Desperate Remedies- Book on Mental Illness
If you have anyone in your life who struggles with mental illness, I recommend reading this book about the history of psychiatry and psychology.
To try to help people and their families who suffer as a
result of mental illness there have been many attempts to cure and help. Sometimes
these attempts have been terrible and sometimes they have been blinded by the
desire for profit and prestige.
Helps that have been attempted include:
-inducing seizures (through chemicals or electricity) so
intense that bones would break. Electroshock was also commonly used as a
punishment or to keep a peaceful ward.
-infecting patients with malaria to induce a fever.
-Cutting out parts of the body that were believed to be infected,
which were believed to cause an infection in the brain. This included pulling
teeth (sometimes all of them, even healthy ones), removing the stomach, the
colon, the uterus, etc. When this did not help (even when 30-45% of patients
died with the more invasive surgery) the doctors would double down saying they
thought that maybe they didn’t remove enough, which is why they didn’t get all
the infection.
-the Asylum system was first created to help patients
retreat from the world and be cared for, which eventually turned to a kind of
prison where an individual’s choices were taken away as patients were
considered evolutionarily broken and should not reproduce, and so were sterilized
(eugenics). This then became unpopular thanks to novels/movies like One Flew
Over the Cuckoos Nest. The Asylum system was slowly shut down, which ejected
patients into the streets and prisons.
-Doctors began to use surgical lobotomy which damages the
frontal lobes of the brain and seemed to reduce the activity of more active
patients (They became easier for the staff to manage).
-There was a divide between seeing mental illness as purely
biological (a brain disease) and those who saw it as a problem of the mind (bad
thinking patterns and habits). Freud became the leading figure in dealing with
mental illness as being a ‘mind’ issue, boiling down mental illness as a way
the mind deals with not being able to express basic physical desires like sex.
-making mental illness seem more like the physical medical
field, the DSM (the Diagnostic and Statistical Manual) was produced which
helped to categorize and diagnose mental illness. It gave mental illness the
appearance of a disease like any other physical illness. The problem was that
it wasn’t very helpful with giving a consistent diagnosis. Two different
professionals could diagnose the same patient with very different illnesses. Changing
the DSM can be very difficult as doctors, patients, and insurance companies now
rely on these diagnostic categories to pay for care, and put a tremendous amount
of pressure to resist drastic changes. Some changes that have been made to the
DSM were not on the basis of research, but on the basis of a vote of the members
of the psychiatric association. A vote of 3000 to 5000 could get a diagnosis
removed from the DSM.
-The modern era has seen a turn away from mental illness as
being a ‘mind’ issue and more as a ‘brain’ issue. The use of medications now
overwhelms the field. A doctor/psychiatrist can diagnose someone with a mental
illness and prescribe a medication with very little time spent (or no time
spent) in talk therapy. The use of drugs and which drugs are predominately used
is a dubious thing in itself. Drug companies had been left to do their own
research and then to promote their drugs on the basis of their own research.
This has often led to corruption. Psychiatrists who worked for drug companies sometimes
worked on the inside of psychiatric associations to promote the use of the drug
made by the company that was paying them. There have been many conflict of
interest cases like this. The ability of the drug to help has been exaggerated (sometimes
the effect is almost the same as the placebo), and the side effects have often
been minimized or hidden. Patented drugs have been pushed, but when the patent
wears off, the drug becomes less desirous. Sometimes unproven claims are made
to support the use of a drug. For example, depression is caused by a lack of serotonin
in the brain. But, there is no understanding or way of measuring a normal level
of serotonin. It is an unproven hypothesis. We might as well say that a
headache is caused by a lack of Aspirin in the brain.
-Millions of dollars have been spent to try to find a
genetic cause for various mental illnesses, but with next to nothing to show
for it. There seems to be no gene or set of genes that can be pointed to as the
culprit behind illnesses like schizophrenia.
The book is not meant to debunk those who claim to treat
mental illness, though it does show that any sense of finding a cure for (especially
serious) mental illness remains illusive. It does, however, give reason for the
public to be suspicious about the field claiming expertise in this field. And
it should also give a good dose of humility to the field. The author believes
we must deal with mental illness from a mind, brain, and social reality- one
not being able to be separated from the other. We cannot talk about how much of
mental illness is due to social causes any more than we can talk about how much
width makes up a rectangle.
https://www.youtube.com/watch?v=wwj2l_RncrI&t=2523s
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