The Elephant in the Room: mental disorder or mental health problem
Posted on 22/02/2012 | 2 Comments
Let’s be honest about it. Sometimes it is difficult to determine where the boundary between a mental health problem and a mental disorder can be. A mental health problem is a signal that a person is having substantial difficulties coping and is suffering a number of difficulties in their feelings, their thinking and even in their behavior. Usually the person is also having some problems functioning in their daily lives – at work or at school for instance. A person with a mental health problem will often sort things out with help from friends or confidants or when the stressors that are overwhelming them pass. Sometimes, help from a counselor or another health provider is helpful. A disorder is more substantive and usually signals that the person needs professional help – treatment to recover.
In the absence of independent biological markers (such as blood sugar levels for diabetes or the electrocardiogram tracings for heart attacks), psychiatric medicine has to rely on signs and symptoms and statistical methods to define disorders. This can leave some grey areas – perhaps more than we would like.
How to deal with these grey areas? One school of thought – exemplified perhaps by Dr. John Oldham, President of the American Psychiatric Association (APA) chooses to extend the boundaries of the diagnosis of disease, to include people with mental health problems – the so called false positives. In order to ensure that those people who need treatment can receive it. Others, me included, think that a more narrow definition of disease is warranted, so that we do not make normal life equal pathology. And, we argue that people with mental health problems are deserving of intervention but perhaps they don’t need treatment from doctors.
One area in which this debate is very heated is in the upcoming plans of the APA to consider normal bereavement as a mental disorder. To me this is just plain nonsense. Any idiot can understand that the loss of a close and intimate relationship leads to depressive like symptoms and that this is not the same thing as depression. There is no need to make usual life a psychiatric diagnosis. There is no need for medical doctors to “treat” normal bereavement. Unless of course there is insurance money involved! I wonder, is that the elephant in the room?
--Stan
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This is a great set of comments and rings very true.
I totally agree that scientists (just like everyone else) have their biases and foibles. After all, scientists are human beings too! But science is different than scientists.
The scientific method is the most objective frame that we have by which to evaluate and predict. Science is not about finding truth. It is only about being less wrong most of the time. The scientific method (experimental design and mathematics) gives us the ability to test what we believe. The scientific method is not used to prove something is correct, on the contrary, the scientific method is designed to prove that something is not correct! It is designed to test what is called the “null hypothesis”. It takes ideas that come out of left field (or wherever else they come from) and puts those ideas to an independent test.
t does not drive our beliefs. It does however challenge our beliefs. In that way it is self-correcting. Of course scientific inquiry and understanding lives within a wider social context. That is one of the great features of science.
But gravity is gravity, social context notwithstanding. And thus it is nasty, brutish and long. As Brecht said, (something like this) - the purpose of science is to save us from everlasting error.
By Christina Carew on May 11th
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garyoak said...
But which is more critical and incurable amongst these both?
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