why are we prone to silence re: mental health issues

[Thomas]

okay, this makes sense - between evolution/passive eugenics, and predictability I can see this being rationales for how things have become as they are. And I don't discount them: they are valid.

But - we know that there are people in these mental institutions. We also know that there are people who ought to be treated for something or another. Do we simply accept that there are some in society who will be left behind?

And how much do we lose as a society when individuals know there's something wrong but don't seek treatment for fear of being ostracized?

 

[Thomas]

Originally Posted by lee_44106

Are you OK Thomas?

What's with all this deep thoughts on, of all days, a MONDAY?

It confuses the brainz.

Lee: I'm okay, thanks, but this was something I've been turning over for a while now but haven't really been able to articulate to my satisfaction or reconcile myself to. Plus, I didn't want post 10,000 to be about cologne or some dumb news of the day.

 

[globetrotter]

Originally Posted by Thomas

okay, this makes sense - between evolution/passive eugenics, and predictability I can see this being rationales for how things have become as they are. And I don't discount them: they are valid.

But - we know that there are people in these mental institutions. We also know that there are people who ought to be treated for something or another. Do we simply accept that there are some in society who will be left behind?

And how much do we lose as a society when individuals know there's something wrong but don't seek treatment for fear of being ostracized?

how effective is treatment of the really crazy, at this point in time? there seems to be huge resistance to drugs, by the borderline mentally ill. I would guess that the level of drugs and therapy needed to treat the seriously crazy must be huge, probrably unpleasant and probrably very expensive. but does it really work?

 

[mccvi]

Originally Posted by thekunk07

it is frowned upon for males for whatever macho, bullshit reasons. i have battled anxiety and depression at various times over the years and just didn;t find therapy all that helpful. meds were in the short term. i didn;t find either to be helpful in dealing with real things like financial issues or death, only with self-made and irrational issues, but YMMV

Originally Posted by globetrotter

how effective is treatment of the really crazy, at this point in time? there seems to be huge resistance to drugs, by the borderline mentally ill. I would guess that the level of drugs and therapy needed to treat the seriously crazy must be huge, probrably unpleasant and probrably very expensive. but does it really work?
Many individuals are led to believe that once a week therapy is sufficient, and find fault with therapy if it fails to helps (and rightfully so). To draw and analogy with exercise, if one is overweight or out of shape and is told that exercising one hour a week will be sufficient, then of course they will be frustrated with the results. For most therapeutic endeavors to be successful individuals should be in treatment 3-4 times a week for at least a year (for dealing with long standing anxiety and or depression, many years more for characterological issues). Yes, of course, this is expensive. However, if quality of life is important then this is how to allow therapy to be successful.

 

[Milhouse]

Originally Posted by globetrotter

how effective is treatment of the really crazy, at this point in time? there seems to be huge resistance to drugs, by the borderline mentally ill. I would guess that the level of drugs and therapy needed to treat the seriously crazy must be huge, probrably unpleasant and probrably very expensive. but does it really work?

Well, let's take an example like bipolar disorder. For some, bipolar can be managed with a series of antidepressants and tranquilizers. Antidepressants are useful during the depressed phases of the disease, tranquilizers during the manic phases of the disease.

Unfortunately, this kind of ignores that the patient must be able to monitor and self identify these phases. . . and assume they are willing to manage away a manic phase (which is often described as the best feeling in the world, limitless energy and enthusiasm, etc).

Further, it takes a lot of work to find appropriate drugs and dosages to manage these things without being too potent or not potent enough. Just enough therapeutic effect.

Then, there is lithium. This manages the whole spectrum of bipolar. It stabilizes the mood of the patient. It takes careful blood monitoring to determine the proper dosing.

But, the discussion can be had with lots of diseases. . . cancer, HIV, endocrine disorders, etc. Treating and managing illness can be very complex, no matter the illness. Many of these things can't be cured either. And changes over time alter the treatments necessary.

 

[globetrotter]

Originally Posted by mccvi

Many individuals are led to believe that once a week therapy is sufficient, and find fault with therapy if it fails to helps (and rightfully so). To draw and analogy with exercise, if one is overweight or out of shape and is told that exercising one hour a week will be sufficient, then of course they will be frustrated with the results. For most therapeutic endeavors to be successful individuals should be in treatment 3-4 times a week for at least a year (for dealing with long standing anxiety and or depression, many years more for characterological issues). Yes, of course, this is expensive. However, if quality of life is important then this is how to allow therapy to be successful.

I would agree with that - the question is, do people get this type of treatment? and I would suggest that even long standing depression or anxiety isn't the worst type of mental illness, so for the really mentally ill, maybe 4 times a week and heavy medication isn't enough with today's level of technology and knowledge. just suggesting.

 

[MrG]

Originally Posted by Milhouse

I really was not intending it to be personal. The general public often holds notions that mental illness can simply go away if the person wants it to go away, that it is some kind of choice. Then again, sometimes I hear similar arguments for other diseases. Hell, it wasn't long ago that HIV/AIDS was "gay cancer". I just don't have much faith in the general public on most topics... admittedly, though, the general public is WAY more knowledgeable about reality tv than I will ever be.

Another point I'll make is that in mental health, unfortunately (and this really makes me angry), there are a lot of quacks. Truly, these quacks should lose their licenses for practicing anything other than evidence based medicine, but yet, somehow, a lot of quackery continues. I can remember things in the news about such quackery. IIRC, some therapist used blankets and pillows to help "relieve birthing trauma" or something from small children with behavior problems. Well, one kid suffocated. Pure quackery.

