Redefining “Mental Illness”

Its been quite awhile since I posted and apologies for that. I have been working a lot at a large psychiatric hospital as a creative arts/dance movement therapist digesting experiences and theory in order to make some sort of sense of me, the universe and everything.

In the midst of the coming changes in the Diagnostic and Statistical Manual of Mental Disorders (or DSM, for short), which devotes hundreds of pages to describing and cataloging mental disorders there is an ongoing dialogue as to what exactly is a mental illness. One could, as seen in my other blog posts, use the methodology of the DSM to seemingly catalogue  any behavior ‘outside’ the cultural norm and deem it illness. Of course there are many cases of clarity, of behaviors that one can be confident in declaring, ‘that is mental illness.  You only need to check the homeless shelters in any major city around the world and look for the folks chatting/arguing with their imaginary friends. Well, that is unless you are in a city where the cultural norm is that ancestors may come and chat with you. 

I came across an interesting article from about the changes in thinking about mental illness and its organic origins. A short clip from the article: Redefining “Mental Illness” 

“British psychologist and editor Christian Jarrett answered the question by citing an editorial published in January in Psychological Medicine. The editorial’s writers, led by Dan Stein, argued that a “mental disorder” has five primary factors: It’s a behavior or pattern occurring in an individual, causing clinically significant distress or impairment, reflecting an underlying physical dysfunction, and is not primarily the result of social deviance or conflicts with society. It’s also not just a response to a stressful event like a friend or family member’s death, where it’s normal to expect someone to appear “depressed” or otherwise disturbed for a period of time. Stein’s team is part of the working group for the DSM-V, so clearly their arguments will carry significant weight in forming the new definition.”

If that will be the new definition than it suggests that all bases of mental illness are organic in nature, which is more or less the current theory in treatment using pharmacological intervention. Another factor in all this is, as I recently learned from another article is  that genes can be “turned on and off” by how we interact with our environment.

A short clip from the BBC News Magazine  article: Is there a genius in all of us?

“They now know that genes interact with their surroundings, getting turned on and off all the time. In effect, the same genes have different effects depending on who they are talking to.

“There are no genetic factors that can be studied independently of the environment,” says Michael Meaney, a professor at McGill University in Canada. It would be folly to suggest that anyone can literally do or become anything. But the new science tells us that it’s equally foolish to think that mediocrity is built into most of us”

“And there are no environmental factors that function independently of the genome. [A trait] emerges only from the interaction of gene and environment.” This means that everything about us – our personalities, our intelligence, our abilities – are actually determined by the lives we lead. The very notion of “innate” no longer holds together.”

So, I assume that it is possible that a person in a state of say, depression, produce (or not) chemicals in the body which in turn activate/turn off genes which increases the depression to a clinical level. That clinical level of depression can and is typically treated with a pharmacological (medication). The pharmacological reproduces a missing chemical in the body, which the body in turns stops producing altogether, thus continuing the need for the med. However if the body and its genes respond to the environment could one not engage a person in therapeutic treatment, with minimal med intervention and achieve the same result?

The institution where I work used to have patient stays of months and used less medications and had fewer repeat visits from patients; suggesting that long-term therapeutic treatment works. Which is something that e could continue to do … that is if the public/private insurance companies did not demand that psychiatric patients be stabilized and released in a short a time as possible.


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