Wednesday, January 05, 2005

Prevalence & Some Insane History

Do you know just how crazy the country is? And how much that matters?
Please note:
1) ~21% of the US population over 18 has had a diagnosable mental disorder in any given year. That's about 44 million Americans
2) 4 of the 10 leading causes of disability in the US and other developed countries are mental disorders
3) Mental illness, including suicide, accounts for over 15% of the burden of disease. That's more than all cancers combined.
4) Direct treatment (i.e. MDs, RNs, social workers, drugs and NOT lost productivity, sick days etc.) of mental illness, substance abuse and Alzheimer's disease costs $99 billion dollars a year.
5) The prevalence of suicide in the US population is 1% i.e. every year, one percent of the population kills themselves successfully.
I had some idea of the magnitude of mental illness and suicide but I had no idea tens of thousands of people were killing themselves each year or that almost a quarter of the population looses it in some diagnosable way. In my psychopathology course, we'll spend the next semester learning all about the varieties, management, medications and other facts surrounding tmental illness.

Our next class will be on the stigma of mental illness so this might be the last time I use the word "crazy." Or "nutty". Or "loony tunes" or "out to lunch" or "mad as a hatter" or "------- in the head" or "cookoo" or "nut job" ...

Over the break, I started reading a great book called "History of Psychiatry" which is, well, what is sounds like. The author, Edward Shorter, presents an argument which argues against Foucault's idea of a "grand confinement" that took place in the 19th century i.e. the nasty capitalist society shipped their non-comformist or eccentric relatives off to insane asylums and this explains the large increases in asylum populations of the mid to late 19th century. Shorter argues that this simply was not the case and the bourgeois were not so petty (hahahaha!) as all that but, simply, there were more mentally ill people at this time. He blames this increase on syphilis (which leads to neurosyphilis which will make you extremely, uhh, eccentric), alcoholism, DTs (alcohol withdrawal-related insanity) and schizophrenia (he doesn't quite explain how schizophrenia suddenly popped up). I like the idea of all of a sudden people going crazy over the span of 50 years or so. It's easy to see how Foucault tried to link it up with capitalism!

4 Comments:

Blogger DD said...

You are obviously an intelligent person and an enthusiastic nursing student. Against all the odds, however, I would urge you to take with a very large handful of salt the various psychiatric propaganda campaigns designed to sell us on the notion of a galloping mental health crisis in modern times. In brief:

1) The first and largest component of the "crisis" is, and has always been, a crisis of redefinition as in Orwell's <1984>. See the following website for a very tiny, tip-of-the-iceberg description of how all this works currently (see also some of the topics under "Issues" in the left-hand column):
http://cchr.com/issues/drugs/page01.htm

2) Psychiatric "treatment" is itself a major part of the problem (not to mention the mind-set it has instilled in a gullible public). The psychiatrists of any given era readily admit that their predecessors were brutal and misguided, but always claim that their latest-and-greatest solution is a panacea. Historically, we had whips, chains, cells and straitjackets; that was followed by the era of lobotomies, insulin shock and electroshock "therapy"; today we use drugs to handle the "biochemical imbalance."

I'll never forget my good friend -- something of a wild child but kind-hearted and loyal -- who was sentenced by her fundamentalist parents to a mental institution for the crime of sneaking out of the house at night and running around with boys. They then signed the papers for shock treatment. Next time I saw her she refused to even look me in the face. She sat and trembled, afraid to go out, afraid to talk about anything real, terrified that they would send her back for more of the same punishment -- which is precisely what it was. She wasn't crazy to start with, but she darned sure was by the end.

My mother-in-law was a psychiatric nurse for many years, then suffered a complete breakdown -- from a thyroid disorder, as it turned out years afterward. Her husband was convinced by the psychs to sign the papers for shock, something for which she never forgave him. Paradoxically, she knows that she absolutely hated it and found it a horror, and that it was completely wrong for her . . . yet at the same time she sort of thinks it's a good idea for other people.

3)These days drugs are the greatest problem in mental health: partly illegal drugs, but in greater part the legal drugs prescribed by the psychiatrists and their medical henchmen -- Ritalin, Prozac, Xanax, etc. Many have noticed the uncanny correspondence between acts of senseless, unmotivated murder (and suicide) and psychiatric drugs. As far as I know, every one of the widely publicized school killings (for example) was perpetrated by at least one person who was taking such a drug. Countless others have reported the murderous and suicidal inclinations they have experienced as the result of those drugs.

