From Lit Hub:
Like thick curly hair, mental illness
runs in my family. Psychosis and mood disorders, the two major groups of
psychiatric classification, can both be found in the last three
generations. Rumors and realities of institutionalization have been
passed down my maternal line. My mum remembers the day when my
grandmother, Renee, was taken away to a mental institution in the 1970s.
“That is one of my worst memories,” she told me over the phone in
August 2017. “We didn’t know whether she was going to come back.”
Called High Royds, it was just one so-called asylum within a short
van drive from their home in Thornton, a village just outside of
Bradford in northwest England. But this memory is blurred in its details
and may not have even happened. She was a child then and memories can
be manufactured like nightmares. There’s no doubt that Renee struggled
with depression, especially after her husband, Eric, my grandfather,
died of lung cancer in 1975.
At a time when SSRIs like sertraline hadn’t yet been put into
prescriptions, she was given diazepam (Valium) to calm her anxiety and
dampen her grief. When at her worst, she described her mental anguish as
“tearing down the wallpaper.” But no one else in the family remembers
Renee being taken away for any period of time. The patient reports from
High Royds, although incomplete with whole years missing, hold no trace
of her. (Read more.)
The seed of suffering. From Aeon:
Since the publication of the DSM-III in 1980, psychiatric diagnosis has helped to select the right treatment for a person’s symptoms. It’s also made the tracking
of diagnoses over time and space possible, a field known as
‘psychiatric epidemiology’. However, while these diagnostic guides might
be useful for doctors who must make daily decisions about care and
treatment, some critics argue that diagnostic systems have actually
stymied the progress of psychiatry. While other specialities of medicine
have drastically reduced mortality rates from heart disease, cancer and
stroke, there haven’t been similar successes in mental healthcare. As a
paper
from 2013 put it, ‘mortality has not decreased for any mental illness,
prevalence rates are similarly unchanged, there are no clinical tests
for diagnosis, detection of disorders is delayed well beyond generally
accepted onset of pathology, and there are no well-developed preventive
interventions.’ In short, psychiatry appears stuck.
Perhaps it’s because the diagnostic system is faulty. Indeed, the
fact that around half of patients with one mental disorder also fulfil
the requirement for a second disorder has been well documented
since the 1990s: major depression and generalised anxiety disorder
(GAD), substance use disorders and attention deficit hyperactivity
disorder (ADHD), bipolar disorder and schizophrenia. Either mental
disorders really do tend to aggregate or, perhaps more likely and more
worryingly, our classification system is drawing lines in unnatural
places, carving nature far from its joints.
There’s an alternative approach. A growing troupe of scientists think
that focusing on one or two diagnoses in a study – as is common in
psychiatric research – has meant that the true nature of mental
disorders remains hidden. To understand what are essentially brain
disorders, they argue you have to zoom out. Considering the whole
spectra of psychiatric possibility reveals similarities in symptoms,
brain circuitry and genetics. Shaking off the shackles of diagnostic
classification, there is growing evidence that all mental disorders are
actually the product of a single underlying dimension, a common
liability for psychopathology. Known as the ‘p-factor’, this theoretical concept brings the potential for important new ways to treat and prevent psychiatric disorders.
The p-factor also raises the question
of whether Oliver and I are far more similar than a cursory glance at
our symptoms might suggest. Perhaps we share the same underlying
vulnerability, but certain life experiences have influenced the way it
manifests. If my experiences had been different, perhaps the depression
of my mid-20s could have emerged as
psychosis in my late teens. And if all this is true, is it possible that
Oliver’s and my experiences will merge in the future? (Read more.)
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