Delirity

How can just a few little words (“Nicole, this thesis is really excellent, I really hope you won’t leave the field.”) always screw with my head so much?!

This semester one of my classes is a seminar on the biological basis of psychopathology. Instead of learning only about the symptoms associated with psychological disorders like schizophrenia, depression and anxiety disorders, we’ll be reading journal articles that discuss the biological elements of the disorders.

This week the reading is all focusing on one (ok, actually 2) question: How is “mental disorder” defined? How do you think it should be defined?

As of right now, I’m having a little trouble figuring out exactly what I think about the question. So, in order to figure it out, you’ll have to help me sort out my ideas…

Mental Illness or “Problem in Living”?
Some people are of the opinion that the only actual “mental illnesses” are “brain diseases” such as syphillus. They attribute other psychological problems to “problems in living”. I know that I disagree with this… different psychological disorders seem to have varing amounts of psychosocial and biogenic influences.

I find it hard to believe that someone with Alzheimer’s has that disease solely due to a problem they have dealing with their environment… there must be a biogenic component as these people have a clear pathology that indicates the disease. But perhaps these people would say that Alzheimer’s fits into the brain disease category. What about something like depression? To me, depression is a fuzzy area. It seems to me that depression is something like a brain disease that some people are genetically more predisposed to, but that “problems in living” (aka environmental factors) play a major role. What about people with anorexia and bulimia? While social pressures tend to be blamed for a lot of these problems, there is also evidence showing that abnormal neurotransmitter and/or hormone levels can also play a large role.

Can You Group Them All Together?
I have some hesitation about comparing people with large differences in the severity of theiir psychological problems. For example, how do you compare someone who has had mild depression for a year with someone who has been diagnosed as a catatonic schizophrenic for the past 20 years? Does “mental illness” really encompass both these ideas?

Apparently there’s been some research done that indicates that people perceive people with “mental disorders” with a much more positive attitude if they have been in contact with them, and that saying that mental illness is like physical illness actually makes people more afraid of the people. But all I can wonder is, can you count knowing someone with mild depression as “contact” or do you have to be in contact with people with something that is more obvious such as dementia or Tourette’s? It seems to me that most of the negative ideas people seem to have about people with psychological disorders are caused by a fear of the unknown.

So, does “mental illness” describe this wide range of problems? When I compare mental disorders to physical disorders, yes, that seems to be the correct terminology. If I compare someone who has a cold (a short term problem that goes away with proper care) with someone who occasionally experiences bouts of depression I can see the comparison. A cold is an illness, just as cancer is an illness… they are allowed to vary in intensity and the amount they can affect your quality of life.

So… What is It?!
I googled “what is a mental illness” to see what it would give me… here are some of the definitions:

A disease of the brain that causes unusual thoughts and emotions, including depression, feeling like you can do anything and/or not knowing the difference between reality and unreality. – www.in.gov/fssa/shape/glossary.html

A state of being in which an individual has difficulty in handling situations and feelings of an everyday nature. In certain instances, conditions are characterized by impairment of intellectual functions, the experience of shallow and unstable emotions, and difficulty in adapting to one’s environment. – www.cmpmhmr.cog.pa.us/glossary.htm

Mental illness refers collectively to all diagnosable mental health problems that become “clinical,” that is where a degree of professional intervention and treatment is required. Generally, the term refers to more serious problems, rather than, for example, a mild episode of depression or anxiety requiring temporary help. – www.wfmh.org/wmhday/sec3_pt3_4_glossary.html

A sickness of the brain according to psychiatrists and psychologists, but for which there is no proof at all of its existence. This does not mean that problems don’t exist, or that a person can never feel bad, but there is no evidence that these are caused by a sickness of the brain. – www.fightforkids.com/glossary.htm

Some of the definitions seem ok, some seem to be completely lacking. I think that my answer to the question of the week is that “mental illness” is currently a term which holds different meaning for different people. The best definition I can give right now is that a mental illness is a disorder (lasting for at least a minimum amount of time, to be determined by disorder) brought on by biological and/or environmental factors which cause changes in a person’s actions or thoughts and impair their ability to function. I think this covers a pretty wide range of mental disorders (alcoholism, depression, schizophrenia, Down’s Syndrome, Alzheimer’s…)… though I do have one thing particularly disturbing me about this definition… it implies that all people with a mental illness at one time did not have it, and in that case, how can you include mental retardation?… and is mental retardation a form of mental illness?. I’m nervous about comparing a person’s behaviors to “normal” since we then have to define normal and that’s simply disasterous because of different cultural norms and whatnot.

Thoughts?

This morning the doctor removed the splints from inside my nose. I had been both dreading and waiting for this for days… I knew the splints were causing a lot of discomfort, but I was scared it would hurt when he pulled them out.

What happened is that they felt very odd coming out, for good reason… the suckers were 1 1/2 inches long and about 1 inch wide (though folded in half I think) plastic doodads. I’m starting to feel human again! My nose feels like my nose and not someone else’s!

Ok, I said I was going to go back to school this week but apparently I lied. I’ve decided to stay home and keep up the recovery process… I’m just not ready yet. I’m still on vicodin and still woosy from it. I e-mailed all the appropriate people and now I can just relax and keep working on feeling like a normal person. Oh yea, and I can hopefully work some more on all the stats stuff for my thesis.

It’s been a few days now, but for the most part (especially right after I wake up and everything is stuffy) I feel kind of like someone put a new nose on me and it’s really not mine. It’s pretty stuffy and even when I get all the crap cleared out and can breathe through it things feel funny because it’s swollen. I think the worst part is that they had to straighten my septum a little so I can’t actually move my face much (like smile or rub my lips together) without it hurting. I have been oh-so-attractive the past few days with my swollen face, caked on blood under my nose, and all the blood I’ve been spitting out… but I guess that just comes with the territory.

I was able to take less pain meds yesterday and I’m hoping to do the same today. I’m hoping for a wonderful breakthrough where I can breathe well through the night. Last night I thought I could do it, but there wasn’t quite enough air getting through so I had to switch to my mouth and then everything closed up again.

I think the doctor meant I’d only have a few day recovery if he didn’t have to do anything to my septum. Now I’m a little concerned about having to go back to school… right now it’s hard enough for me to function here at home. For example, in the middle of the night last night I woke up and went to take a sip of water to wet my horribly dry mouth, but apparently fell asleep again before I quite got to that point and spilled a bunch of water on myself… instead of going and changing my shirt (which is kind of hard since it can’t brush my nose when I take it off or put a new one on) I just pushed up my shirt and stuck a tissue under it.

In sum, the nose still isn’t back to feeling normal (but with less capacity for sinus infection), but it’s on the way. I’m hoping it’ll get there very very soon since theoretically I should be driving back to school tomorrow.