Trying to avoid a GD…
Is there a higher rate of mental illness in modern industrialized countries versus developing ones? I know that this is tough to answer because of virtually infinite variables, but I can’t seem to find a cite/statistic anywhere.
To be more specific, I’m curious whether our world of human resources, political-correctness, etc. makes more people per capita go whacko than your average “hunter-gatherer” society without such frivolities.
You asked for data, and I am offering opinions… but they hopefully are still relevant.
First, modern cultures create more and more mental illnesses, ie: social anxiety disorder. I’m not saying this is bad, just that it is.
A “whacko” person may be considered enlightened or mystical in a native culture. Also, some episodes of severe mental crisis may be considered a simple shamanic crisis in a hindu culture( a step forward in life perhaps).
All mental illnesses are arbitrary assesments of behavioural problems, imo, that are well described in DSM manuals, etc. By definition then, they are in a way “can the person exist in this culture”. If this is spoken in ignorance, someone please correct me.
I would love to hear an answer to this question also, but unless a psychiatric missionary surfaces, I am not very hopefull 
In any case, I think it will have to be about a specific illness, instead of the question of sanity in general, to be useful.
“Whackiness” is generally pretty relative. Shamans tripping out on payote had “visions” (halucinations, really.)
I think that when societies become more scientific, we recognize mental illness as illness, and not something superstitious.
IMHO, this is probably headed for IMHO.
I’m assuming the person that opened this thread would move it(if it should be).
DSM IV definitions for Cyclothymic disorder are posted at:
http://www.biologicalunhappiness.com/DSMcyclo.htm
This is a less than, less than, manic depression condition(less than hypo-manic, which is less than manic).
The last necessary criteria is:
> F) The symptoms cause clinically significant
> distress or impairment in social, occupational,
> or other important areas of functioning.
The line between illness and normal cycles of mood, etc., grows even thinner with this illness(not to claim that it isn’t “real”)
by definition, the illness only exists relative to our culture. If our culture is the greatest, then so are our definitions… but of course, we knew that already, like most cultures do. The relevant points I hope I made are, we have more illness definitions(which could skew any count taken), and that the decision about what is an illness may vary(making comparison impossible).
Objective data on this would be interesting to me also, if it is available and usable. The origional notion of this thread seems very plausible, also.
Having just retired from being a skeptical mental health professional, perhaps I can offer a professional dissenting opinion.
As I said at a recent British National Mental Health Conference, ‘I have spent the last thirty years acting under false pretences, by professing to treat ‘mental illness’ whilst really only addressing mental difference.’
The philosophy and taxonomy of ‘mental illness’ is extremely problematic. There are vested interests in defining mental difference as ‘medical diagnostics’.
My belief is that mental difference and mental distress exist as individual realities, but they have to be unduly shoe-horned to fit them into diagnostic categories and considered ‘treatable’.
Basically, all mental difference (as ALL human difference) is socially constructed. Therefore, the ‘mental illness’, present in a society not only depends on what a person does, but on how the society interprets it. Consequently there can be no reliable method of comparing amounts of ‘mental illness’ in one society against another or for one time against another. The same argument also applies to the concept of mental retardation (learning disability) and for criminality. All is social construct.
Society does play a role in determining who is classified insane. Some people who displayed signs of paranoid schizophrenia became religious criminals at the hands of various ‘heretic-burners’ in various times and places. Other obviously ill individuals, like Mozart or Van Gough, were regarded as geniuses with ‘artistic temperaments’ and left untreated. Of course, treatment might have consisted of chaining them and flogging them when the moon was in certain stages. We’ve come a long way in the past two hundred years.
But mental disorders are as real as smallpox or the flu. Even if the locals believe the local paranoid is possessed by demons, the person is still paranoid. Even if Party members thought Hitler was a genius and a godhead, he was still a raving paranoid megalomaniac with severe delusions.
We do shoehorn people to treat them. So what. Diseases are approached in a pragmatic way if they are to be cured, with unsuccessful treatments thrown out. Like any good science, observation outranks theory or hypothesis. Each cancer is different, but we still talk of lung cancer and throat cancer and liver cancer, even if the killing tumor is lodged in the brain or the lymph nodes. Why? Because observations have shown that similar diseases respond to similar treatments. Depressives respond to Prozac. Another group with similar symptoms responds to lithium. So we group those people to help us treat and understand them, just like we group all our other stimuli to help us think about and understand it.
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*Originally posted by Derleth *
We’ve come a long way in the past two hundred years.
Two hundred years ago ‘mental illness’ was treated differently, but not necessarily worse. A Whig view of the history of mental illness would claim this, but it is difficult to document exactly what has improved. My contention is that although the social construction and methods of ‘treatment’ may have changed, whether that is for better or worse is a moot point. In order to believ that there has been an improvement, I would need to see well documented historical research; this I have not yet found.
