Mental illness, and

The stigma attached to mental illness is pervasive and affects the lives of people with mental illness. It makes the patient reluctant to come forward and ask for help. It makes rehabilitation after an episode of illness difficult. It contributes to the loss of self-esteem of the person who has the illness, a consequence that is particularly nefarious because it often blocks full recovery. Stigma also affects the members of the family, making them reluctant to admit that one of them has a mental illness and may need treatment, ft demeans institutions in which treatment is provided as well... 

The collaboration between mental health services and members of families of people with mental illness and their other carers is of essential importance in developing a useful and successful mental health service. Collaboration with carers is not in existence in many of the Third World countries, and in places where it exists it is at present often restricted to a one-way communication of instruction of what the carers should do to assist in the realization of the treatment plan established by the medical practitioners. Advice from carers and information about the effects of treatment can both be of great value in the treatment of individual patients and in deciding the best use of medications and other treatments in health services in general. 

As nylon and the plastics revolution became a part of modern life, the figure of Carothers receded tragically into the shadows. The horror of his death, the social stigma attached to mental illness and suicide, and prevailing social codes that discouraged the discussion of personal tragedies contributed to an atmosphere of secrecy that surrounded his life. As late as 1979, the Encyclopaedia Britannica credited Father Nieuwland with the discovery of Neoprene. 

Gerald N. Grab. Mental Illness and American Society 1875-1940. Princeton, NJ Princeton University Press, 1983. Source for history of psychiatry. 

Invent medicines that go beyond treatment to provide cure or prevention of life-limiting conditions and diseases such as cancer, Alzheimer s disease, mental illness, and diabetes. 

Evaluation of the concept of mental illness suggests that there are other aspects of its definition that create variability. Lilienfeld and Marino (1995) stated that there has always been great difficulty in establishing the boundary between mental illness and normalcy. These authors suggested that we need to accept this fuzzy boundary as a necessary condition of mental illness. They argued that mental illnesses should be considered open concepts (Meehl, 1977) or Roschian concepts (Rosch, 1973). A Roschian concept is essentially the same as the open concept we have already defined. It is a mental construction used to categorize natural entities that are characterized by fuzzy boundaries. Lilienfeld and Marino argued that this conception of... 

The discovery of psychopharmacological medications was revolutionary because they provided a means of treating illnesses that were otherwise intractable. With the exception of electroconvulsive treatments for severe depression, there were no medical treatments for disorders that did not respond to psychotherapy. Once established, the drugs led to an ongoing search for more effective and safer medications. A second reason for their revolutionary status is that they furthered understanding of mental illnesses and normal brain function. Investigations of their therapeutic mechanisms led to theories of the neurochemical bases of mental illnesses. 

There is no doubt that between them mental illness and the mental effects of recreational drugs are of major medical and lay interest and of considerable public concern. The hrst section of this chapter provides an account of the biochemistry and physiology of normal mental activity, to enable a better understanding of how far changes in the biochemistry can explain mental illnesses and the effects of recreational drugs. 

Rachel s account is partly the story of a young woman s efforts to discover her own authentic voice. One of my first questions in our conversation was Where is home She replied, I don t think I have a home. Rachel s response became less puzzling when she later described growing up in a family dominated by a mother s mental illness and a father s physical abuse, a circumstance tailor-made to stifle a young girl s selfhood. Such an outcome may be heightened for a child who takes on the role of family peacekeeper. Here is how Rachel depicted her family life and relationships ... 

Once people have made the fundamental decision to continue on medications, the question becomes how best to live with their new partner how to reach accommodations that will make the relationship healthy and satisfying. The shift in emphasis from whether to how best to maintain a medication relationship solidifies their investment in the biomedical model of mental illness and its claim to appropriate treatments. While many may still dream about a future free of pills, by this point they have likely made a lifelong commitment to drug therapy. The decisive moment comes with the realization that I ve accepted now that this is the way I am. This [using medications] is what I ll need to do for the rest of my life. ... 

Many expressed the feeling that a diagnosis of mental illness and the suggestion that they take medications made them feel defective ... 

M. Brenner, Mental Illness and the Economy (Cambridge, Mass. Harvard University Press, 1973). See also M. Lennon, Work and Unemployment as Stressor, in Horwitz and Scheid, Handbook for the Study of Mental Health. 

Over 10 million women in the United States will suffer from the symptoms of mental illness during their childbearing years (Bourdon et ah, 1992 U.S. Census Bureau, 2000) and more than 50% of pregnancies are unplanned. These two facts emphasize the importance of educating women s health care providers regarding the risks associated with mental illness and the medications used to treat these disorders. 

Mood dysregulation and/or thought disturbance increase the probability of aggression. Recent data suggest a link between mental illness and violence individuals with psychotic or mood disorders are five times more likely to engage in violence than those in the normal population. Substance abuse more than doubles this risk (Swartz et ah, 1998). 

These principles of collaboration are especially important in studies involving pediatric psychopharmacology, in part because the misunderstanding of pediatric mental illnesses and the concerns about medications, have created a climate of distrust and confusion. Direct and open communication between stakeholders and researchers is necessary to accomplish the goals of creating an ethical and valid scientific base. 

NIMH s goal is to reduce the impact of mental illnesses and disorders by developing a better understanding of the brain and how it works. Not only does mental disease affect its victims on a personal level, the losses suffered by the economy due to reduced productivity are severe— 150 billion, according to an estimate by the Department of Health and Human Services. 

Another urgent requirement for biological psychiatry is that the border between mental illness and mental distress needs to be clearly marked. As an analogy, the distinction between the common cold and tuberculosis is crucial if one set oneself to elucidate the pathogenesis of the latter. In the same vein is the distinction between sorrow and depression crucial in biological studies of depression. Modern psychiatry, however, has shown little interest in this problem. 

Glue P, Nutt D Clonidine challenge testing of alpha-2-adrenoceptor function in man the effects of mental illness and psychotropic medication. J Psychopharmacol (Oxf) 2 119-137, 1988... 

The precursors of modem psychopharmaceuticals. Le. opium, hellebore and rauwolfia, cannot be considered in isolation but only by reference to their contemporary healing arts. Mental illnesses and their possible treatment have confronted people with the same questions at all times where do the irrational ideas and impulses of the insane come from their moods, notions, anxiety and illogical behavior Have these people sinned so that God has now cast an evil spirit into them as a punishment What is this evil spirit a spirit of nature, the ghost of an ancestor, a devil Or is it the patient s sick body that produces the delusions without an outside agent an unknown disease, a poison from within ... 

The major authority for medicine in the Middle Ages was Galen of Pergamon, who worked in Rome in the second century AD. Galen adopted the humoral theory of Hippocrates, including the classification of mental illnesses, and his therapeutic recommendations were also based on the tradition of the Hippocratic school diet, vomiting, blood-letting and the administration of soporifics. 

Dickey B, Normand SL, Weiss RD, Drake RE Azeni H (2000). Medical morbidity, mental illness, and substance disorders. Psychiatric Services, 53, 861-7... 

Drake RE, Mueser KT Brunette MF (2007). Management of persons with co-occurring severe mental illness and substance use disorder program implications. World Psychiatry, 6, 131-6... 

Jerrell JM Ridgeley MS (1995). Comparative effectiveness of three approaches to serving people with severe mental illness and substance abuse disorders. Journal of Nervous and Mental Disease, 183, 566-76... 

Johnson S (1997). Dual diagnosis of severe mental illness and substance misuse a case for specialist services. British Journal of Psychiatry, 171, 205-8... 

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