Mental illness has many faces

  • Article by: Kristina Roegiers
  • Updated: May 20, 2013 - 8:07 PM

It has many faces, some of which are far from obvious by outward appearances. We’d be wise to recognize that.

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considerateMay. 21, 13 8:17 AM

Kristina, thank you for writing this. The stigma of mental illness endures in part because the symptoms are behavioral, and people unfamiliar with the many aspects of the disease think that you just need to get a grip, or not worry so much, or try harder. The reason it is called mental illness is because the normal coping mechanisms are not working. Medication and/or therapy is needed, and the process can be long before results are visible. Our fast-paced, judgmental society has no patience for that. Even family members and friends can run the gamut from supportive to dismissive. Commentaries like yours provide some understanding of the mechanisms of this disease and hopefully open up a window for others who may need help.

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cookiemMay. 21, 13 9:04 AM

Kris, thank you for this amazing writing! You have open doors for people who have been trying to get through them for years. This was a very brave and relevant piece and I hope readers will become more aware and learn more about the disease.

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crystalbayMay. 21, 13 6:15 PM

I appreciate this article because it's an honest effort to demystify "mental illness" - something badly needing. At the same time, I've been a therapist for over 30 years, dealt with my own recurrent depression, and do not see depression as a "mental illness" at all unless part of bi polar illness. I cannot buy that any type of other depression necessitates a lifetime on meds or in therapy. I've treated depression for three decades and never yet encountered some form of it which defies resolution. Never once. Med and talk therapy are definitely the only way out, but this author seems to have accepted that this will always be part of her reality. I challenge this base on both my professional and personal experience. I never think of my clients as "mentally ill", by the way. Never. I see them as human beings whose childhood histories set them up for gripping problems as adults and whose wounding early in life have dysfunctional outplays. I do not see this as "mental illness" in any way, but wounding badly in need of healing.

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docgeddyMay. 21, 13 9:02 PM

The discrimination facing the millions of Americans with mental health diagnoses often begins, not with the stigmatizing representations in the media, but with many medical care providers. The system, and all too often the young doctors plugged into its protocols, engenders the suspicion and distrust of those most in need of help. My wife, Marykay, has suffered with bi-polar disorder and PTSD for most of her life. In the 1980s she was also diagnosed with borderline personality disorder. She has faithfully pursued cognitive-behavioral therapy and her prescribed pharmaceutical therapies ever since. She completed an undergraduate degree and some graduate work and is in every way a success story like Kristina. In July, she injured her back, incurring great pain. However, it wouldn’t be her recent history of bone fractures. It was her mental health diagnosis. Her pain was diagnosed as drug-seeking—despite a medical history of over 20 years of sobriety. She was referred for Physical Therapy and told to get used to the pain. “Work on your core,” she was advised, despite not being able to sit or stand for long or bend over. The doctor’s notes for that back pain visit began with a review of Marykay’s mental health history. Not one word about her having broken four limbs in five years. This refusal to treat is one form of discrimination the mentally ill face in getting medical help. And the new “protocol-driven” medicine designed by doctors, lawyers, and insurance officials that is passing for health care reform will only make this problem more severe. Mentally ill Americans can present with heart disease like anyone else, but the cardiologist must compensate for psych meds that make the patient gain weight or become lethargic. Patient protocols that limit the treatment process to test/procedure/drugs/diet/exercise are sufficient for most patients. For the mentally ill, who are already engaged in often-conflicting chemical therapies, that same treatment can sound very like “get used to suffering and plan accordingly.” We’re talking here about those who are faithful to their therapies, who know the rewards that can follow. The increasing de-personalizing and “protocolizing” of medicine will ensure that the mentally ill are never treated as whole persons with complex and sometimes conflicting diagnoses. And for those entering a system that may never see them as more than a set of symptoms to triangulate with the DSM-V and the PDR (Physicians’ Desk Reference of drugs), we can say advocate for yourself, stick with the therapies that help, but question everything and everyone. Until we start treating the mentally ill holistically and without prejudice, we’ll never get to the second thing we need to do to fix the mental health system.

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farmeretteMay. 22, 13 9:57 AM

Crystalbay, I must disagree with you. Recurrent major depression is indeed a mental illness that requires lifelong treatment. Talk therapy may be helpful but medication is necessary. The depression you refer to is something else - maladjustment, bad feelings, unhappiness. . . Major depression is, as the author implied, incapacitating. Furthermore, as a therapist, rather than a psychiatrist, you are not qualified to diagnose mental illness.

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crystalbayMay. 22, 13 1:05 PM

"Furthermore, as a therapist, rather than a psychiatrist, you are not qualified to diagnose mental illness"...............I'm sorry to have to correct you, sir, but across this whole nation, psychologists and clinical social workers have indeed been diagnosing and treating mental illness for decades! Psychiatrists are rarely the first place troubled individuals turn and are not the professionals who actually treat mental illness or do therapy. Psychiatrists write prescriptions, something therapists cannot do, but 90% of treating mental illness is done by professional therapists. In Minnesota, clinical social workers perform nearly 70% of all therapy. I'm not sure why/how you've formed your opinion, but it is completely incorrect. Furthermore, after 30 years of doing therapy, I've dealt with hundreds of people diagnosed with recurrent major depression who have indeed moved beyond it and not been consigned to a lifetime of medications. The exception is with bi polar illness.

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