But mental disorders are as real as smallpox or the flu.
Smallpox and flu are caused by known agents and follow predictable courses. Psychosis, depression, neurosis, personality disorders ec. etc. are socially defined, have no known causative organism and respond extremely variably to treatment.
**We do shoehorn people to treat them. So what. Diseases are approached in a pragmatic way if they are to be cured, with unsuccessful treatments thrown out. **
Most other diseases are treated with the full consent of the patient; this is rarely the case with mental illness because of the social construction of it- stigma abounds! It is far more difficult for service users to reason successfully with medical practitioners over ‘mental illness’ treatments than with physical illness treatments.
**Like any good science, observation outranks theory or hypothesis. **
More than any other ‘science’, psychiatry uses research funded by the organizations that depend on one particular answer- drugs. Drugs presume the medical model and so the main research in psychiatry is forced into a medical paradigm. Social explanations and possible responses have no drug company to fund research for them.
Any ‘mental illness’ which has been found to have a physical cause within the nervous system had been transferred to neurology. Psychiatrists no longer treat primary cases of epilepsy, strokes, and other well founded neurological disorders although they may treat sequalae. Those neurological disorders which require considerable and expensive long term in-patient intervention- The dementias, Tertiary Syphilis (GPI), Huntingdon’s Disease etc have been left within the remit of Psychiatry for financial and social reasons. The remaining non-neurological parts of ‘mental illness’ are essentially those parts of human behaviour for which no cause has been agreed and are therefore cast into the field of psychiatry and generally treated by medication or confinement by default (although other treatments are available- Cognitive Therapy, Psycho-therapy etc- which are notably also seen as effective for non psyciatric human difference such as low self esteem, learned behavioural responses etc.)
A claim has been made for more than three hundred years that differing behaviour can be seen as an ‘illness’. The claim has been extremely successful, but the underlying scientific support is minimal.
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*Originally posted by Pjen *
**
You make some reasonable points but to state that "Psychosis, depression, neurosis, personality disorders etc. etc. are socially defined, have no known causative organism…" is a pretty large claim given that every month there are blurbs in the news about the identification and discovery of some new, biologically based, “causative” factor for a variety of mental differences/illnesses. If memory serves these “causative” factors often have to do with physical differences in brain structure and/or related bio-chemical processes between those exhibiting a type of difference/illness and those who do not.
It may be true that a specific, single causative mechanism is not applicable to the complex way these differences/diseases may manifest themselves but to state that they have “no known causative mechanism”(s) is significantly overstating the case. We may be in the early, baby steps stages of being able to say “This person washes his hands 200 times a day because xyz uptake receptors are malfunctioning in abc areas of the brain combined with etc etc” but, for better or worse, that day is not far off.
I do not disagree with you that it is a slippery slope between “difference” and “illness” but current human societies, in the main, are similar enough that someone who is mad/different/ill and acting in dangerous or irrational and potentially destructive ways is institutionalized or otherwise socially restrained. It is one thing to be enamored of the ontological mysteries of socially mediated distinctions in what is considered an “illness” but at some point you have to stop being cute and put a straightjacket on the babbling man with the ax who thinks you are a tree.
As a budding sociologist I’ll offer my oppinion.
As has been said in this thread before, the answer to the OP is most probably found through looking at societies perceptions of “whackos” and their ways of dealing with mentally abnormal individuals.
Modern society generally likes to diagnose mental abnormalities as diseases and treat them as such. I am NOT saying whether I think this is a good or bad thing, it doesn’t matter and it’ll only hijack the thread.
In many cultures the abnormal are not considered outsiders because the situation is simply not the same. A person who would be too “whacko” to work in an office enviroment in a modern culture could be quite the respected prophet in another. It’s all a matter of the interests that society has, we simply need more people who can think clearly than we need “weirdos”. In other places people may need guidance, interesting company and amusement more than they need efficient and clear thinking minds.
Those are my two jiao.
— G. Raven
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You make some reasonable points but to state that “Psychosis, depression, neurosis, personality disorders etc. etc. are socially defined, have no known causative organism…” is a pretty large claim given that every month there are blurbs in the news about the identification and discovery of some new, biologically based, “causative” factor for a variety of mental differences/illnesses. If memory serves these “causative” factors often have to do with physical differences in brain structure and/or related bio-chemical processes between those exhibiting a type of difference/illness and those who do not.
The very fact that multiple claims are made year after year (and often later found to be based on insufficient evidence) supports my contenetion that ‘mental illness’ is a severely ill defined category. I do not disagree that bio-chemical processes underlie mental differences; the problem is defining why ‘psychosis’ (etc.) is seen as a ‘treatable’ ‘illness’, yet ‘criminality’ is seen as a ‘chosen behaviour’ to be reacted to by punishment. The choice and the reaction is a social construction, and often very variable.
