Tuesday, May 17, 2011

Stigmatizing the Human Mind

In the last 100 years of Psychiatric and Neurological Medicine, an amazing amount of discoveries and theories have been made, and a greater understanding of how the brain works has been achieved. More specifically we have learned a great deal about mental illness, how and why certain things go wrong in the brain, and what happens when they do. However, as many people might say, we have moved to the Age of Prozac. As we move away from basing the reason behind the cause of psychological disorders on purely psychological reasons or, in the case of nature vs. nurture, the nurture side of reasoning, we begin to see and over-reliance on medication and the myth that merely taking drugs will cure your "disease." In the field of Psychiatry, the age-old practice of talk-therapy is seeing a drastic decline in favor of psychiatric drugs. With the advent of the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition), what were once simple, normal behaviors, now are serious, psychological disorders, treatable by drugs. While we have made much progress in the world of neurological sciences, to say we have enough evidence to support the idea that the behaviors are actually disorders, and to say that they need be treated, to even say that full-blown, well established disorders such as schizophrenia need be treated, and be treated by drugs at that, is ridiculous. We do not yet have substantial evidence to fortify the idea that these so called mental illnesses are truly detrimental to the society. If anything, we just do not have enough knowledge of what is truly going on, because for every negative there is a positive. The brain is an extremely complex organ and even with everything we know, we still have only scratched the surface of what is truly going on. What are the ethics behind changing a psyche we deem inferior or undesirable through drugs, however messed up we may think it is, and what right do we have to label one behavior as a disorder and one as normal? 

Now, I don't know what your opinions are, but I feel as though everyone at some point in their life has wondered if the behaviors or personalities they exhibit are "normal". I know I have, as well as most of my friends. Even through just my observation, with the help of the knowledge of mental disorders that I contain, most people I am in contact with for extended amounts of time seem to exhibit at least a few traits which could be described as less that desirable or even within the realms of a mild mental disorder. There is a little bit of narcissism, maybe some hyperactivity, over-aggressiveness, or antisocial, and a little bit of paranoia. Of course all the behaviors they exhibit are very low key, in comparison to the full blown   exhibits that would be considered a mental disorder. The point is, though, that there is such a wide spectrum of behaviors and personalities that humans exhibit, that it even as we may deem them undesirable, it would be hard to say that they are not normal. So if they are normal behaviors, even when scaled to be considered a disorder, as professionals would diagnosis, behaviors where "there is personal distress, or adverse impact on the social environment, or both, clearly attributable to the behavior," why do we deem them unsatisfactory? What goal could possibly be achieved by feeding the populations we deem detrimental to society drugs in which to neutralize these characteristics, only to create a mass of emotionless, blank zombies. Or at least a society of perfect look- and act- a-likes. Of course that seems a bit absurd, but thinking logically, it is a pretty well established law that for every negative, there is a positive. And so?

So, it is important to remember that some of the most influential people in our history, some of the most amazing minds of the day, were and are people with some sort of mental disability or disorder. Artists such as John Denver and Vincent Van Gogh, both of whom dealt with depression, or great scientific minds such as Albert Einstein, who was believed to have had Aspergers Syndrome, and John Nash, who was believed to have schizophrenia. And we can't forget the stories we hear of autistic children and adults who, though they have deficits in their ability to interact socially and communicate, often times show superior skills in perception and attention, and sometimes show unusual abilities ranging from splinter skills to the extraordinarily rare, sometimes prodigious talents that would classify them as autistic savants. There is reason to believe, as many do, that it is because of their deficits in one part of their brain, that they are gifted in another. And it would make sense that this applies to the lesser contrasting parts of life as well. We are obviously not 100% percent perfect in everything we do. Just think personally, and you would agree that you have your strengths as well as your weaknesses, yes? This contrast of skills and weakness, of behaviors and personalities is the reason we have such diversity in the mentality of humans. And because it is the strengths that influence the weaknesses and vice-versa, it is hard to believe that if you were to neutralize the weakness, the strength would not as well be neutralized. In the realm of mental disorder, we focus too much on the negative aspects of the condition. We don't focus on trying to utilize and maximize and discover what possible potential could be aroused from these people with high contrasting minds. Instead, we become so focused on the differences of these people to us, so we decide that we need to "cure" them of the horrible disease. We focus on only the negative, we end up making the people who have these "disorders" even worse off. We convince them that they are in fact messed up, and that they do need treatment. We label them and often times become attached to the diagnosis, defining who they are by it. We have created a culture of sickness, were anyone of us could be cursed with these awful, debilitating, mental diseases. Instead of embracing the diversity of the human mind we have stigmatized the very differences that are so characteristic of humans. The DSM declared war on the introverts, and the educationally challenged among others and has attempted to define what a normal human should be, an extroverted individual who works well with people, progresses well in conventional schooling, and will succeed in a conventional job. 

