Mental Illness is Invisible
Mental Illness is a Physical Disease
The title of this article may sound like a strange statement but the difference between mental disease and any physical disease is simply the visibility of the condition.
The moment you see your friend walking towards you in a very awkward manner, you know they have hurt their back. People with laboured breathing, those who have to stop and inhale a shot of nitroglycerin for their heart, and others with walking canes, walkers, wheel chairs and special sticks to indicate their blindness are all obvious to us. The shrunken look of your friend or loved one as they slowly succumb to the cancer within them is so visible it hurts. And yet mental illness is just as physical but we cannot see it.
The fact that this disease is so invisible causes many of us to be dismissive. We all have good days and bad days so why doesn’t this person just get hold of themselves and get on with their life? We may feel that this person’s illness is in their head or self-induced and as a result we have very little sympathy for those afflicted with mental disease. Sometimes it is visible to us when we see children with Down’s syndrome or Autism or even the ramblings of homeless people but in most cases this illness is totally invisible. As human beings we tend to be judgmental and bigoted whether we admit it or not. That is why we accept mental disease when we can see it but very often dismiss it when we cannot.
Let us consider for a moment the recent deaths of three hockey players, all of which played enforcer roles and took many hits to the head. What a strange coincidence that all three felt so depressed they either killed themselves with drugs and alcohol or in the case of Wade Belak, hung himself while all alone in a Toronto hotel room. Like Mark Rypien and Derek Boogaard, he had a beautiful wife and very young children and yet he chose to die. I do not believe he made that choice. I personally think that his brain, like the others, suffered so much damage that it was in physical disarray and would not work. Neurons and synapses were damaged and none of these men had the ability to use any logic to operate their lives.
The nineteenth century German philosopher, Friedrich Nietzsche, wrote that if you want to commit suicide do not do it today but wait until tomorrow. You can always commit suicide the next day if things are still just as bad. This is a rational thought available to anyone with a normal brain but not available to a person who has suffered some brain damage.
In the same way that there are hundreds of thousands of diseases and infections that can make you physically ill, there are probably just as many ways for the wiring in your brain to go wrong. Look at the boxer Cassius Clay (Mohammed Ali), who after years of fighting did not commit suicide but came down with Parkinson-like symptoms that rendered him an invalid. The blows to his head caused different problems than those to our hockey players.
We know very little about mental disease and all the different conditions except for the terms we see on television like paranoid schizophrenia, obsessive compulsive disorder and attention deficit disorder. These are labels for a disease we cannot see and cannot understand but all these diseases pale in comparison to the one that seems to affect us the most, depression.
According to Health Canada and Statistic Canada, 8 percent of all Canadians will suffer from depression at one point in their lives. In 2008 there were almost 20 million doctor visits for this condition, second only to heart related diseases such as blood pressure and cholesterol. Statistically twice as many women are diagnosed with depression as men but this is probably because of the nature of men who do not like to open up or share their feelings easily. This is the most common of all mental diseases but it cannot be explained. We all have good days and bad days. If you lose your job or lose a loved one you should feel down and depressed. That is normal. However, if nothing changes and you find yourself in a depressed mood that will not go away, something has happened in your brain. You could give a clinically depressed person a million dollars and they simply would not care. I believe it is a physical phenomenon, no different than acquiring a stomach ulcer, a herniated disc or a sore back. Something has physically gone wrong and we do not know why.
If you see your physician or a psychiatrist they will give you drugs that may treat the problem. But the research on brain disease is in its infancy and we know too little to be using drugs that have such harmful effects. Penicillin was discovered in 1928 but it was not until the mid 1940’s that we started using it as an antibacterial. Our knowledge in those days was that all infectious diseases were caused by bacteria and we could treat these diseases with penicillin. Since then we have discovered, viruses, fungi and all types of infectious parasites that require specialized treatment and which cannot be eliminated with mere penicillin. Imagine a physician trying to treat AIDS with penicillin.
Yet we use antidepressants such as SSRI’s (selective serotonin re-uptake inhibitors) that interfere with the normal ebb and flow of serotonin, a naturally occurring hormone in our brains. The newer antidepressants now interfere with another transmitter, norepinephrine and this has unusual effects on dopamine and our pain and pleasure centres. People react differently to these medications. Some are actually helped so whatever happened in the brains was adjusted by the drug. Some stay depressed and commit suicide while on the drugs. In fact, many studies show that people on antidepressants have a higher rate of suicide but of course they felt that way before they even started the drug. Most people who take the drug experience a strange set of side-effects such as insomnia, sexual dysfunction and drowsiness and weight gain. Many asinine psychiatrists, unhappy with the results of the antidepressants have the patient take anti-schizophrenic drugs along with it even though they do not have this condition.
