Mental disorders aren't necessarily valid

aaaaaack! don’t hit me, ** auliya **! Just reread what I posted and it sounds like I’m asking you for the cite and, of course, it’s TVAA who is citeless!

What leads us to see certain behavior as falling under a broad category, and, more importantly, as disorderly. Relative to what “order” do we make those judgments? Better yet, relative to whose order? Once upon a time “onanism” was a disorder, now “homosexuality” is slowly escaping that designation, and so on. Why were they ever “disorders”? Because they didn’t fit in with the social order, and thus were subject to politically, morally, or religiously motivated censure under the guise of science and medicine. The academic establishment has no business telling people what it part of the order and what is “disorder” based on the subjective standards of the time.

Note, I have no problem with people drugging themselves to high heaven, since that is their chosen wait of raising the quality of life. As for medicine, it has the good fortune that basic bodily functions are almost universally valued by people.

Let me also add this, to avert any confusion: Disorders and perceived problems are very different from simple observable phenomena. Arguably, a disorder is a combination of a perceived problem and an observable mechanism. What I do not wish to claim is that distinct mechanisms cannot be sliced out of physical reality, since that would be manifestly false. A purely hypothetical “gay gene,” for instance, would be a distinct physical mechanism. I do wish to claim, however, that most disorders are initially identified as “problems,” and solely diagnosed in those terms (symptoms being manifestations of the problem), which leads to the interlinking of condemnation and identification. Condemnation, again, is rooted in some desired order of society and human behavior, thus producing the identification: as that which does not fit the order, i.e., a disorder. Upon further research, psychologists may find that this bit of dis-order has a clear cause, but that does not justify the status it has as illness; everything has a cause, after all. Interestingly, it’s also not easy to pin many “disorders” on singular factors, much like the rest of human behavior. Left-handedness, for instance, is a very significant variation that costs us millions upon millions of dollars to accomodate, but do we call it a “disorder”? Of course not. It’s part of the accepted order. It is part of the norm, because we admit that variation is itself normal. Well, the same applies for variations of the mind. Ultimately, seeing a given bit of behavior as “variation” depends on whether it’s important, it’s usually important only if it’s problematic, and “problems” are always relative to the operator.

Grrr…the “show sig” box keeps getting unchecked. :mad:

Well yes, if by the operator you mean the person with the “variation”. You are aware that many of the criteria in the DSM IV carry the following proviso

meaning, of course, the variation or disorder or label it as you will, is causing the individual who is experiencing it A Lot of Problems. Which is why mental illness is considered a disorder and handedness isn’t :rolleyes:

You are safe Primaflora, I understood :wink:

TVAA, it is somewhat ironic that you mentioned parkinson’s disease…as this particular illness has played a large part in treating schizophrenia. In fact, some schizophrenic treatments are the direct opposite of parkinson’s treatments…due to people being treated for parkinson’s disease by increasing dopamine levels in the brain exhibiting psychotic symptoms. Hence, it was figured out that perhaps dopamine plays a part in schizophrenia, and now most medications out there for schizophrenia inhibit post-synaptic reception of dopamine (lowering levels in the brain).

You’re suggestion that psychiatric illnesses aren’t well-understood is flawed at best. Even medications from the 60’s and 70’s are still recognised as effective treatments for the “major” psychiatric illnesses (depression, schizophrenia, etc). They have demonstratably better efficacy than placebos, and have successfully treated millions. It is true that the brain is incredibly complex, and we still don’t know how every part works, however you seem to subscribe to the “we don’t know anything about the brain and therefore anything anybody says they know about it is wrong”.

I do, oddly enough, agree that mental illnesses are not as simple as diagnosing a broken leg. Some people can display some excessive paranoid thoughts throughout their lives, but not enough to warrant being hospitalised or even to seek treatment. It is more like…well, intelligence. People aren’t arbitrarily lumped into groups of “stupid” and “not stupid”, we recognize that there is an extremely wide range of intelligence. Similar thing with psychiatric illnesses. If someone does develop compulsive symptoms that have a large effect on their lives, it is likely they will be given the diagnosis of OCD, and treated for it (most likely with serotonin reuptake inhibitors). If they have some compulsive symptoms, but it doesn’t become a problem, then it won’t even be given the chance to be diagnosed, let alone treated, as the absolute need is not really there.

