What do you Tell Someone Who Doesn't Believe Mental Illnesses Exist?

[ChristineN]

Perhaps you psych nurses don't encounter many of these types of people, but I've been debating one recently. He believes that since the autopsy of the brain won't prove the deceased had bi-polar, ADHD, SAD, or any other mental illness, they don't exist. He thinks people just claim to have mental illnesses due to pride and mis-information, and that all they need is a little counseling (perferably from a "religious leader") and they'll see the error of their life of lies. Suggestions anyone?

[txspadequeenRN, BSN, RN]

WHAT IS THIS??????? ARE YOU KIDDING ME??????

Well, all I believe is with schitzophrenia is that it is pure evil, nothing but the devil. I mostly believe this for ones who are drug attics. I am not saying there is no psych problems though.

[CharlieRN]

Another approach might be to avoid the labels and instead discribe the sx. Then ask, "if this were somone you were responsible for, how would you deal with it?"

For example:

"This is about your brother. He has lost 60 lbs in the last 3 months. He was not overweight before. He has lost his job because he stopped showing up at work. He has not bathed in a week. In the last week he has slept less than ten hrs total. You are called by the emergency room staff to inform you, as next of kin, that he has been admitted to ICU, invountarily, after overdosing on a bottle of tylenol. When you talk to him in the intensive care unit he says, nothing means much to him anymore, he has no energy to do what needs to be done. He is angry that he was saved from death and says he will doit right next time."

That is a fairly common senario representing the presentation of a major depressive disorder. Depression is the common cold of psych.

[CharlieRN]

Perhaps you psych nurses don't encounter many of these types of people, but I've been debating one recently. He believes that since the autopsy of the brain won't prove the deceased had bi-polar, ADHD, SAD, or any other mental illness, they don't exist. He thinks people just claim to have mental illnesses due to pride and mis-information, and that all they need is a little counseling (perferably from a "religious leader") and they'll see the error of their life of lies. Suggestions anyone?

Let me guess, you met this a$$hat over on Theology On Line?

[CharlieRN]

I am not saying that there are no psych problems out there but I do believe that drug induced schitzophrenia is nothing but pure evil, the devil.

Drug induced psychosis is a legit psych diagnosis and so is Schizophrenia. But they are not at all the same thing. There are also people who believe they have been possessed by a devil. I personally had a person crawl across the floor like a snake in a human body, hiss at me, and growl that it's name was legion. She made a full recovery.

The prognosis for drug induced psychosis is pretty good too. Usually it clears after the person is kept off the drug for awhile. Occasionally, a patient does go around the bend and not come back. No one is really clear about why that happens.

Schizophrenia is a long term, most likely genetic, and treatable but not curable. Its incidence is one in one hundred males. It is much rarer in females. Onset is almost always between the ages of 15 and 25. It presents as a psychotic break, charaterized by hearing voices, paranoid delusions and often grandiosity. Usually the break is precipitated by some sort of stress such as the breakup of a relationship or college exams. With threatment the psychotic episode clears but reoccures. With each break the patient become a bit less able to manage life. After several breaks and the documentation of this general downward course, the dx of schizophrenia can be made.

[kadokin, ASN, RN]

My stepmom thought that people could just snap out of it. I told here that if peopel were able to do this, they would have already.

Good Answer!:)

[kadokin, ASN, RN]

Addicts?

In my experience, people were born with it, and i've also noticed an inherited trend. Drugs had nothing to do with how they have it.

I wonder if she is thinking more of a disorder brought on by chronic drug/ETOH abuse (I have heard people call it the "fried brain syndrome"). Not Korsakoff's (caused by liver damage from chronic ETOH abuse), but something different. I have seen it before and wish I had a better name for it. For all I know, "Fried Brain Syndrome" might BE an official DSM dx. I should look that up. Anyway, my point is that sometimes chronic drug/ETOH abuse CAN seem like the most obvious cause of psychotic-type disorders, especially self-limiting "brief psychotic disorder". ETOH can certainly lead to depression and psychotic sx are NOT UNCOMMON in depression. Hell, lack of sleep can cause psychotic sx. I hope the poster who commented that schizophrenia is evil and "of the devil" can stay w/this thread and maybe add to their knowledge. Before I became a nurse, (have worked mostly psych since), I had no IDEA how many people suffer from psychiatric disorders. Boy, did I learn. And, you know, if someone has never been exposed to severe psychiatric disorders before entering the healthcare profession, it shouldn't surprise us. Many people who suffer from severe psychiatric disorders are not always obvious to the rest of society. They often have difficulty maintaing employment and relationships. So, the "general public" is not necessarily exposed to these disorders on a daily basis. As far as "evil" goes: Metaphoricallly speaking, a lot of dx could be called "evil"-Alzheimer's, M.S., Cancer. Are they from the devil, I don't know, speak to your clergyperson. Sorry so long. As for Tom Cruise, he needs some schoolin' before he spouts his "medical" opinions in such a public forum.