No sweat. A clear misunderstanding. Incidentally, I agree with this analysis completely.

 

[Thomas]

Originally Posted by globetrotter

how effective is treatment of the really crazy, at this point in time? there seems to be huge resistance to drugs, by the borderline mentally ill. I would guess that the level of drugs and therapy needed to treat the seriously crazy must be huge, probrably unpleasant and probrably very expensive. but does it really work?

That I do not know. I'd guess that you'd have a bell curve of treatable issues: within 1 sigma you have a good chance of simple treatment, while outside of 3 sigma there is no hope. And, you'll no doubt have unsaveable patients in all fields (cancer, AIDS, scleroderma, etc), so that's inevitable.

My focus in origianlly posting was more towards the kid who can't get out of bed morning after morning for years and everyone denies that he has a problem. Or towards the kid who has major aggression issues but no one wants to take him to a therapist or seek meds, because then he'll be 'labeled'. Or the bi-polar who has spending binges but won't take his meds because he sees them as a crutch. For some reason it seems that leaving the problem untreated is preferable to addressing it. Does that seem right?

As for therapy, the people I've spoken to and the books I've read indicate that three times a week is a minimum requirement, and daily reinforcement is even better. Even better is that you get reinforcement from other parties, which means that you involve others in your treatment which - given the stigmas associated - is a bold step, indeed.

 

[globetrotter]

Originally Posted by Thomas

My focus in origianlly posting was more towards the kid who can't get out of bed morning after morning for years and everyone denies that he has a problem. Or towards the kid who has major aggression issues but no one wants to take him to a therapist or seek meds, because then he'll be 'labeled'. Or the bi-polar who has spending binges but won't take his meds because he sees them as a crutch. For some reason it seems that leaving the problem untreated is preferable to addressing it. Does that seem right?

.

I understand. I'd rather have my kid "labeled" than have him kill himself one day, if I had any control over the matter.

 

[mccvi]

Originally Posted by globetrotter

I would agree with that - the question is, do people get this type of treatment? and I would suggest that even long standing depression or anxiety isn't the worst type of mental illness, so for the really mentally ill, maybe 4 times a week and heavy medication isn't enough with today's level of technology and knowledge. just suggesting.

the overwhelming number of people do not seem to get the correct type of treatment, for reasons ranging from affordability to access to willingness. unfortunately, it seems, imo, that increasingly industrialized societies have resulted in more isolated environments in which the broader safety net of the community or village for support is also absent. the combined effect is a double whammy of sorts with modern treatments often being out of reach and more traditional forms of support being absent.

this is a truly devastating state of affairs that created the niche for psychopharmacology to come in and try to remedy the situation with medication, but with only partial success and without addressing the broader psychological and societal problems contributing to the underlying causes of these mental difficulties.

as for the severely mentally ill, for many 4x a week therapy and medication is, indeed, not enough, and much more supportive, structured environments (residential homes, hospitals, etc...) are needed, but are, again, not very available, often are underfunded, and don't seem to be all that well run. a much larger policy and public attitude change will be necessary in the long run for the severely mentally ill, though i'm skeptical that this is attainable.

for those dealing with less severe, but ongoing, mental health issues, i reiterate the need for more intensive and longer term psychotherapy.

 

[mccvi]

Originally Posted by Thomas

As for therapy, the people I've spoken to and the books I've read indicate that three times a week is a minimum requirement, and daily reinforcement is even better. Even better is that you get reinforcement from other parties, which means that you involve others in your treatment which - given the stigmas associated - is a bold step, indeed.

+1, as previously stated.

 

[globetrotter]

Originally Posted by mccvi

for those dealing with less severe, but ongoing, mental health issues, i reiterate the need for more intensive and longer term psychotherapy.
hey, no argument from me.

 

[Thomas]

Originally Posted by mccvi

(...) as for the severely mentally ill, for many 4x a week therapy and medication is, indeed, not enough, and much more supportive, structured environments (residential homes, hospitals, etc...) are needed, but are, again, not very available, often are underfunded, and don't seem to be all that well run. a much larger policy and public attitude change will be necessary in the long run for the severely mentally ill, though i'm skeptical that this is attainable.

(...)

This is my sentiment as well. As long as there are no advocates (and, why would there be?, seeing the attached stigma) then there is no awareness, no outcry, no funding. If only Miley Cyrus or a celebrity of that stripe would come forth with some sort of issue!

 

[kwiteaboy]

Originally Posted by mccvi

for those dealing with less severe, but ongoing, mental health issues, i reiterate the need for more intensive and longer term psychotherapy.

The problem you face here is, which intensive long-term treatment modalities are empirically supported? The pressure from insurance companies for short-term (12 session) therapies has influenced the bulk of treatment outcome research towards cognitive and behavioral therapies, so there's little evidence (that I'm aware of) that long-term therapies are effective. This doesn't mean that they're not, of course, just that we don't know which orientations are successful over the long-term.

 

[martjc786]

im not following what disorders constitutes someone as "severely mentally ill," or what disorders some think are prone to suicide, or what disorders make someone unfit to be around children?

thomas - ur missing the point of labeling someone. the label would be assigned by his ignorant peers. essentially, labeling = ignorance. there is more to this kids pathology than just being depressed. stress is handled differently among people. some are just more psychologically hardy than others.

mental health also needs to be seen from a cross cultural perspective. in some asian and latino cultures, it is normal for a relative of someone who has died to hallucinate and perceive their presence in the room, or even hear their dead relative speak to them. this individual would carry out full conversations with their dead relative. would this considered normal in america? probably not. theyd be labeled as a schizophrenic.