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My ideas are constantly changing as I learn. Sometimes they even change midway through writing a post.

Tuesday, July 19

More on Mental Illness at Setting The World to Rights

I have replied to a post about Mental Illness.

"Or at any rate, let me try to convince you that serious mental illness implies underlying brain disease, involves peoples choices and is affected by cultural phenomenon in the same way that type 2 diabetes implies the existance of an underlying endocrine disease, but also involves peoples choices and and is affected by cultural involvement." -Michael Golding

That's quite a bold statement (not necessarily untrue, just that it implies that serious mental illness couldn't exist without brain disease). How do you know serious mental illness implies underlying brain disease? Have all know mental illnesses been linked conclusively to brain disease? How do you distinguish a disease from a healthy difference? How is "serious mental illness" defined? Is there some mechanism for differentiating it with "extreme differences from cultural norms"? What if it's the "norm" that is "wrong"? What is the mechanism for addressing this? I suppose as with homesexuality, the medical community can correct mistakes about specific differences that they later realize to be healthy/normal. What about the harm done to healthy people in the meantime? This could be less harm than is done to people who avoid treatment because of the stigma attached to "mental illness". It might be good to drop "mental illness" simply because "brain disease" doesn't have the negative social connotations that mental illness does. (I'm not expecting answers to all of this. I often ask more than anyone, including myself, has time or inclination to answer or think about).

"In my opinion, whether an illness is caused by an interaction with others or not, should not matter if the consequences to the person are a potentially permanent change in physiology which shortens his life and damages his organs.

For example, even if Fred deserves to be punched in the nose, he still may have a crushed maxillary sinus from the punch, and a crushed maxillary sinus is certainly an illness, which should be treated by doctors." -Michael Golding

I agree that medically treatable aspects of the problem should be treated, of course, but what about the matter of the person punching him in the nose? Do we just chalk it up to Fred's nose-punched tendency or try to do something about nose punchers?

"So whether certain types of mental illness are caused by an interaction with other people should not be relevant, if such interaction causes a substantially increased risk for development of an abnormal physiology and if this pathophysiology shortens peoples lives and damages their organs. If obese children now are developing type 2 diabetes which damages their kidneys, if someone is punched in the nose and the damaged maxillary sinus is now prone to infection, or if someone is cruel to someone else and the victim becomes depressed, and this damages their heart; and if all of these are caused by interactions with other people, why is the depression the only one that is not an illness?" -Michael Golding

I think I'd agree if there weren't the problem as I mentioned above where mental differences are diagnosed and treated without a lot of consideration about whether they really are disorders and whether the more important cause and solution might be external. Just because the conditions required to ... "trigger" bipolar disorder haven't been discovered, doesn't mean they don't exist. I would think it would very difficult to isolate or control for all social and ideologically oriented causes as it can be in medicine.

"In short, the software damages the hardware." -Michael Golding

Nice analogy.

"The work of Nemeroff (JAMA) and others, in primates (mildly) experimentally abused as infants, and women abused as children, provides ample scientific evidence of life-long damage to organ systems due to early childhood stress."-Michael Golding

That's very interesting and a bit discouraging.

"With physical symptoms, there's usually some idea of harm they are doing to the person's body." Becky Moon

"Ms. Moon, you may be confusing cause and effect, just a little, in this statement. Physical symptoms don’t (in general) cause harm in a person’s body, they are a consequence of harm." -Michael Golding

Oops, my bad.

" Why is the acute brain shrinkage from a stroke the consequence of a “real” phenomenon, but the acute brain shrinkage from schizophrenia a consequence of a “Superstition”, according to Mr. Alan Forrester. How can a “superstition” shrink a brain?" -Michael Golding

I can't site a study or article for you. I've just assumed from the time it first occurred to me to think about the subject at all that thought affects the chemistry of the brain. I've seen articles that seem to support this. If this is so, then couldn't certain types of thought that contributes to brain shrinking? Is my assumption erroneous? I'm not claiming any knowledge about how brain chemistry is particularly affected. It could be that size isn't much related. I had thought I read something, though, that children (and animals) who were exposed to lots of stimulation had more of some type of brain matter (neurons? or links between neurons?) I don't see how this could be related to brain shrinkage though. A person who was very actively stimulated .. it would seem their brain would increase in size or connections.

Forgive if my lack of brain chemistry knowledge is getting me really far off track here, but I want to go off on a bit of some imagining about how thought could affect the brain: Could some bit of knowledge be so upsetting as to make a person "forget" large bits of knowledge as a sort of "self-defense"? It might only "work" for people with a particular genetic flaw or difference, or it could be that most people don't experience anything so upsetting or don't tend to try (or even be able to) forget things they find upsetting or overwhelming. If thoughts can change the brain, then it would be case for some thoughts even possibly harming the brain or causing disease.

"Very perceptive comment, in my view. I agree with you 100%. Homosexuality is not consdered an illness or a disability, nor should it be. -Michael Golding"

Homesexuality was once thought of as a mental illness, though, wasn't it? (Or was that just something lay people thought?) Is this just a mistake that was unavoidable or could changing the way people approach mental issues have avoided this?


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