Mental illness is a result of misery, yet still we stigmatise it

[firemonkey]

It matters how we talk and think about mental health. Get it wrong, and people can end up being misled, or even worse, hurt. Last week the BBC ran a well-intentioned season about mental health that, unfortunately, gave a completely lopsided view of psychiatry.


The headline programme was Stephen Fry***8217;s The Not So Secret Life of the Manic Depressive: 10 Years on. Like many mental health professionals, I have enormous respect for Fry***8217;s openness about his mental health. I also feel a personal sympathy towards him: we were both boarders at Uppingham school, Rutland, in the early 70s (though he has no reason to remember me). Our unhappy experiences there have no doubt helped to shape our pathways since, which have converged many years later on a shared interest in mental health ***8211; in my case as a clinical psychologist and researcher.

The BBC focused on an extreme biological approach to psychiatry, which is contested by many psychologists and psychiatrists. This approach sees psychiatric problems as discrete brain conditions that are largely genetically determined and barely influenced by the slings and arrows of misfortune. According to this view, psychiatric conditions occur largely out of the blue in individuals who are genetically vulnerable, are uncontrollable and lifelong conditions, and the only appropriate response is therefore to find the right medication. This approach is not supported by recent research, which tells a more complex story.


http://www.theguardian.com/commentis...ldhood-traumas

Speaking as someone who has a chronic,severe mental illness(it might be different at a milder level) I think brain chemistry/genetics/psychological/social and environmental factors all have their part to play. The degree to which each plays a part no doubt differs from individual to individual.
Unfortunately while there are still fundamentalists pushing one size fits all answers as to causation and remedy this argument/debate as to biological vs environmental,psychological and social factors will rage on.

My own treatment has been almost exclusively with medication except for a couple of brief therapeutic interventions. These failed because the emphasis was on character judgement and moralising rather than being supportive and helping to overcome problems arising from life experiences.
With regards to medication I have a two tier view. One based on knowledge of others experiences which is more positive, and the other based on my own which is less so.
After 42 years of various forms of medication I have yet to reach what might be called "recovery". However the $64K question is would I have been even worse off without medication? I can not say for certain either way except for a pdoc sanctioned break off medication resulted in having to go back on after just over a year.
I do wonder if there is a difference in terms of the biological and environmental,psychological and social effects between what are labelled as more serious mental illnesses like bipolar,major depression,schizophrenia and some personality disorders vs things like mild depression with anxiety(general and social). That is not to deny that things like social anxiety, especially if severe, can be very disabling.

I do think there is a need for a more holistic approach which takes into account the whole person. A narrow approach confined to textbook psychiatric symptoms has for me resulted in the effects of aspergic/non verbal learning disorder traits on my occupational and social functioning being severely and detrimentally neglected.

[firemonkey]

Any other thoughts?