The treatment of mental illness

Okay, so today I want to talk about what I think is one of the biggest problems within the mental health field. The idea that once the symptoms stop interfering with a person they are cured (recovered, etc). I frequently discuss and read information regarding mental illness, and other things which semi-relate to mental illness, and often the key factor is something like “causes sever emotional distress”, or ” interferes on ability to function”. Well that’s good and all for a diagnosis, since some things are hard for a layman to separate something like asexuality, with one of the “lack of sexual desire/libido or attraction” syndromes/disorders. (Yes, I’ve had many people try to tell me that I’m not asexual/aromantic, I’m mentally ill.). Even still, I’ve heard about people who’ve learned to manage probable ADHD, they literally fit the diagnosis. The only reason they don’t get the diagnosis is because of that one little criteria (causes emotional distress, or harms ability to function). Or people with eating disorders. they have to be so severely underweight to get the diagnosis that I find it ridiculous. Truthfully, In my (uneducated) opinion, they need to get rid of the weight requirement, because the other symptoms are bad enough, with the weight requirement it’s like the people who set that requirement didn’t realizes that it’d be easier to treat people earlier before they were that set in the mind set. Yes I do know that there is the unspecified eating disorder, or something like that. but people deserve to get the right diagnosis the right treatment for their condition. they don’t deserve to be told “well, in spite of meeting all the symptoms you can’t get diagnosed since it’s not affecting your life enough.”

I think that mental illness is like cancer or asthma. It can be simple, or hard to treat, depending on when it’s caught, what type of disorder it it, and how sever it is. I think we need diagnosis categories that reflect that. How about Chronic Depression disorder, which similar to bipolar depression, lasts most, or all of your life, where your depression doesn’t sit at one constant level, but fluctuates. I know there is Dysthymia, but that’s long term minor depression, and doesn’t account for long term ,or frequent re-occurrence of major depressive episodes. I know that the people who fit this diagnosis get diagnosed with major depressive disorder. But I think that people who continue to relapse into depression deserve to have that recognized, because to me, it’s only logical to assume that there is something different from them, either chemically, or in their environment, etc (Who knows what it could be) that causes them to relapse, and that their treatment should reflect that, compared to the person who only ever has one major depressive episode.

There also needs to be a new “Standardized Questionnaires”. The one I was given was not accurate for me, I mean it was partially accurate, but some of the questions I had to say no difference, because I had nothing to compare it with, and it was asking about a two week time period. I’ve been depressed for half my life now, usually at the Dysthymia level, with a few MDE’s thrown in the for ‘fun’ (on a self diagnosis, reflection bias). Any question like “do you feel less interest in things that you used to enjoy” is going to get a no, not because that might not affect me, rather, it’s been so long since I’ve done anything that’s not a coping mech that I’ve nothing to loose interest it. The questionnaire I had though, would be good for monitoring changes in how depressed you are, if modified slightly, but once again, only on the short term. It’s the same with interpersonal relationships. It’s been so long since I’ve had one, and their are so many things unrelated to depression that can affect this, that it’s inaccurate at best.

What needs to be asked? though a leading question, it is important, “how long has it been since you have felt predominately happy?”. And the questionnaire given out needs to be tailored to the answer. If it’s only been a two or less months, give them the current questionnaire, otherwise you need a brand new questionnaire, because time does affect our ability to answer the questions.

And when your symptoms start going away, you shouldn’t be told “I think we should stop seeing each other” as my councilor essentially did. We were seeing each other every three weeks, and as it was a busy low stress time, and I let myself be led by her, rather then talking about what I wanted or needed to (I would forget, or we’d run out of time), and she just popped it on me, thinking that would be our last session. What I feel it should have been was, “I think we need to consider whether you are ready to stop counseling, and how to prepare you for that” and used the next few sessions for that. Which we kinda did, I have this small sheet of things I can do to keep myself healthy. But it’s not what I needed. Or at least, not what I think I need. I also didn’t need the pressure of deciding whether or not to book a new appointment each session, when I feel pressured to or not. I wish it would have been like I thought it would be, three to six more sessions (we spaced them one a month, could have spaced them out more), to see if I stay stable, to make sure I feel ready, and then reassess in the last session. I could have dealt with that (Actually Friday will be my last session, hopefully she’s right).

And, no matter what disorder it is, depression, anorexia, it should be treated like some one who’s in remission for cancer. The file shouldn’t close after three months, there should be check-ups, and monitoring, and emergency help available. When I went in originally for help, it took two weeks I think to get evaluated for where I should go to get treated (I went to the free gov. serves), Then my appointment was set a month after they decided where I should go. When I went in there I was in melt down mode. Struggling to do anything, and I had to wait almost two months for help. I worry about having to go through that again. I know others have to, and it’s not fair. Especially since many  mental illnesses are life long, or have high relapse rates.


One comment on “The treatment of mental illness

  1. Your post is very interesting; we are so used to listening to those who work to “normalise” everyone. But mental health is a very, very grey soggy area, and it’s next to impossible to diagnose anyone who isn’t at the extreme end of their spectrum – and even then…
    If possible, we should all work to match the standard WE want to meet, the way of life and way of looking at the world that makes us as happy as possible. We want joy in our lives, regardless of what others think we should have or want.
    We’re all the same, and we’re all different. One size does not fit all…
    Good luck with your struggles!
    cheers, Charlie

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