Perhaps you think that people are using mental illnesses are “crutches”? That anyone with a slight leaning towards a symptom of a particular mental illness will be diagnosed with it? Far from reality, I’m afraid. Yes there are people out there who overstate their symptoms, but then, that is ironically what happens in almost any medical field (especially when talking about things like back injury, which suffers a similar lack of knowledge and proof of illness that most psychiatric illnesses do).

Might I ask what exactly you are suggesting we do to psychiatry? You don’t seem to be happy with the way it operates, so how would you change it?

** Autism manifests at a single developmental stage, with only a short period of apparent “normality” preceding it. It’s common features are fairly distinct and notably unlike usual human behavior.

Autism is better-supported and carries plenty of neurobiological signs. And since its onset is so early, it’s highly unlikely to be psychological.

That’s the point – I don’t know what kind of physiological problem is involved, and there’s always the possibility I could be mistaken. But the evidence leads to a tenative conclusion that autism is a neurological condition of some kind.

** You’re joking, right?

Presumably because the simple, honest answers are disturbing, while the simple, dishonest answers are so transparent.

** That is NOT how the dopamine hypothesis began, and I suspect you know that.

** Depending on the condition and the treatment, not significantly better. And that does not indicate that the conditions themselves are understood. Most of those drugs were discovered by trial and error, and the ones that weren’t were modifications of existing drugs. We have no explanation for the atypical drugs, and the explanations for the typical ones are extremely weak.

Psychological therapies work just as well as drugs for most cases of depression – better by some standards. Yet they’re used far less often.

** We know plenty about the brain – enough to know that our explanations are wrong. But we repeat them anyway because having no explanation isn’t sufficient.

First, stop mouthing explanations which are known to be incorrect and admit what we don’t know. Second, make people aware of all the therapies that are known to be helpful to some degree, the manner in which they are helpful, and our best understanding of how they work.

I wasn’t questioning it’s validity, I believe it myself.

It just seems that for you to believe it, it would have to be grounded in some sort of research.

i am mentally ill. i live on disability because i am functionally disabled by my mental illness. i don’t want to live on the dole. this was not my ambition in life. i am perfectly able to contribute positively to society, if society could just get over the fact that i am a bit of a mentalist and let me.
i went to a hospital school for both fragiles and phobics. i have lots of experience with psyches, psychos, mhn’s, ewoks and keywoks ( for the uninitiated that’s: pyschiatrists, psychologists, mental health nurses, education welfare officers and key workers) and the main thing that i would change is the obsession with fault, blame, validity and invalidity ( no pun intended). the basic underriding tenet of psychiatry seems to be: you’re different, and that’s bad. i don’t think that sanity is a fixed value. it’s more of a consensus really. as posts above continually state, what is considered normal in one culture is seen as dangerously deviant in others.
being naturally analytical, and being forced to endlessly analyse my psyche by psyches, I am well aware of the root causes of my deviance. a combination of slight deafness, poor ability to interpret tone and body language, and a resulting detachment from social interaction made other children confused by my conflicting signals. this confusion lead them to ostracise me, which further compounded my detachment. as we all grew older, this confusion turned to fear and anger and i was physically abused at school. coming from a highly academic background, it was not an option to reject this abusive environment (school) conciously and so my brain went on the defensive and physically manifested it’s mental torment. beginning with coftiecolds, i got iller and iller. my body learned that if i was sick, i didn’t have to go to school. as each measure was discovered and countered, my brain turned to more and more extreme measures to protect me from the perceived danger. as i was moved from school to school to hospital to drop in centre, the number of safe spaces diminished and more and more places became a threat until i got to my current situation of the whole of the outside world being panic attack land.
and my reaction to this is well? so what? to be honest, knowing this is no different to knowing that you hate chocolate cake cos you ate so much on your tenth birthday you were sick in your shoes. and i enjoy being mad as toast. i have enviable concentration, to the exclusion of all else. i can happily read a book in a riot. i don’t want to be that attached to society, you all seem to be neurotically obsessed with shoes (or is that me again)and J-Lo and, well, other people, and personally, i’d rather solve a maths problem or do the crossword. i’m glad that my detachment means i don’t really worry about my weight or my hair or whether so and so thinks i’m a bitch. i never get bored. i’m not depressed. being obsessive means the house is always tidy, i’m terrifically organised. i have a partner who i live with and thinks i’m great, apart from the odd freak out. sure there are limitations, but everyone has limitations, some are just more socially acceptable than others.
now, i’m not saying that all mental disorders are fabulous and we should just let it be, i’ve seen the pain out there. i’m just saying that there are lots of different ways of thinking and that just because you’re not normal doesn’t necessarily mean you need to be fixed. at the hospital school there were kids who underwent all sorts of surgery and treatments to make them better when they kind of felt that that time could be better spent helping them function within their disability, or to explore their different abilities.
i feel i need a closing paragraph which sums up my point of view, ties it in with points already raised, offers solutions and poses intelligent, pertinent questions but to be honest, i can’t think of one. so i’m going to prop myself up on my panic attack crutches and hobble off into the anticlimax…

