Can mental illness be cured?

[Meraki]

Hi,

There was a comment on another thread that said "true mental illness can't be cured" and this has line of thinking has alwys intrigued me. This is not about that thread or that comment specifically but in general there seems to often be the line of thought that to be truly mentally ill you have to have a chronic debilitating illness. I know this thinking exists outside of the field of psychiatry, possibly within it as well and I'm interested in people's thoughts.

To me mental illness exists on a continuum in the same way that physical illness does. I can have a cold or the flu and this is considered physical illness despite the fact that it is short term and can definitely be 'cured'. To me illness is anytime the body or mind is not healthy, and not functioning as it should and that can range from very mild illness to very chonic severe illness. Yes, someone with cancer is sicker than someone with a cold and yes someone with paranoid schizophrenia is sicker than someone with dysthymia but me to they are all still ill. I'm not sure where the idea comes from that illness such as depression or anxiety are not 'true' mental illness. Are you not "truly' physically sick if you have a cold or the flu?

Mosby defines illness as:

an abnormal process in which aspects of the social, physical, emotional, or intellectual condition and function of a person are diminished or impaired compared with that person's previous condition.

I like it as it encompasses all aspects of a person and sets no limitations on duration, intensity or other conditions that one must meet before being considered truly ill.

Thoughts?

[RochesterRN-BSN, BSN, RN]

Generally this is where the idea of how the illness may be exasserbated at certain times in a persons life. I know where I work all of us--Psychiatrists and nurses and SW subscibe to the theory that People can very often suffer from mental illness all their life and live a relatively high functioning life.....maybe with some exasserbation of symptoms or dysregulation of mood which can be triggered by a variety things from drug use to stress to a life changing event or loss or other things...

Then there are the SPMI patients that are more likely to have a lower level of functioning.....more hospitalizations, more interventions, generally less stable a lot more often.

Some of the things we see with the kids......well that is another story......with environmental changes and age SOMETIMES kids can overcome--but keep in mind I am speaking of things not in the psychosis or mood d/o areas...more the behavioral dx like conduct d/o, Intermittant Explosive d/o, etc....... yes a large number with these end up with an Axis II Dx as an adolescent or adult but.....

Hope this helps......you might want to get your hands on a DSM IV-r

this might be helpful as well.

[Meraki]

I understand the theory you hold - I just don't agree with it! Absolutely some mental illness are life long and absolutely people with chronic mental illness can go through periods of stability and instability and that various things can exacerbate their condition. I just don't agree that these are the only situations that can be deemed mentally ill.

Why does it have to be chronic / life long to be considered mental illness? It certainly isn't that way when it comes to physical illness?

[RochesterRN-BSN, BSN, RN]

Thats not what I said....or meant anyways......No it doesn't have to be life long to be considered mental illness. But generally once one has a diagnosis one might just say a person say 'has a hx of Depression but has had no sypmtoms without tx x10 years'. That hx does put that person at higher risk then someone with no history....it's just a risk factor then per say.

[Atheos]

Technically they are all mental illnesses.

We should be more specific in our descriptions.

By true mental illness I mean life altering, if I miss my meds life could end abruptly, violently or horribly for me or someone else. To me anything short of that is well not real.

I should probably refer to them as minor and major illnesses.

I also don't argue the technical definition. So technically they are all mental illnesses. You just can't expect the cancer patient to look at a cold patient and feel bad...

[Meraki]

Thank you both for your comments - my questions are out of curiosity trying to figure out how others view mental illness and why....

PsychRNinNY - I agree it is definitely a risk factor. Would you have considered that person mentally ill during the time of their depression? Would you still consider them to be someone who has a mental illness today?

StanleyRN2B - Do you agree with the sentence: "By true physical illness I mean life altering, if I miss my meds life could end abruptly, violently or horribly for me or someone else. To me anything short of that is well not real."

Also if someone goes through a depression or has anxiety and their functioning and life is altered by those illnesses would you consider them mentally ill?

Thanks!

[Atheos]

StanleyRN2B - Do you agree with the sentence: "By true physical illness I mean life altering, if I miss my meds life could end abruptly, violently or horribly for me or someone else. To me anything short of that is well not real."