This is a very strange condition that affects somewhere between 1 and 2 percent of all Canadians and is a little more obvious. A person who has this condition will experience two phases, one is a high energetic phase know as the manic phase and a lethargic almost catatonic stage in which the person does not want to do anything at all known as the depressive phase. They do not want to get out of bed, eat, wash or anything.
Once again, it is not like the person with this condition suddenly decided to become two opposite creatures at once. Something damaged the brain but in this case it has been shown that excessive amounts of drugs or alcohol very often cause this type of brain damage. Unfortunately once all the drugs and alcohol are withdrawn, the condition usually remains for a long time. There are of course drugs for the condition but most of them keep the person away from their manic phase and in a constant state of depression but allow them to function at a subliminal level. The main side-effect of bi-polar medications is weight gain and it is usually very pronounced.
This is a very strange and rare mental disorder that is usually invisible if the person is taking their medication. Schizophrenia usually affects males and starts in the low twenties. It usually affects highly intelligent people and is definitely a very physical disease. A person with this condition does not see images the way you or I do. Colours run from object to object and shapes blur because the lines around them move into different shapes. This is an obvious physical problem with the manner in which the eye sees objects. Add to that the fact that schizophrenics hear sounds as if they were in a tunnel with an echo so sometimes they cannot distinguish between a normal conversation of a person near them and other sounds they hear which they usually attribute to voices that talk to them and make them do things. Although the drugs that treat this condition greatly diminish the quality of life of the afflicted person, they allow them to exist in communities and render them fairly safe. The problem is that once stabilized with drugs, the patient feels good enough to get off their medication and all the symptoms come back. The term paranoid schizophrenia is actually redundant because if you saw images and heard sounds the way they do you would always be fearful and paranoid. An interesting fact about schizophrenics is that over 80 percent of them smoke and if they quit smoking their symptoms become worse. It seems that nicotine is somehow helpful to people with that condition.
Although the most effective treatment is cognitive therapy (Freudian style conversations with a therapist in which you try to sort out the root of your depressed feelings), it can take up to a year to get a referral to a psychiatrist. Even if you did get to see a psychiatrist most of them only do drug therapy in which they can see four patients an hour as opposed to talking therapy which limits them to one patient an hour. Given the choice of $150 an hour or $600 an hour what would you cho0se?
However, our provincial government in all their wisdom is actually asking family physicians if they would like to attend lectures on psychiatry. They pay for the whole trip, hotel meals and even pay them for the time spent there. Pharmaceutical companies actually sponsor these lectures and indicate the drugs they feel your family physician should be prescribing for specific mental disorders, usually depression. For the drug companies it’s a win-win situation and for the patient who is waiting for the psychiatric appointment, a new antidepressant will be prescribed. In fact, the majority of antidepressant prescriptions are written by family physicians who have no background whatsoever in psychiatry.
Sometimes a wiser choice is to sit down and talk to your priest, minister, reverend or rabbi and open up about your feelings. Your conversation is strictly confidential and will never leave the room. Furthermore, you can see them almost right away; this is cognitive therapy at its finest without any government intervention and without any drugs being prescribed.
Addictions either to drugs, alcohol, gambling or even sex are physical defects of the human brain. They require a special form of treatment but in most cases there are far too many addicts for too few treatment facilities and too few professionals who may be able to help these people.
If you encounter a disease for which there is no really effective treatment or cure your best chance is to do whatever you can to try and avoid mental illness. It may not always work but as a general rule, people who are healthy, do have any underlying physical conditions, eat well and exercise are less likely to get any disease. So that is my advice to you. Take precautions. So many of our physical ailments are treatable that we sometimes do not take enough care to avoid them. However, in this case I would strongly suggest it is time to get healthy and try and avoid any form of mental illness.
No more excuses. You will now schedule yourself for a 30 minute walk every day. The time has come to finally quit smoking and reduce your alcohol consumption to about one drink a day. If you really love fast food, then just do it once a month and eat at home the rest of the time. Forget the packaged foods and try your hand at some new recipes that you make entirely yourself at home. Five servings of fruit and vegetables a day should become your mantra. And of all the supplements you take, high potency fish oil and powerful antioxidants are the most effective products you can take to protect your brain.