Saturday, 26 February 2011

Recent thinking on Mental Illness

Recent thinking among the boffins in mental health circles is running along the lines of everyone being mentally ill. What they are suggesting now is that we are all a potential car crash waiting to happen with regard to becoming ill. All it would take is a trigger to start it all off. Or to put it another way, apparently we're all crazy, it's just a question of degrees.

Gone are the days whereby it's a simple case of nature versus nurture. The thinking is that, as genetics and environmental influences can never be separated both can be the foundation stones for someone becoming ill, but neither on it's own may trigger it. They are just two of a myriad of factors that have to be in place in the right order to act as the catalysts to illness.

This is born out by the evidence of many case studies. Mental illness may run in your family, but rather like diabetes it can skip generations so even when there is a strong genetic element it is not a fait accompli that you or your children will ever get ill. If you've been brought up with a family member who has a permanent condition of mental illness it is more likely that your own behaviour will be shaped by those experiences to make it more likely for you to suffer illness yourself.

A person from different genetic stock  with no evidence of mental illness suddenly having to live with a severe form of mental illness in a loved one is likely to experience bouts of stress, anxiety and depression, so it's become unwise just to assume that genetics are the only factor in play when people are blood relatives.

Likewise, environment or circumstances into which we are born do not in themselves mean that we will become ill. Some people brought up in a disturbed setting can follow suit but many don't. In short there is no one answer and no one way to predict who will become ill and who won't.

Everyday potential for illness
If we have a passion or interest in anything at all, some boffins now say, then we are probably suffering from some form of Obsessive Compulsive Disorder (OCD). This includes passion for our jobs; our hobbies like sport such as keep fit, football, working out at a gym, walking, cycling etc; creative activities like art, theatre and music and even everyday interests like shopping. So long as those passions and interests remain containable we are considered well. It is when they become all consuming to the point of interfering with our ability to function in other things that adverse effects may occur.

Added to which, as human beings we are all prone to every day stresses, worries and anxieties. We might have concerns about our jobs, our health, our finances, our homes or our relationships which are all perfectly 'normal', or average. However no one can predict what events might transpire to exacerbate normal stresses, worries and anxieties into some form of illness. For example, we can not assume any of us will not experience redundancy, a house fire or becoming a victim of crime.

Given this, suddenly we come to realize that there is no such thing as immunity from mental illness and that it really does come down to a bit of a lottery as to who becomes ill and what may trigger it. You may be a person that can cope with losing a job, but are one who is more susceptible to becoming mentally ill over the breakup or loss of a loved one. Hence we can look at the statistics in a slightly different way and say that 25% of the population become mentally ill because they were unlucky in the events and circumstances that came their way and that 75% of the demographic were lucky because nothing that could have triggered illness happened during the course of their lives.

However bereavement is, in my opinion, a form of depression and as none of us are immune from losing a loved one, (indeed we except our parents to predecease us), we can and should expect to be pretty miserable at such a loss at some point. In that period of adjustment known as bereavement it would be unusual for people to feel like doing cartwheels and throwing a party and to continue their interests in normal life in the same way.  Even people who experience relief over an aggressor dying can experience symptoms of bereavement including guilt and shame over their relief.

80% of us can expect to experience bereavement at some point in our lives (not everyone will) and that state is a painful and distressing one often to the point of making us introspective and miserable. A mind that is distressed and/or miserable for more than a couple of weeks is considered to be a depressed one and therefore can be considered to be ill. In the light of this the stats should read that 80% will experience mental illness in some form.

It is also common for people to experience a sense of loss akin to many symptoms of bereavement when they lose partners through divorce, or lose their jobs or home. Depression is classified as a form of mental illness and one of the most common at that. Along with stress and anxiety millions of people each year go to their doctors for help with it. How is it then that stigma over mental illness still exists?

In correspondence with a psychologist in Australia I was shocked and appalled to learn that in third world countries people do not become psychotic from being left on their own while dealing with a bereavement, because in third world countries retain their sense of community and care for each other at such times. I don't know if the statement is true or not, but to me even the thought that it might be constitutes a damming indictment on the entire developed world.

The challenge has to be to eradicate the stigma to increase the chances of people feeling OK about seeking help when they need it. The stigma alone can prevent people seeking help and result in the problems escalating in their severity and becoming long-term. That said the statistics show that people rarely have more than one episode of serious illness in their lives. I wonder how many remain ill because recovery can be incomplete or prevented due to the stigma.

By being supportive of those around us, by allowing them to talk, by encouraging them to go for help early I vehemently believe we can jointly make significant inroads into reducing the severity and longevity of many forms of mental illness. To that end I feel we need to encourage people to get informed and no longer be ignorant about the subject, to deal in facts and not in assumptions because even a staunchly prejudiced person may find they could be the next person to become ill.

I don't advocate going on a crusade and turning into a raison d'etre (reason for being), but I do suggest that we become more aware and correct people in their assumptions as and when it's appropriate and when there are openings. After all there is a sharp difference between being dedicated and being obsessive. Obviously this blog is concerned with the subject, elsewhere I do other things and I recommend you do the same.


  1. I know what you are saying here. However, I can see both sides of the argument. You see I agree with the boffins. Everyone can be obsessive or compulsive at times. But not every when they this becomes disordered to the person it becomes OCD. Truly, the word disorder is the defining word in the diagnosis. Everyone has mood fluctuations somewhat on average. Bipolarity at its minimal frequency if you can imagine. You see what I mean? Same with anxiety, personality. Nature and nurture still correlate and are certainly do contribute to well-being. But, that's the difference. The word "Disorder". Not everyone has a mental illness. Any medic that expresses otherwise this is incorrect. The derogatory term "Mental illness" should be dropped. I there are many a genius with a mental illness. Mental skillness. Anyway, the plot, yes. Lost it haven't I? I keep runner ducks in my garden you know, they produce very tasty eggs.

  2. I think all terms need a serious overhaul when it comes to mental illness. I'm in favour of looking on at things from an entirely different prespective that of Mental Wealth. And am in the process of drafting a book entitled "The Quest for Mental Wealth". Hoping no one will pinch the title, but if they do there's no stopping me doing my own version. This blogsite is rapidly turning into my notepad for it's content and research.

  3. You know what? I did an article on such a thing myself. I wrote for Mental health practice can't remember the issue but I could e-mail a photo of it to you.

  4. I am planning on doing some recovery/anti stigma work soon. Promotion of service user led health services and occupational stuff.

    I could imagine you doing well in something like that.
    Seriously, you are a fountain of knowledge.

  5. Bless you for that, but my view is we are all fountains or certainly all have the potential for being one... see previous blog!


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