So TVAA, are you saying that medications are not significantly better than placebos? What exactly is your definition of significant for starters? Are you trying to tell me that they are pointless or of little value? I am not denying that non-medication therapies can be effective, but they are primarily complimentary. For example, medication plus cognitive behavioural therapy is usually more efficacious than either of them alone, which are both in turn usually more efficacious than placebo, which is again more efficacious than nothing at all.

As far as whether or not drugs are found via trial and error, it doesn’t quite matter. What matters is if they are effective at treating the illness. And we DO have explanations for how the atypical drugs work, and basically it is that they selectively inhibit the reuptake of dopamine in the post-synaptic process. This isn’t exactly witch-doctor stuff you know.

Put simply, if the medications did not work, people wouldn’t use them. They carry serious, and sometimes life-threatening, side-effects…and also tend to cost a lot of money. Here in Australia, most medications are subsidised by the government, and in order to get subsidisation, pharmaceutical companies have to actually prove their product works or it will get knocked back and almost no-one will use it. Unless you subscribe to the conspiracy theory that the psychiatrists are in collusion with the pharmaceutical companies to just make money (despite the fact that psychs would actually earn more money if they engaged in only non-medication therapies).

I would also like to hear your criticism of the way we believe the brain operates. Are you disputing the synaptic processes? Do you deny that dopamine plays a part in schizophrenia?

The operator can be anyone dealing with an issue, such as another person trying to interact with the individual who has the “disorder,” or the individual himself.


Again, if the “patient” deems himself to have a disorder, then that’s fine, since it they who are expressing a desire for some other order of things. When others deem the variation to be dis-orderly, then they are merely reflecting their own prejudices about the way things should work; recall the “study” which claimed that Newton and Einstein had Asperger’s. The same goes for people who condemn homosexuality, for that matter.


You’re saying that left-handedness doesn’t cause a lot of problems for both the afflicted individual and society?!

** It depends on the condition and on the medications.

The placebo response in depression is notably greater than most other conditions, psychiatric or otherwise. Antidepressants are rarely significantly better than placebos.

Now, manic-depressives don’t respond to placebos nearly as much.

** This depends greatly on how you measure improvement. Drugs alone lead to some remission of symptoms; they tend to do so fairly quickly, but the results often fade once the drugs are stopped, so people can come to rely on them. Therapy alone also leads to remission of symptoms; it doesn’t do so as quickly as drugs, but it’s noticably better at reducing future problems and maintaining improvements after the treatment stops.

Combining the two leads to a more rapid and complete improvement than either alone, but the effects wear off more often and more significantly once treatment stops. When people rely on the drugs to maintain a mental state, they find it harder to maintain it themselves when they drugs aren’t used. On the other hand, people can find it difficult to muster themselves to respond to therapy initially.

** But effective how?

Physicians once believed that women who complained of severe PMS symptoms were hysterical, and prescribed large doses of B vitamins as placebos; since the supposedly harmless placebos reduced complaints, the symptoms were obviously psychosomatic, right?

Then they found that the prescribed doses of B vitamins were actually massive overdoses, causing several toxicity problems – including a deadening of the peripheral nervous system, which did indeed reduce some of the PMS symptoms.

