but only as indicators of one of the illnesses belonging to one of the classes listed above. Crime is not a symptom of mental illness; however, movies often portray murderers as being mentally ill. This makes a villain more emotional, interesting, and dramatic. In truth, mentally disturbed people commit fewer crimes than the elderly. TREATMENT Medicine has been unable to cure mental illness. Many conditions, like Schizophrenia , Bipolar Disorder , and Depression , can be treated with Medication , however. The function of the Psychiatrist is in administering, monitoring, and managing the prescription of these medications and their effects on the patient. Loosely speaking, there is a cure for some mental conditions in the same sense that there is a cure for Cancer . That is, if a person has a mental illness, it can be treated until the symptoms disappear. The chances of the symptoms recurring will be affected by the number of episodes the patient has had in the past, the effectiveness of the treatment, as well as external factors. If the patient's symptoms never recur, he is said to be 'cured'. If they recur, it is the same concept as a cancer patient coming out of remission, i.e. the patient never was cured in the first place. Since mental illness is a physical illness manifesting through, and exacerbated by behavior, most people with mental illness also benefit from Psychotherapy , either from a psychiatrist or some other qualified Clinician , like a Social Work er or Psychologist . The most basic treatment involves identifying maladaptive, self-destructive, or inappropriate behaviors and finding ways, with the patient, of coping with, eliminating, or altering those behaviors to promote overall Mental Health . Often individuals with serious mental illness will engage in several different treatment modalities, all with specific goals. For example, a patient with chronic Schizophrenia may be involved in treatment with a psychiatrist for medication, and he or she may also be engaged in psychotherapy to help manage their life-long condition, as well being engaged in case management (sometimes referred to as "service coordination") or a Day Treatment , Vocational , or Psychosocial Rehabilitation program to help move them towards a more productive and independent role in the community. PATIENT ADVOCACY Patient advocacy organizations have been helpful in changing the Stereotype of psychiatric illness. These stereotypes are typically made by individuals or groups who know little or nothing about psychiatric illness and mistakenly believe that these illnesses reflects a lack of willpower by the individual. It is important to emphasize that these illnesses are not a sign of personal weakness. In fact, the truth is that most psychiatric patients have endured more pain than those that do not have these illnesses will ever experience. A case could be made that these individuals are in fact quite strong, even when compromised by symptoms. Moreover, most individuals would like to be productive and high-functioning. Thus, patient advocacy organizations try to reverse the stereotype problem by educating the public, fighting stigma, supporting local, state and national legislation that is helpful to individuals with psychiatric disorders, encouraging those with illnesses to seek treatment and to instill hope in those afflicted so that they can continue on the path toward recovery, wellness and a fulfilling and meaningful life. IN ART AND LITERATURE Books
Motion Pictures Many motion pictures portray mental illness in inaccurate ways leading to misunderstanding and heightened Stigma . Some movies, however, are lauded for dispelling stereotypes and providing insight into mental illness. In a study by George Gerbner, it was determined that 5 percent of 'normal' television characters are murderers while 20% of 'mentally ill' characters are murderers. 40% of normal characters are violent while 70% of mentally ill characters are violent. Contrary to what is portrayed in films and television, Henry J. Steadman, Ph.D. and his colleagues at Policy Research Associates found that, overall, former mental patients did not have a higher rate of violence than their control group of people who were not formal mental health patients. In both groups, however, substance abuse was linked to a higher rate of violence. (Hockenbury and Hockenbury 2004 ) See List Of Films Featuring Mental Illness . SEE ALSO
WikiBooks EXTERNAL LINKS Government sites
History and professional specialties
Media coverage
Compiled mental health news and resources
Online support groups
Stories of Recovery from Mental Illness
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