[kadokin, ASN, RN]

I have to say on the subject of ADHD/ADD that there is some controversy regarding the diagnosis. In Australia for example the incidence of diagnosis and treatment varies considerably across each State, now I cant for the life of me imagine we have State's that cause more ADHD/ADD than others. It seems to me while the illnesses are most certainly valid and there are many sufferers, there is also a proportion that are misdiagnosed and treated, when in fact the cause of the behaviour is not due to brain chemistry but poor behavioural management on the part of parents.

It is sometimes hard for doctors not to diagnose, when the parents are demanding to know why little johnny is throwing tv's through windows, and that if he doesnt diagnose, the parents will simply go to the next doctor who will, rather than looking at family therapy which would address the systemic problem.

As I said before I know the illness is real and have met some very unwell children, but there have been quite a few where I have been left wondering.

regards StuPer

I know what you mean. I understand that ADHD/ADD is real. I also know that SOME people think Drs and Medicine can cure everything. I am sometimes skeptical of ADD/ADHD dx. SOMETIMES. I believe it can be a very slippery, subjective critter to dx. and some parents can put the screws to their provider looking for a "quick fix". Kind of like people that want a course of antibiotics every time they have a sniffle. Drs would never cave to that kind of pressure, would they?

[kadokin, ASN, RN]

Another approach might be to avoid the labels and instead discribe the sx. Then ask, "if this were somone you were responsible for, how would you deal with it?"

For example:

"This is about your brother. He has lost 60 lbs in the last 3 months. He was not overweight before. He has lost his job because he stopped showing up at work. He has not bathed in a week. In the last week he has slept less than ten hrs total. You are called by the emergency room staff to inform you, as next of kin, that he has been admitted to ICU, invountarily, after overdosing on a bottle of tylenol. When you talk to him in the intensive care unit he says, nothing means much to him anymore, he has no energy to do what needs to be done. He is angry that he was saved from death and says he will doit right next time."

That is a fairly common senario representing the presentation of a major depressive disorder. Depression is the common cold of psych.

Good approach Charlie. And, Danu, Thank you. You go. . . w/the web sites and the CTs and the neurotransmitter imbalance, how can they figure that from an autopsy?

And yet, some people remain unconvinced of the validity of mental illness. If someone like this wants to pull me into a debate, I tend to respond as such, "I hope you never have to encounter mental illness in yourself or those you care about, 'cause, Buddy, if you do, you are in for a ride (and not in a good way)":)

[Chaya, ASN, RN]

I would use electricity as an analogy. It is only recently in human history that we have been able to detect and empirically quantify electricity. Does this mean it did not exist before we learned to understand it?

[kadokin, ASN, RN]

I would use electricity as an analogy. It is only recently in human history that we have been able to detect and empirically quantify electricity. Does this mean it did not exist before we learned to understand it?

ANOTHER good argument! Bravo!

[Northern Star]

You tell the person who does not believe mental illness exists that perhaps he/she is correct. Because any patient with an abnormal lab result is physically ill, and most psychiatric patients have abnormal lab tests. The underlying abnormal physical state causes the mental illness.

[katy_kenemy]

Perhaps you psych nurses don't encounter many of these types of people, but I've been debating one recently. He believes that since the autopsy of the brain won't prove the deceased had bi-polar, ADHD, SAD, or any other mental illness, they don't exist. He thinks people just claim to have mental illnesses due to pride and mis-information, and that all they need is a little counseling (perferably from a "religious leader") and they'll see the error of their life of lies. Suggestions anyone?

I thought some mental illnesses, such as schizophrenia, change the very structure of the brain and would be visible during an autopsy. ?