What Is the mental illness

What is mental illness?  It’s a hot topic in the news recently, because of proposed gun control legislation. I saw a photo yesterday of people holding up a huge sign saying, “Keep guns out of the hands of mentally ill.”

There is far more to the demonization of the mentally ill than just the firearms issue. It spills over into the Federal Aviation Administration and the Department of Transportation. It is not just guns; it is airplanes and trucks as well. This brings us to the core question of, “What is mental illness?”  The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) is the current handbook for classifying mental disorders.  DSM-V is in the final stages of development and will be published in May 2013. That is only next month.

Which brings us back to the original question of what exactly is mental illness?  In New York, a man’s home was raided, his Concealed Carry Permit revoked and guns confiscated because someone told the police he was taking an anti-anxiety medication.  I have received emails in the past week from several friends about this issue.  One of them is a vet, M?F transgendered. She is concerned about being able to renew her own Concealed Carry Permit (CCP). As a veteran and avid target-shooting hobbyist, she is well trained in gun safety and use. As a transgender woman, she is a target and prey according to FBI statistics. Hate crimes against LGBT people are at a 14-year high.

According to the DSM-IV-TR, “Gender Identity Disorder” is one of the mental illnesses. In the DSM-V, it is renamed “Gender Dysphoria.”  While claiming it is not a mental illness, the fact that Gender Dysphoria is in the DSM-V in the first place makes it suspect in the eyes of many. Two days ago, she sent this excerpt from a local outlet:

The enforcement action started on March 29th when New York State Police asked the Erie County Clerk’s Office to pursue revoking the man’s pistol permit because he owned guns in violation of the mental health provision of New York’s newly enacted guns law called the SAFE ACT.

The allegation turned out to be untrue and his guns returned to him. As it turned out, the police, sua sponte, initiated the action. The only lawyer involved in the matter was the man’s own attorney.

Erie County Clerk Chris Jacobs said, “When the State Police called to tell us they made a mistake and had the wrong person…it became clear that the State did not do their job here, and now we all look foolish.”

Flaws in the mental health reporting provisions of the NY SAFE Act were blamed for the misunderstanding.  The county clerk added, “Until the mental health provisions are fixed, these mistakes will continue to happen” (source: WKBW-TV)

The bigger issue is how come taking an anxiolytic prescribed by one’s family doctor disqualifying?  It would be interesting to know just how many of those raiding officers, and their supervisors, are taking medication for anxiety, depression or sleep.

Is mild anxiety a reason to stigmatize someone, and possibly violate his or her civil rights?  It gets better. The FAA Medical Examiner will not allow psychiatric medications for any class of Medical Certificate. If a psychiatric medication, it is an automatic disqualification. Several non-psychiatric medications are disqualifying as well. When Tagamet (cimetidine) was first released to treat ulcers and hyperacidity, it disqualified one from holding an FAA Medical Certificate in order to fly.  I first heard about that from a friend who was an Aviation Medical Examiner at the time. He told me the FAA put Tagamet on the list because, “It acts on the central nervous system.”

What is mental illness? Some say it is anything that is in the DSM. However, as I have pointed out in court many times, the DSM is a handbook put together by a committee. Everyone has heard the old joke about what a committee produces: “An elephant is a mouse designed by a committee.”

The new DSM-V will be expanding the definition of ADHD.  The definition of PTSD is supposed to be clarified in the final definition.  Homosexuality was removed from the DSM-IV. If it was a mental illness, the why was it removed? The answer to that is simple. It is not a mental illness.

How prevent the mental illness

There's no sure way to prevent mental illness. However, if you do have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control. Follow these steps:

 Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends in watching for warning signs.
  

Get routine medical care. Don't neglect checkups or skip visits to your family doctor, especially if you aren't feeling well. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication.
  

Get help when you need it. Mental health conditions can be harder to treat if you wait until symptoms get bad. Long-term maintenance treatment also may help prevent a relapse of symptoms.
  

Take good care of yourself. Sufficient sleep, healthy eating and regular physical activity are important. Try to maintain a regular schedule. Talk to your doctor if you have trouble sleeping or if you have questions about diet and exercise.

The brain and mental health

The brain is a complex grouping of nerve cells and other structures that help us think, react to the environment, make decisions and plans, and carry them out. In conjunction with the nervous system, some parts of our brain are responsible for our vital bodily functions, such as breathing and the heartbeat. Other parts of our brain control learning and memory, our senses (sight, smell, hearing, taste, and touch), and emotions.

To keep the many functions of the body and mind working properly, the billions of nerve cells in the brain (which are also called neurons) must communicate with each other and work together frequently. Brain chemicals called neurotransmitters help to send electrical signals or messages from one neuron to another. At any given moment, millions of these messages are transmitted throughout the brain, allowing it to process information and send instructions to various parts of the body. In response, we engage in a wide range of behaviors, some of which we are aware of and can control, like making choices, and some of which are more automatic, like breathing.

There are many conditions which can affect our brain health, and this can have a wide range of effects on our ability to function normally. Scientific advances in recent years have made it clear that the brain plays a central role in mental health. We understand mental illnesses as conditions that negatively affect a person's thoughts, emotions, and behaviors. Mental illness disrupts one's ability to relate to others and to function when meeting the demands of daily life.

Mental illnesses include mood disorders such as major depression and bipolar disorder, schizophrenia, and anxiety disorders, to name a few. Researchers studying the role of the brain in these illnesses have found strong evidence that imbalances in certain types of neurotransmitters can cause abnormalities in the communication among neurons. When this occurs, the brain may not send the proper instructions to the body, which may, in turn, lead to certain symptoms of mental illness.

In addition to imbalances in brain chemicals, changes in the size and shape of actual structures in the brain can also contribute to certain mental illnesses. These neurological abnormalities observed in people with some types of mental illnesses are a good demonstration of the overlap between the symptoms of neurological and psychiatric illnesses. Because of the prominent brain abnormalities that have been observed, certain conditions that are considered to be mental illnesses, such as schizophrenia have been theorized by some scientists to be neurological diseases.

Dementia is another excellent example of the overlap between brain abnormalities and psychiatric symptoms. As an illness with both neurological and psychological symptoms, dementia affects thoughts, personality, feelings, and behavior. The causes of dementia, although not fully understood, have been in large part, traced to structural and chemical deterioration in the brain. For this reason, various types of dementia are diagnosed and treated by teams of professionals that include both neurologists and psychologists, both of whom are trained to assess and treat illnesses that involve brain health.

What is the good mental helth

Mental health is not just the absence of mental disorder. It is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

In most countries, particularly low- and middle-income countries, mental health services are severely short of resources - both human and financial. Of the health care resources available, most are currently spent on the specialized treatment and care of the people with mental illness, and to a lesser extent on an integrated mental health system. Instead of providing care in large psychiatric hospitals, countries should integrate mental health into primary health care, provide mental health care in general hospitals and develop community-based mental health services.

Even less funding is available for mental health promotion, an umbrella term that covers a variety of strategies, all aimed at having a positive effect on mental health well-being in general. The encouragement of individual resources and skills, and improvements in the socio-economic environment are among the strategies used.

Mental health promotion requires multi-sectoral action, involving a number of government sectors and non-governmental or community-based organizations. The focus should be on promoting mental health throughout the lifespan to ensure a healthy start in life for children and to prevent mental disorders in adulthood and old age.