That's not to mention the violent acts associated with getting people OFF the drugs, as I know directly from a 13-year-old who had been put on Ritalin at the age of 6 months (his mom was a crackhead who just wanted him to keep quiet -- more or less like many in the government school system). When his aunt (who was working for me at the time) attempted to get him off the Ritalin, he attempted to burn the house down and repeatedly attacked people. He would have been expelled from school except that she went to the principal and explained what was going on. The man understood completely and was willing to bend over backwards for her: it seems that he'd experienced exactly the same thing when trying to wean his own son from Ritalin (which, by the way, is closely related to cocaine, and is widely sold in Canada as a popular illegal street drug).

I also will not go into straight-out psychiatric ABUSE of many kinds -- sadism and brutality of various sorts, fraudulent diagnoses and treatment prescribed in order to drain insurance resources (a major problem that is now waning somewhat due to vigorous counter-attacks), sexual exploitation -- but I have to mention these things at least in passing.

Well-known psychiatrist Thomas Szasz has written many books detailing the various crimes and obfuscations perpetrated by institutional psychiatry (check Amazon.com), and the Citizens Commission on Human Rights has many magazine-style issues on specific aspects of the problem (see website).

I recognize that in a nursing school environment such views will get short shrift (if any shrift at all!). You would have very little support for exploring alternative viewpoints. But I noticed from your post that you were a perceptive and intelligent person, so I couldn't let your comments slide without at least attempting to offer some different notions.

The best of luck to you on your career endeavors. Oh, by the way -- your math problems are not all that hard to fix. Write me if you're interested. Like "dyslexia," "ADD" and "ADHD," it's just one more situation that has become exaggerated into a "mental disorder."

Dege Didear

7:09 PM  
Blogger DD said...

You are obviously an intelligent person and an enthusiastic nursing student. Against all the odds, however, I would urge you to take with a very large handful of salt the various psychiatric propaganda campaigns designed to sell us on the notion of a galloping mental health crisis in modern times. In brief:

1) The first and largest component of the "crisis" is, and has always been, a crisis of redefinition as in Orwell's <1984>. See the following website for a very tiny, tip-of-the-iceberg description of how all this works currently (see also some of the topics under "Issues" in the left-hand column):
http://cchr.com/issues/drugs/page01.htm

2) Psychiatric "treatment" is itself a major part of the problem (not to mention the mind-set it has instilled in a gullible public). The psychiatrists of any given era readily admit that their predecessors were brutal and misguided, but always claim that their latest-and-greatest solution is a panacea. Historically, we had whips, chains, cells and straitjackets; that was followed by the era of lobotomies, insulin shock and electroshock "therapy"; today we use drugs to handle the "biochemical imbalance."

I'll never forget my good friend -- something of a wild child but kind-hearted and loyal -- who was sentenced by her fundamentalist parents to a mental institution for the crime of sneaking out of the house at night and running around with boys. They then signed the papers for shock treatment. Next time I saw her she refused to even look me in the face. She sat and trembled, afraid to go out, afraid to talk about anything real, terrified that they would send her back for more of the same punishment -- which is precisely what it was. She wasn't crazy to start with, but she darned sure was by the end.

My mother-in-law was a psychiatric nurse for many years, then suffered a complete breakdown -- from a thyroid disorder, as it turned out years afterward. Her husband was convinced by the psychs to sign the papers for shock, something for which she never forgave him. Paradoxically, she knows that she absolutely hated it and found it a horror, and that it was completely wrong for her . . . yet at the same time she sort of thinks it's a good idea for other people.

3)These days drugs are the greatest problem in mental health: partly illegal drugs, but in greater part the legal drugs prescribed by the psychiatrists and their medical henchmen -- Ritalin, Prozac, Xanax, etc. Many have noticed the uncanny correspondence between acts of senseless, unmotivated murder (and suicide) and psychiatric drugs. As far as I know, every one of the widely publicized school killings (for example) was perpetrated by at least one person who was taking such a drug. Countless others have reported the murderous and suicidal inclinations they have experienced as the result of those drugs.