Also if someone goes through a depression or has anxiety and their functioning and life is altered by those illnesses would you consider them mentally ill?

Thanks!

I agree with that sentence because I said it.

I, personally, only consider people mentally ill if their life or function is affected AND they need medicine to control it.

Technically those that don't fall into that ARE mentally ill. I just don't recognize it as such. I know, it doesn't make sense does it.

Just the opinion of someone TRULY mentally ill.

[Meraki]

I agree with that sentence because I said it.

I switched out mentally for physically - I didn't make that very clear though...oops!

I agree with you though that all mental illness are not the same.

[DesertKat]

Why would one not say that some mental illness is, indeed, incurable? Are there not plenty of physical ailments which are incurable? Therefore, why would we expect any less from mental illness, especially when one considers that the treatment for such an illness is the alteration of the biochemistry of the brain? It is true that any mental illness, like almost all chronic illnesses, may tend to have a large variance in severity and presentation therefore making no two paranoid schizophrenics or people with bipolar the same.

And that's just Axis I. One could make a loose argument that Axis II is mental illness and once you get into that, well, there really is no "cure" for a person's intrinsic personality.

[RochesterRN-BSN, BSN, RN]

Wherehastimegone: I will say this...I don't tend to use that wordage a lot actually......I am more apt to give report to a doc--we do the evals were I work--I have a 30 YO White female with a remote hx of mental health treatment. Diagnosed with Depression around age 20 and saw a therapist for a year or so, took Prozac times 2 years but stopped and has had no treatment or meds since and reports that she felt she did not need any further tx and has been doing really well since with no further problems until now........and so on.....

So I do say "Mental health problems" really more then "mental illness".

I may be more apt to use that now and then--maybe when talking about a patient with Chronic mental illness-- more of your SPMI patients.

So I guess maybe its semantics.......but I just don't think as a nurse we have the libery to question the MDs who have given a dx. Just cause it's a mild thing maybe doesnt' make it not a dx. Thats like saying diabetes is a "real diagnosis" and hypoglycemia is not.......or MI is real and Angina is not.......

Just my thoughts.

[wonderbee, BSN, RN]

I don't think there is any illness that merges with one's identity as mental illness. Once diagnosed, many fear fully engaging for fear of return of the illness and the painful occurrence of additional loss. The stigma provokes shame which provokes self-loathing and more episodes. There is no lab test a clinician can point to to say, "it's over, you're cured." They become enmeshed and dependent on the social services system. They live marginal lives as a result. The stressors of every day living in a broken system leads to hopelessness hence altered brain chemistry and recurrence.

Notice I'm talking about the patient and not the illness. We are our thoughts. We are our feelings. We are not cancer or a cold or even AIDS. My question would be if we can cure the illness, can we cure the patient. Can this person go back out into society as though the illness suffered was no more innocuous than a common cold? Or will this person feel a need to hide it, fear its return and run away from the experience. Will this person who has been so afflicted recognize when the affliction is no longer a specter.

My thoughts are that physical illness and mental illness in many ways is like comparing apples and oranges. The study of mental illness is still in its infancy. There is still the argument of nature vs nurture. I know my generalization is probaby just so much rambling and doesn't apply to all illnesses of a psychiatric nature or all patients.

[inthesky]

Good discussion =). Most absolute generalizations don't hold water (and I think it might have been me who said it =P). First, what is the definition of mental illness? At least a fourth of all people experience a depressive episode within their lifetimes and it certainly does not mean that a quarter of the population has mental illness. Second, what is the meaning of 'cured'? We know so little about brain chemistry.

Behavioral health is very complex. Depression gets complex as it can be situational and fade as the person works it out. The meds are also much less targeted than most non-psychotropic meds. Most mood stabilizers are anti-convulsant drugs and on their very manufacturer label will state that it is unclear in its exact mechanism of mood stabilization.

There is no cure for bipolar disorder or schizophrenia like there is no cure for diabetes. Other things can get complex depending on definitions. There is also a complicating factor in misdiagnosis.

Emphasizing meaning of 'chronic illness' can be pretty much telling people to take your meds and keep your appointments. I'm tired. I hope this made sense. =)