What is mental illness,mental health,mental disorder?

teejai · Jan 29, 2009, 09:09 AM

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A more difficult question to answer than one might think. As usual your definition depends on all or some of: your point of view, how deeply you wish to probe, how many people are sitting on your committee and how long you’ve got to write it before you break for lunch.

Before I get stuck in, it’s worth noting that the term ‘health’ is a non-exact term used loosely in everyday speech. Equally ‘mental health’, ‘mental illness’ and ‘mental disorder’ are used with an comparable lack of precision and the latter two most often interchangeably. In addition psychiatric health/illness/disorder are used synonymously with mental health/illness/disorder. A further problem with this concept is that there is no clear cut off point between mental disorder and mental health; indeed one person’s mental health, might be another’s mental disorder.

With this poverty of precision already built in, it is probably unfair to expect too much. For this posting I will be mostly using the phrase ‘mental disorder’. Whatever their definitions, common sense dictates that ‘mental health’ and ‘mental illness’ are at least related such that as one increases, the other decreases. There is no definition of mental disorder which is either entirely satisfactory or uniformly accepted.

For legal purposes, the UK’s Mental Health Act 2007 defines mental disorder succinctly and thusly:

‘Mental disorder’ means any disorder or disability of the mind (page 7)

It is clear here, even to the casual reader, is that there is a marked circularity to this statement. Verbose as ever the World Health Organisation makes the following submission:

Mental health can be conceptualized as a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Furthermore they state emphatically:

Mental health is more than the absence of mental disorders (read the rest)

Inspiration for the definition of mental disorder often comes from the world of general medicine. Whether or not a mental disorder can or should be considered in the same way as, say, a viral illness is a discussion for another day but it is a direction that modern psychiatry is wedded to. Looked at this way mental disorder can be:

An absence of mental health.
A stumbling block here is that health is at least as difficult to define as illness. Always willing to have a bash, the WHO have defined ‘health’ as ‘a state of complete physical, social and mental well-being and not merely an absence of disease or infirmity’.

A presence of significant psychopathology.
This is related to the definition ‘disease is what doctors treat’, in that psychopathology would be identified by a nominated professional (but with their own distinct gaze…). It is another rather circular argument which allows for expansion of the concept which it describes, as when treatments become available for a condition it is more likely to be considered a disease (think of depression).

Similar to defining mental disorder as the presence of psychopathology is the wish to define mental disorder as the ‘presence of suffering’. This defines the group of people most likely to consult doctors, or other health care professionals. However unlike the definition relying on psychopathology, it leaves out people with mental disorders whose main effect is not felt by the sufferer at the time, for example during the manic phase of bipolar disorder or schizophrenia without insight.

Finally depending on our agenda, we can also choose to define mental illness out of existence. Enter the philosopher and anti-psychiatrist Thomas Szasz who wished to define a disease purely in terms of its physical pathology. Since most mental disorders do not have any demonstrable physical pathology, they are by this yardstick not illnesses. Although not sunk, this view has come under considerable attack from research which suggests genetic and neurobiological processes are involved in the aetiology of mental illness.

Further reading:

There’s a chapters in this book
Clare AW (1997) in The Essentials of Postgraduate Psychiatry
and a section in
Shorter Oxford Textbook of Psychiatry

Also Wikipedia

http://frontierpsychiatrist.co.uk/wh...ntal-disorder/

Rhapsody · Jan 29, 2009, 12:52 PM

IMO - it is when the mind, thoughts and actions of a person do not perform within the realm of what is considered normal for a human being.

Berries · Jan 29, 2009, 01:44 PM

In my mind it means significant impairment or disabled social/occupational functioning, from either emotional distress or cognitive inabilities or both.

teejai · Jan 29, 2009, 06:28 PM

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Originally Posted by Rhapsody

IMO - it is when the mind, thoughts and actions of a person do not perform within the realm of what is considered normal for a human being.

Isn't regarding people as mentally ill on that basis a means of pathologising divergent or eccentic thinkers?
It brings up the spectre of correcting behaviours as a means of social control.
I believe Soviet psychiatry went down this road.

teejai · Jan 29, 2009, 06:51 PM

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Originally Posted by Lbien6

In my mind it means significant impairment or disabled social/occupational functioning, from either emotional distress or cognitive inabilities or both.