That's not to mention the violent acts associated with getting people OFF the drugs, as I know directly from a 13-year-old who had been put on Ritalin at the age of 6 months (his mom was a crackhead who just wanted him to keep quiet -- more or less like many in the government school system). When his aunt (who was working for me at the time) attempted to get him off the Ritalin, he attempted to burn the house down and repeatedly attacked people. He would have been expelled from school except that she went to the principal and explained what was going on. The man understood completely and was willing to bend over backwards for her: it seems that he'd experienced exactly the same thing when trying to wean his own son from Ritalin (which, by the way, is closely related to cocaine, and is widely sold in Canada as a popular illegal street drug).

I also will not go into straight-out psychiatric ABUSE of many kinds -- sadism and brutality of various sorts, fraudulent diagnoses and treatment prescribed in order to drain insurance resources (a major problem that is now waning somewhat due to vigorous counter-attacks), sexual exploitation -- but I have to mention these things at least in passing.

Well-known psychiatrist Thomas Szasz has written many books detailing the various crimes and obfuscations perpetrated by institutional psychiatry (check Amazon.com), and the Citizens Commission on Human Rights has many magazine-style issues on specific aspects of the problem (see website).

I recognize that in a nursing school environment such views will get short shrift (if any shrift at all!). You would have very little support for exploring alternative viewpoints. But I noticed from your post that you were a perceptive and intelligent person, so I couldn't let your comments slide without at least attempting to offer some different notions.

The best of luck to you on your career endeavors. Oh, by the way -- your math problems are not all that hard to fix. Write me if you're interested. Like "dyslexia," "ADD" and "ADHD," it's just one more situation that has become exaggerated into a "mental disorder."

Dege Didear

7:13 PM  
Anonymous Anonymous said...

you can say that again, Dege!

Jonathan Lear pointed out an interesting fact in his Freud class last year, viz., that people's neurotic symptoms (and i believe it's fair to extend this to other regions of 'mental illness') are shaped and influenced by whatever view of mental life they inherit from their time. so, people in Freud's time would get severe cramps, go numb, lie bed-ridden for months, faint, and so on; people in our time seem to do different things, some of which i think Dege described in a frighteningly apt way.

i don't hold quite as strong a view against the use of drugs and our other current psychiatric practices as that, but i definitely am curious to hear from you which of those mental and behavioral patterns we currently tag as 'mental illnesses' seem to you to be more psychological and personal than strictly clinical and medical--or at least to hear just how 'holistic' a therapeutic approach the psychiatric community endorses? maybe i don't fully understand what it is to have, say, depression clinically (though i believe i do), but i have an almost naive, blind faith that people can, at any stage of their lives, work to find a happier and more whole sense of themselves and their lives and learn--through therapy, drugs, spiritual practice, taking up a hobby, whatever--to find a healthy and successful life, even if certain conditions and personality types can make this a near-impossible task. i think the 'take-two-Paxils-and-hope-you-feel-better-in-the-morning' approach is totally misguided, and would be saddened to find out from you that this characterizes the way we currently deal clinically with depression.

similarly, though i worry i'm being insensitive, i often feel skeptical toward people's claims to suffer from ADD/ADHD, as if the ostensibly 'neurochemical' nature of the disorder somehow exculpates them from having to work hard to improve themselves and their focus. this touches on what i think is a deep philosophical problem about when it is appropriate to describe, treat, and understand ourselves on such strictly scientific terms (e.g. as a set of chemicals in the brain that need to be balanced), as opposed to thinking in terms of 'mental states' properly conceived -- beliefs, desires, hopes, fears, wishes, and other such attitudes and contents. i worry that in treating people who can't adjust to or deal well with everyday life, we get off on the wrong foot by making a sort of 'category mistake' and failing to recognize how personal history, dreams, religious beliefs, extreme or peak experiences, and other strange psychological matters bear just as immediately and relevantly on mental disorder as do issues of physics, chemistry, biology, neurology, and so on.


sorry, that post was a mess, but i am very interested to hear your reflections in the next few months, if you have time to post such things! :)


natester

11:05 AM  
Anonymous Anonymous said...

dear unlikely RN,

I read that you returned to BC for winter break. I am curious about your decision to study bscn in the us. Would it not have been cheapter/easier to study at UBC or UVIC? Is the program faster in the US? I am looking at BSCN programs here and am a bit disheartened by the four year commitment, although worth it, it is a long time. Did you have a previous degree, therefore able to finish a second-degree bscn in short time? Any info appreciated!

11:35 AM  

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