**It may be true that a specific, single causative mechanism is not applicable to the complex way these differences/diseases may manifest themselves but to state that they have “no known causative mechanism”(s) is significantly overstating the case. We may be in the early, baby steps stages of being able to say “This person washes his hands 200 times a day because xyz uptake receptors are malfunctioning in abc areas of the brain combined with etc etc” but, for better or worse, that day is not far off. **
Similarly for every behaviour, but we do not necessarily reify these behaviours as ‘illness’ categories. Thus we may be able to explain bio-chemically why I am likely to behave in a certain (non-‘illness’) manner, but this does not make it a diagnostic category; to do that requires a social construction of the behaviour to place it in an ‘illness’ category.
**I do not disagree with you that it is a slippery slope between “difference” and “illness” but current human societies, in the main, are similar enough that someone who is mad/different/ill and acting in dangerous or irrational and potentially destructive ways is institutionalized or otherwise socially restrained. It is one thing to be enamored of the ontological mysteries of socially mediated distinctions in what is considered an “illness” but at some point you have to stop being cute and put a straightjacket on the babbling man with the ax who thinks you are a tree. **
I agree with you about the necessity for social reaction to ‘dangerous’ behaviour; where I disagree is with the category of ‘illness’ which separates the behaviour from the person and makes it the province of mental health professionals.
Please note that I am in no way denying the reality of the experience of ‘mental disorder’ and the pain that it causes. Similarly I am not denying that society will need to react to abnormal behaviour in some way at some time. My argument is with the all too easy definition of some 'difference behaviour being defined as ‘illness’, and thus attempting to use a medical model to define the behaviour and the potential response to that behaviour. This has been an all too convenient method of failing to deal with mental difference.
Consider that we now do not consider homosexuality to be a mental disorder, but have admitted gender dysphoria to the canon! Why has this happenned? Because the social construction of mental disorder has moved in opposite directions in these two cases.
All I am saying is that the medical model of personal difference is far less certain and secure than society finds it convenient to believe.
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*Originally posted by Pjen *
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I’ll grant your contention that the semantic distinction between what is considered a behavioral “illness” and behavioral “difference” is subject to socially and personally mediated lenses and that opinions about which category is applicable for a specific situation can and do differ.
If your point is that in a lot of situations this approach is sloppy, intellectually dishonest, potentially unfair to the stigmatized “different” social actor… well sure, I’ll bob my head up and down in agreement. I still don’t want the “different” homeless man taking a dump on my lawn even if they might consider to be “just folks” behavior in other societies. Whether he just considers himself “different” or the distinction between my lawn and a toilet is simply a minor point of etiquette for him is irrelevant to me. I will use whatever forms of social coercion are available to me to have him restrained from repeating this behavior. I would probably also have no problem with authorities institutionalizing him against his will and forcing him to take medication that would help him understand the lawn/toilet distinction.
Regardless of how “unfair” this might be, this is how it plays out in the real world including the political games the American Psychiatric Association plays in assigning “illness” tags to certain behaviors. I’m a tall man but I eat too much and I need to lose about 30 lbs or so. I know I eat too much but the discipline required to stop eating too much and lose weight is something I can only muster every few years or so. I am bio-socio-psycho-neurologically addicted to eating too much. I’m sure it’s quite “unhealthy” for me. Am I ill or am I just different?
Your point is clear but in the end it’s little more than simply a consideration about who has power and who doesn’t. Gay people can enforce their will not to be classified as “ill” because they now have substantive social power but the basis for considering homosexuality as an illness was mediated more by theist mores than the perceived, empirical damage gays were doing to themselves or others. Some people with “differences” are dangerous and slapping the “illness” category on them poses no issues for me. At what point you stop and start that process is a thornier issue I suppose.
I agree with all of your post! I too have no problem with people who cause severe and measurable societal distress being treated in such a way as to alleviate the problem.
The problem that I have is when such a medical response is made towards people to whom the criminal law would not apply. It is certainly arguable that some people should be treated as criminal and others as ill for displaying the same behaviour because it comes from ‘different’ sources.
However, such a medical response is often offered to the actions of people to whom the rigors of the criminal law would not apply; however, because we can label it ‘ill’ rather than ‘criminal’, sanctions can easily be made against people purely because they are ‘ill’ rather than because of their actual behaviour.
You are right about the power nexus surrounding diagnosis. That is my point: whether ‘criminal’, ‘socially undesirable’ or ‘ill’, such taxonomies are merely a reflection of the power structure of society. The problem is that such an analysis is acceptable for ‘criminal’ or socially undesirable’ categories, psychiatry claims a scientific status that would be incompatible with a power structure analysis.