Posted by laima on March 2, 2007, at 13:57:48
In reply to Re: Diagnoses, interesting and otherwise, posted by Meri-Tuuli on March 2, 2007, at 9:32:01
I still think there is a legitimate argument to be made for one being able to FUNCTION in a normal, culturally appropriate way. But some matters of what it means to be able to function are absoluetly basic to any human, anywhere, anytime.Ie, being unable to get out of bed because of wanting to die is not ok, no matter how many people feel it. Being unable to utter a coherent sentenece or to think at all, causing serious harm to self or others, having constant and severe hallucinations and attacks of paranoia without trigger is not functional, not normal. Being unable to eat, despite food being available, starving oneself to death due to eating disorder, believing self to be fat at 50 pounds is not functional or normal. Having a fetish or compulsion to murder others is not functional, not normal. Having a manic episode which causes one to impulsively and over-optimistically spend their life savings overnight gambeling, etc, is not functional, not normal.
This has nothing at all to do with insisting everyone be the same- note how it's a good thing "gay" was finally recognized to NOT be a disfunction, or a disorder, in and of itself. Gay people do not need to be made straight, do not need any "improvement" or "cure" for being gay, despite the feelings of some conformative extremists.
I am not a fan of certain politicians or political persuasions, but as much as I dislike them, or think their ideas are folly, even dangerous- I can't consider them mentally ill, because they are technically functioning well, as themselves, with each other, and as much as I hate to say it, in general per the norms of society, too. (Ie, in theory they follow the electoral procedures, participate in organizations, other rules; at least don't rant or hallucinate...) I just disagree with their values and/or methods. Yet can recognize that they are coherent, can reason, are highly functioning, etc. Their brains scans likely look just like any others. (Well, there may be some borderline cases and exceptions...)
I am not a fan of certain religious groups, but for the most of them, there is no way they can be considered ill, as strange or unpleasant as I judge them to be- because they are able to function well-as themselves and in society.
Levels of intelligence, wealth, poverty, race, gender, marital status--all thankfully now are not considered illnesses or reasons to consider a person as "less". I guess some of this is murky-meaning in particular: cases of intelligence so low that functioning is impaired. Yes, wealth could stand to be equalized, but poor people are not "mentally ill" despite not fitting societal ideals- and that race, gender, or marital statuses are not considered by intelligent people to not be illnesses or reasons to disqualify anyone's credibility are so obvious today no further comment need be made.
No reasonable person today will consider members of the wackiest seeming subcultures to be ill, if they can function and speak and think coherently and without major delusions or hallucinations, etc.
Artists are no longer suspect societal devients.
Single independent women in Europe used to be suspected as witches once, when religion, rather than any sort of recognition of psychology, let alone psychiatry, was used in judgement of "normalcy".
Yet even hundreds of years ago in that era, interesting that a person who walked around uttering gibberish and talking to inanimate objects was considered abnormal, unwell- though maybe said to be possed by demons rather than suffering from psychosis.
I am not going to go through my closets looking for my undergraduate anthropology and abnormal psych notebooks, but can assure you of vividly remembering professional PHD anthropologists and PHD Psycholgy professors explaining to the occasional undergrad that manifestations of "mental illness", as conditions of being "not ok", "not normal"- have occured in wildly varied societies. The New Age story of how "schizophrenics" were revered as shamans with "visions" in "tribal societies" is utter unsubstanciated nonsense.
Do you see what I mean? Some frowned upon behaviors and conditions are culturally determined, others are biological problems, cross-culturally recognized as problems- whether the explanaition be demons or biology--others remain murky.
Sure- ADD/ADHD is one of the controversial categories- but you can't tell someone whose distractions and spaciness and impulsiveness are severe enough that they cause their relationships to be damaged, cause them to be unable to hold a job, or complete simple tasks, etc that they don't have a problem. And this can lead to severe depression and sense of personal failure. If I am not mistaken, brain scans do show some sort of difference, just as brain scans of depressed people do. There seems to be a dopamine association, or an "executive function" disfunction. Of course, other possibilities, ie, too much sugar, need to be ruled out. One can argue for behavioral interventions, and that can help--of course, some claim even severe depression and anxiety can be completely 100% taken care of with behavior modifications and "attitude changes".
And I think we both know that's not quite the case?
I've had an ADD inattentive problem my whole life, and it causes problems even when I do not have to sit still at any desk job. I still have to be able to organize my day, my finances, remember to do what I need to do, answer phone calls, not lose stuff or forget things on the bus, finish tasks without getting sidetracked by new ones, not to spoil conversations because I was thinking about something else while someone was talking, perhaps distracted by something across the room and just blurt out a comment. I have to be able to concentrate no matter what I am doing, without being distracted by the noises outside, wondering if I remembered everything I need to do, etc. It's hard to feel engaged without being able to pay attention well, which makes flow states kinda tough to achieve. I've felt pretty darn incompetent and get depressed from this kind of thing, and am grateful for medication that has made a world of difference. Therapy helped- to only a point. Oh sure- creativity is a great side of this- but medication doesn't dim it- it helps me actually follow through with my ideas.
Finally, you wrote:
" If the whole world were populated by depressives, then the 'normal' ones would get treated!" Um, what about in places like Iraq? That's not the whole world, and I haven't been there, but I will go out on a limb to speculate that a whole lotta people there are suffering from severe anxiety, depression, despair, fear, anger--if that turns out to be most of the population- should they just be considered "normal", you know, "normal for an Iraqi- no need to treat"?Yes, I see and agree with the legitimate concern of how "abnormal" or "ill" is defined and who gets to do it, and understand that cultural and societal values seep in. But that doesn't negate the fact that there are legitimate and undisputable mental illnesses, with biological basises or markers (which we still know so little about). I really think being able to function as a human being is one good key way to start sorting it out, while also keeping an eye on how behavioral choices may or may not be contributing to the disfunction. Researchers are pretty active looking for accurate biological markers.
The field of psychiatry is still a bit of a murky mess, so many factors to consider. So little known about the brain. But the plus side of attempting to codify what is normal or not normal medically in an evolving document like dsm is...to codify. Hope fully to help codify appropriate treatments... What's the alternative?
> Hey, well I'm with declan on this one- its like whos to say we're the ones who are ill/abnormal? If the whole world were populated by depressives, then the 'normal' ones would get treated! Like ADHD - I think some people are just like that, whos the say that they are 'abnormal' etc etc? Why do you have to force eveyone to become the same? Just because (for instance) ADHDers are the minority, doesn't mean they're ill. Its just society isn't set up to ADHDers reality, so they're forced to sit and concentrate etc. You know what I'm saying?
poster:laima
thread:737261
URL: http://www.dr-bob.org/babble/20070302/msgs/737697.html