What right does any group of people have to deem one type inferior to another? And not only to label them as less than, but then to convince them that they are in fact diseased and need treatment through drugs to cure their illness. Yes I do agree that in many cases it is the person own decision to get treatment, and this understandable. No one really wants to be depressed or in disarray because of their restless mind. But there is better ways to deal with it then to diagnose them diseased and medicate them. Not as a standard anyways. If someone truly wanted medication, then they should not be denied them, however medication should not be the first choice for each and every patient. Talk therapy and helping the persons through whatever is troubling them and looking for connections in their life that may have caused their problem, in cases of depression and anxiety, as well as helping them understand what positives could possibly have come out of it all. What the strengths that counter their weaknesses are. The psychiatry field and practitioners need to be reminded of the classic bio-psycho-social model, and through talk therapy, come to understand the patient and understand what other factors could be contributing to their troubles. Use this instead of the bio-bio-bio method, where everything revolves around the chemicals of the brain and where medications are the instant answer to resolve these chemical problems, as many in the psychiatry field do in this day and age. 

Of course with all this, I'm not trying to say that once afflicted with a mental disease or disorder, be it behavioral or social or personality-wise, that they should just be stuck with it. In cases such as depression and anxiety, where there could be outside influences and factors (such as a rough childhood, trauma, socio-enviromental factors, etc) it is probably best for the person to seek some sort of help. We just shouldn't treat it like some horrible, hopeless disease. We shouldn't diagnose them, because then they will just obsess over their diagnosis and use it as their self-defining trait. And if it is something more naturally occurring by means of chemicals or neurological make up, like schizophrenia, then instead of trying to mess with the brain, we need to try to learn to best utilize this special mental makeup, as I have said before. We also shouldn't make prescribing drugs the first choice cure for certain things that might truly be caused social or pychological reasons. We still have a lot to learn in the world of neurology and psychiatry, and to mess with the delicate world of the brain is a risky thing. What we think is the cure one day, can suddenly be the source of new problems the next. The human race is amazingly diverse, and our psyches are party the source of so much of this diversity. So have we crossed the line of trying to help someone, to destroying the fabrics of emotion, personality, and behavior? And at that, where do we even draw the line? These are the questions that we will be asking and answering in the years to follow in the fields of psychology, psychiatry, and neuroscience. We have made 100 years of positive progress in these fields, and with all the great minds in the world presently, and all the great thinkers question the way the systems revolving around the study of the human brain and mind, I can only imagine what progress has yet to come.



  1. what a strong statement Lucas. so many poignant points that you make. one of my favs:
    We label them and often times become attached to the diagnosis, defining who they are by it.

    i have learned so much from you this year.
    thank you.

  2. This is insightful and brilliant. I appreciate your ideas and the fair and logical way you present them. I especially agree with how our society often attaches a negative stigma to the idea of mental issues. People with these issues are made to feel like outsiders when, ironically, I feel more and more people now than ever before in our society are experiencing depression, anxiety, and the like in their lives. This is a very significant issue that you have eloquently and poignantly tackled.

  3. I second the notion that you've written an insightful and brilliant post.

    If you get the chance I recommend you read the just published: The Psychopath Test: A Journey Through the Madness Industry

    I found it very helpful to understand the history since the 1970's to help see where we are today.

  4. This post is in great contrast to your previous post. What about these people who don't fit in the organism you envision the world becoming?

    What about the people that don't even fit in their own families because their madness is unmanageable? What if their families have tried and tried to no avail to understand and excuse behavior that ends up controlling perhaps dozens of other individuals in the family? Do these other family members have the right to eventual peace? What if, what if the person with the illness is a parent? What if prescription medication saves a marriage, or the life of a child?

    The thing about psychology is that it is not simple. There are so many facets to a diagnosis. As you say, there are factors in the patient's environment, their upbringing, underlying health problems. The DSM-IV is an attempt to bring order to a naturally disorganized field.

    I would argue that our current medical system and insurance practices have significantly worsened psychological care. Many health-care plans don't even cover talk therapy. If you're self-employed, most likely that will come out of pocket, and only if you're among a very few lucky individuals will you be employed by a company that might provide a limited number of sessions with a psychologist. It's much easier for patients to get pills. It's many times less costly than exacting the change they need in their lives to reduce stress, better their environment, move away from things that remind them of the past, or track down underlying health conditions.

    I certainly hope this all changes before my kids are adults.

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