So – was that a valid treatment, or not? Distinguishing between a helpful and a toxic response to medication is extraordinarily difficult for even simple systems, and the nervous system is extremely complicated.

Are the beneficial effects of lithium initial aspects of lithium poisoning? It’s really, really hard to tell. Are antipsychotics actually modulating the cause of schizophrenia, or merely inhibiting its symptoms? It’s really, really hard to tell.

** But how does that actually affect the underlying condition?

What do you mean, “plays a part”? Dopaminergic systems are responsible for many of the positive symptoms of schizophrenia, but not the negative. We don’t know what’s wrong with those systems, nor do we have any particular reason to think antipsychotics normalize them. (They probably wouldn’t cause tardive dyskinesia if they were merely “restoring the balance” in the brain.) More to the point, “biochemical imbalance” is just a catchphrase to cover up the fact that we don’t know what’s going on. Actual biochemical abnormalities are usually compensated for quite well in the brain. (More than 90% of the substantia nigra needs to die before there are obvious symptoms of Parkinson’s, for example.)

You’re barking up the wrong tree. Even if we couldn’t yet alter the symptoms of so-called disorders, it will happen very soon. In fact, we’ll be able to improve mental performance far beyond its most common levels, as studies w/ amphetamines and learning hint. The brain is a mechanical system which produces a wide range of effects, all of which are part and parcel of human variation, and what we need to decide (and what psychiatrists do decide) is which variations are orderly and which ones are disorderly. Homosexuality is now considered orderly, so we do not seek “treatment” for the condition, great mathematic abilities are also orderly, but not so for tendencies toward isolation, “insubordination,” or violence. This is a cultural judgment, and may be criticized, but please do not become manifestly anti-scientific in doing so, such as by suggesting that “conditions” cannot be “treated.” Ultimately, all human behavior can be molded by manipulation of environmental and genetic factors, though no single cause need be behind some particular perceived disorder.

I’m bipolar. I don’t think bipolar disorder has anything to do with cultural norms, is a physical problem, and should be medicated if you want to treat it.

First, what is “unacceptable” behavior that would apply to all cultures? How about hallucinating, thinking you’re god, becoming violent for no reason, extreme paranoia, hearing voices, being unable to sleep, loss of identity, etc… All of this has happened to me in my manic phases and I feel it’s necessary to stay medicated the for the rest of my life. As for my depressed phases- paranoia, hearing voices, extreme confusion, being unable to sleep, and being extremely suicidal. These were also problems.

As for why I think it’s a physical problem and not entirely psychological- genetics, my grandmother and several uncles are bipolar, my childhood was fine(no abuse or traumatic experiences), and my depressed and manic times are not preceeded by any significant events.

Treatment. Meds work. Therapy is usefull if you have issues or need to learn to cope with damaged relationships, but otherwise it’s just psychobabble.

I think the largest problem, is that the efforts in these medicines will reach a point, and already have to an extent, that the government authorities will be able to forcibly change who we are at the deepest level. They for once will be able to enforce a standard of behavior by changing the people they don’t like, and so if people develop a paranoia about any type of behavior, government can quickly step in and hospitalize and then mandatorily change the behavior of these people, regardless of what that behavior is.

The drugs used in Brave New World are what this is leading to.

Originally posted by TVAA *
**** Autism manifests at a single developmental stage, with only a short period of apparent “normality” preceding it. **
Cite? You’re wrong BTW. There is no single developmental stage at which autism develops. Not all children have a period of apparent normality.
** It’s common features are fairly distinct and notably unlike usual human behavior.

and the common features are?

** Autism is better-supported and carries plenty of neurobiological signs. **

which are?

And since its onset is so early, it’s highly unlikely to be psychological.


**That’s the point – I don’t know what kind of physiological problem is involved, and there’s always the possibility I could be mistaken. **

Yes. That possibility certainly exists.

This is rubbish TVAA. I have just done a major project on this exact subject and I can provide you with 30 good references to research studies to prove it, if you are interested. I am in no doubt that you aren’t of course, because they wouldn’t agree with your biased and totally unsubstantiated position on this subject.