I am not sure that a lack of functioning due to cognitive abilities necessarily renders a person mentally ill. Agreed cognitive disability occurs within mental illness most especially schizophrenia but not all people with cognitive inabilities exhibit signs indicative of a mental illness.
I agree that a reduction in occupational/social functioning is something that can and does occur in people who have symptoms that are seen as pointing to mental illness.
Indeed cognitive disability whether it be in terms of an overall ie generalised reduction in cognitive ability or specific areas of reduced intellectual functioning is reckoned to play a part in the ability to function successfully both socially and occupationally.

pachyderm · Jan 29, 2009, 07:40 PM

Here's my two cents: mental health means that the person feels his or her feelings or emotions without internal censorship. That is, thoughts and feelings come to consciousness as they happen, and are not hidden from the person.

sgrrsh26 · Jan 29, 2009, 09:32 PM

Is it just me? can i snap out of it? sometimes. Sometimes i tell myself im normal. and sometimes that works. Other times im so mentally confused i cant. Im stuck in this depressive state and no matter how much i tell myself its just a dream, i cant shake it. that is to say, if i even think of it, the "coping technique".

Rhapsody · Jan 29, 2009, 11:32 PM

Quote:

Originally Posted by teejai

Isn't regarding people as mentally ill on that basis a means of pathologising divergent or eccentic thinkers?
It brings up the spectre of correcting behaviours as a means of social control.
I believe Soviet psychiatry went down this road.

No - I don't think so...... as we know what is basically normal (just like we all know what is basically right & wrong) and this is how we can tell if someone we love is not acting right - based on a unstated description of normal.

Ex: we all know that it is not normal to hear voices, to see people that are not there, to feel that everyone is out to get you / kill you, to think that a dog can talk and that cats are aliens sent here to impregnate the universe, to believe you are God, Satan or a Famous Dead Person... etc.

teejai · Jan 30, 2009, 01:01 AM

Quote:

Originally Posted by Rhapsody

No - I don't think so...... as we know what is basically normal (just like we all know what is basically right & wrong) and this is how we can tell if someone we love is not acting right - based on a unstated description of normal.

Ex: we all know that it is not normal to hear voices, to see people that are not there, to feel that everyone is out to get you / kill you, to think that a dog can talk and that cats are aliens sent here to impregnate the universe, to believe you are God, Satan or a Famous Dead Person... etc.

So we are talking about a marked degree of divergence from what is considered normal ie it is the qualitative nature of the divergence as opposed to merely the mind, thoughts and actions being divergent that indicate mental disorder/mental illness ?

pegasus · Jan 30, 2009, 07:34 AM

I think you are making this more difficult than it should be.

Mental illness/disorder = Psychological distress

scoobywho · Jan 30, 2009, 07:40 AM

Quote:

Originally Posted by teejai

So we are talking about a marked degree of divergence from what is considered normal ie it is the qualitative nature of the divergence as opposed to merely the mind, thoughts and actions being divergent that indicate mental disorder/mental illness ?

I understand what you are saying. I dont think there is any clear way of thinking that when you describe mental illness you have to label it, I feel mental illness is over labelled if there were no labels people would probably cope alot better.
I have been wondering wether I am developing bi polar or is this just another label you tell me.

pachyderm · Jan 30, 2009, 08:49 AM

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Originally Posted by pegasus

I think you are making this more difficult than it should be.

Mental illness/disorder = Psychological distress

I disagree. Psychological distress might be caused by the death of a loved one, for instance, without there being any (long-term) disorder involved.

And being out of the norm does not cut it for me, either. The norm, or "normal", just means you fit within a certain distance of the average of what exists in the surveyed population. That would be the same as "healthy" only if the population average is healthy -- which I think is subject to dispute. The definition of healthy depends on "objective" factors (at least theoretically) and not on averages of what exists in any given population.

Freud was one, for instance (and I agree with him) who wrote, in The Psychopathology of Everyday Life, that everyday life is, to some extent, psychologically pathological. That seems to be backed up by evidence: would you say that our societies display notable emotional health? Crime, wars, child abuse, unbalanced "leaders", emotionally disturbed people such as us -- those things do not come from nowhere.

pegasus · Jan 30, 2009, 08:57 AM

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Originally Posted by pachyderm

I disagree. Psychological distress might be caused by the death of a loved one, for instance, without there being any (long-term) disorder involved.

It doesn't surprise me that you disagree with me pachyderm.

There are varying degrees of psychological distress, how it presents itself and how long it can effect you.