Mental illness

A mental illness is a disorder of the brain that results in a disruption in a person's thinking, feeling, moods, and ability to relate to others. Mental illness is distinct from the legal concepts of sanity and insanity.

Mental health, mental hygiene, behavioral health, and mental wellness are all terms used to describe the state or absence of mental illness.

Most psychologists attribute mental illness to organic/neurochemical causes that can be treated with psychiatric medication, psychotherapy, lifestyle adjustments and other supportive measures; however, many of the causes of mental illness are still unknown. The battle between "nature" and "nurture" goes on as it has for years. Neuroscience and genetics are still unable to fully explain the effects of genetic inheritance and developmental environment.

Advocacy organizations have been trying to change the common perception of psychiatric disorders, which are frequently seen as signs of personal weakness and something to be ashamed of. Advocacy organizations instead liken psychiatric disorders to physical diseases like the measles.

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:

More effective diagnosis and better characterization of mental illness, due to over a century of research in a new field of science and academia;
A highly increased incidence of mental illness, due to some causative agent such as diet or the ever-increasing stress of everyday life
An over-medicalisation of human thought processes, and an increasing tendency on the part of mental health experts to label individual "quirks and foibles" as illness.
Increasing politicization of the DSM, perhaps due in part to the Peter principle, which may allow decision-makers with more discriminating, compartmentailizing thought processes to dominate the higher ranks of the medical establishment.

Controversy over its nature

The subject is profoundly controversial. For example, homosexuality was once considered such an "illness" (see DSM-II), and this perception varies with cultural bias and theory of conduct.

Neurochemical studies have proven that there are systemic lacks of certain neurotransmitters in the brains of certain individuals. Also, some structural differences between brains of people with behavioral differences can be detected in brain scans. Some mental illnesses tend to run in families, and there have also been strongly suggestive, but not conclusive, links between certain genes and particular mental disorders. Routine tests for these conditions are, however, not generally required for prescription of drugs, and are not always employed in law either.

It is not clear whether these differences in brain chemistry are the cause or the result of mental disorders. Traumatic life experiences may exceed an individual's coping ability and 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 may ultimately restore so-termed "healthy" brain chemistry.

Drug therapies for severe mental illnesses such as bipolar disorder and clinical depression, which are consistent with biochemical models, have been remarkably effective, and there are reports of increasingly effective treatments for schizophrenia. Some argue that drugs merely mask the symptoms of mental suffering by physically crippling the brain's emotional response system. Studies have shown that many patients' symptoms return once drug treatment is ceased. Others reply that many physical conditions, such as diabetes, must also be controlled with use of medications for an indefinite period of time.

It is important to note that the existence of mental illness and the legitimacy of the psychiatric profession are not universally accepted. Some professionals, notably Doctor Thomas Szasz, Professor Emeritus of Psychiatry at Syracuse, are profoundly opposed to the practice of labelling "mental illness" as such. 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, or else suggests that all human experience has a biological origin and so no pattern of behavior can be classified as an illness per se.

Other arguments against psychiatry include controversial treatments, such as Electroconvulsive therapy, or the practice of placing patients in a mental institution with other mentally ill people. This does much to increase the emotional stress levels of the patient by influence of the other patients, causing the mental illness to worsen.

See the topics anti-psychiatry and causes of mental illness for a fuller treatment of these topics.

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. 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. 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.'

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

Strictly speaking, there is no cure for 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 at its base behavioral illness, most mentally ill patients also benefit from psychotherapy, either from a psychiatrist or some other qualified clinician, like a social worker 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 or vocational program to help move them towards a more productive and independent role in the community.

In art and literature

Books

One Flew Over The Cuckoo's Nest by Ken Kesey
The Catcher in the Rye by J. D. Salinger

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 Steadman and his collegues 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 in both groups.