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This is a discussion on Beliefs about Origins of Mental Illness in Psychiatric Nursing, part of Nursing Specialties ... I am curious about how you conceptualize mental illness and if those beliefs have changed over...by seizetheday Nov 22, '11I am curious about how you conceptualize mental illness and if those beliefs have changed over time. I was reading an article while preparing for a lecture on the beliefs of health professionals about mental illness and it made me think of my own. I have definitely changed over time and I think become less sure rather than more sure.
Do you see mental illness as solely medical model (e.g. a neurobiological illness). Do you see a sociocultural component (e.g. how we view those who are odd, quirky, eccentric,). Does mental illness stem from early years (e.g. abuse, trauma, neglect, attachment issues, parent modeling). What about spiritual factors (e.g. oppression, sense of worth, meaning, purpose, hope). What about a constructivist view (e.g. if you believe you are well and can function then should someone else be able to deem you ill).
When someone with a mental illness acts aggressively/antisocially (e.g. serial killer or psychotic break) what is behind that antisocial behavior. Why do some people act aggressively and others don't - where does that begin.
Where does personal responsibility meet mental illness? With cognitive distortions and altered perspectives and negative self-talk and delusions...how capable is one of making the best decisions for themselves even if competent.
I see how all these factors and likely others play into mental illness, sometimes trying to define it is like sand through my fingers. I used to be heavier on the medical model side but have shifted a little over time...
Interested in others thoughts on this..
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- Nov 23, '11 by Davey DoWhew! Your questions are interesting ones, seizetheday, and to adequately answer them would take an essay several pages in length. But, lessee if I can give you a "TV Guide Synopsis" of my perspective:
Mental Illness has its feet in both the Nature and Nuture realms. For example, Erick Erickson's Developmental Stages strongly suggest that Nuture plays a big part in the outcome of the Personality. However, William White, in his book Born That Way, asserts that the personality is a genetically predisposed template; the personality is mostly Nature.
Just as other illnesses have a genetic predisposition, Mental Illness can be passed on through the genes. However, the reconfiguring of the brain's electro-chemical processes through organic means (e.g. drug abuse) can be a precipatating factor contributing to a Mental Illness.
Environmental Stressors (e.g. childhood abuse) can also contribute to the reconfiguring of the brain's electro-chemical processes, hence being another contributuing factor for Mental Illness.
Since certain neurotransmitters have been identified as being in levels greater or less in many Mentally Ill Individuals, this could also be a factor contributing to the type of behavior the Mentally Ill Individual manifests. For example, dopamine antagonists usually calms agitation. Hence, we can surmise that an over-production of dopamine in the brain causes agitated behaviors.
Mentally Ill Individuals are given a certain diagnosis because they manifest a group of symptoms. Diagnosis is a systematic approach, as the Professional utilizes the DSM-IV for symptoms and diagnostic criteria. That's the diagnostic process in a nutshell.
Of course Mental Illness spans the spectrum in its affect upon the Individual. Most Mentally Ill Individuals are quite capable of functioning adequately in the general community. Some Mentally Ill Individuals need constant Professional monitoring. The trend, in the last several years, is to allow the more severely Mentally Ill to live independently in the Community with regular visits by Mental Health Professionals.
Mentally Ill Individuals, as All Individuals, have Rights. There are guidelines, rules, and Watchdogs out there to assure everyone is theorectically treated fairly.
I don't believe I've addressed all of your questions, seizetheday, but this will give you an idea of where I'm coming from.
The best to you.
- Nov 24, '11 by seizethedayThanks Davey Do for sharing your perspective. You are right that there are no easy or short answers! Just pontificating on life!
We still in many ways know so little about neurotransmitters as they exist in such minute quantities in the brain. We know that levels change naturally as well - the serotonin/ melatonin conversion cycle for sleep/wake. It just makes me wonder if genetics can control neurotransmitter levels. Is there really something on the DNA strand that makes serotonin drop 15 or 25 or 45 years into one's life and that keeps it from restabilizing?
Your comments on personality are interesting too...it seems that early childhood and attachment and traumas play such a key role in development of pretty much every aspect of development. Mental illness is definitely an outcome of many negative experiences early in life, the nature /nurture debate still has so many unknowns.
- Nov 24, '11 by zcoq72mehsmental illness is not necessarily related to personality or personality development.
furthermore, the process is not JUST chemical, but structural too.
different areas of the brain are less active and others may be more active, depending on the illness, and certain neuro pathways (physical) are more inclined to be used (the interconnectedness of the different areas of the brain, and even just the number of raw connections themselves) than others, independent of the neuro soup.
we are not going to completely undersand this subject matter anytime soon.
bipolars and schizophrenics have familial and environmental predispositions, both resulting in different chemical soups, and shizos with structural changes.
antisocial (serial killers) behaviour can frequently be traced (but not always) to an under-utilized frontal/prefrontal cortex
SPECT and its variants are allowing us to look closer into these processes, but we are nowhere there yet.
but major mental illness is biological and is not 'free will'
however, our legal system can not allow this to exist as truth, and thus we loosely define 'free will' for them as simply knowing right from wrong (simplified) in most cases--unfortunately, this is not justice.
the choices these mentally ill ppl have are much less under the control of their free will despite knowing right from wrong.
u probably could get a few books on forensic psychiatry to get yourself closer to understanding these processes.
- Nov 25, '11 by seizethedayYou come at this from a very neurobiological perspective. I agree that neurobiology plays a role but maybe not to the degree that you do. For example PTSD develops after a traumatic event - not necessarily due to structural changes in the brain. The brain changes with use, and that is true of every activity, not just mental illness. Reading, talking...all impact on the brain.
I agree that mental illness is not free will if by that you mean choice. No one wakes up and decides to be mentally ill. But many illnesses like depression and anxiety are interconnected to many aspects of mind, body, soul not just neurobiology. Some of it is chicken and egg and there is no real answer.
I have worked in psych for almost 15 years and over the years and as I read and teach my thinking fluctuates... learning is a moving target and i don't know if we will ever have a definitive answer but I find it interesting how others conceptualize mental health and illness.
Thanks for sharing!