Mental health - Research Paper Example

Schizophrenia In the serene world of mental illness, modern man no longer communicates with the madman: the man of reason delegates the physician to mad men, thereby authorizing a relation only through the abstract universality of the diseases. (Foucault, 1965, p. x) The words of Foucault seem to tell us that mental illness has been turned over to the doctors to handle because families could no longer keep their "mentally ill" family members at home. This statement seems to create several questions about the issue of mental illness. Common Thoughts About Mental Illness In the modern world mental illness has always carried a stigma in the United States and in many other countries. When people start acting out in ways that society deems "unacceptable" or "inappropriate" they are looked at very closely. Sometimes this means that an individual may have to spend time in a mental hospital or be subjected to different types of treatment including pharmacology, psychiatric care, electro-shock therapy and more. These situations are usually instituted by the family who then turn their family member over to a doctor because "the doctor knows best". Foucault says that society does not take care of its mentally ill anymore; instead they turn this care over to the physician to distance themselves from mental illness. He was speaking of mental illness in the Victorian age but today people still distance themselves from anyone or anything that looks different than what is considered to be normal. Foucault is somewhat truthful in his statements but doctors in this century do a good job of working with the mentally ill. To look at this premise schizophrenia has been the subject of this research in order to understand how this illness is treated. This paper will discuss the symptoms of the illness and what doctors do in order to assist patients who show schizophrenia. Schizophrenia has been a mental illness that many people have suffered from and that has a lot of stigma attached to it. People who talk to themselves and have hallucinations are scary to the average person. An interesting point is that this particular illness is one that is diagnosed more quickly than others. According to Torrey and Miller (2001) schizophrenia has always had "the highest reported first admission rates between 1923 and 1940" (p. 292). This is important to note because although there was high admission doctors still do not have all the answers where this illness is concerned. Torrey and Miller also point out that this illness was a popular one with authors, some of which suffered from the illness. Authors like Eugene ONeill, F. Scot Fitzgerald and Tennessee Williams suffered from some form of mental illness and wrote about it extensively. World War II brought more information about mental illness into the mainstream because 18% of men who were rejected from the armed forces were mentally ill. When President Truman heard this he brought information to the American public and shed light on the subject (Torrey and Miller, p. 295). The challenge for society is that they have always been given an idea of how to feel about mental illness and they had adopted what they see in the movies or in the media. This meant that when someone is "mentally ill" they are shunned by society in favour of someone who is considered "sane." The media is changing a bit in its depiction with movies like "Shine" and "A Beautiful Mind". Both of these movies depicted what schizophrenia is like for the individual living with it. In "A Beautiful Mind" the spotlight was on the mathematical genius, John Nash, Jr. In the movie his hallucinations were seen as real people but from his interviews and the book by the same name, he had auditory hallucinations. Nash was a rare commodity because he suffered from schizophrenia for a period in his life and then he decided there was no reason for it to continue; he just stopped listing to the voices. Nash is recorded as being the only person to have schizophrenia "in remission" and he did it without taking the drugs that he was given. Because of these movies society has an easier time of dealing with this particular disease but there is still more room for education (NPR Streaming Video, n.d.). Definition of Schizophrenia According to The Royal College of Psychiatrists (2008 "What is Schizophrenia"), schizophrenia "is a mental disorder which affects thinking, feeling and behaviour. It is most likely to start between the ages of 15 to 35 and will affect about 1 in every 100 people during their lifetime." Schizophrenia can be a very difficult and devastating illness because it cause people to lose time at work and it can cost a large amount to treat. As an example, in 2002 in the United States, according to Wu, Burnbaum et. al. (2005) the "cost of schizophrenia was estimated to be $62.7 billion with $22.7 billion excess direct health care cost ($7.0 billion outpatient, $5.0 billion drugs, $2.8 billion inpatient, $8.0 billion long-term care). It is not really known today how many people suffer with schizophrenia because many people go untreated and undiagnosed. Symptoms of Schizophrenia In order to describe the symptoms of schizophrenia most psychiatrists put them into "negative" and "positive" symptoms. The positive symptoms are those that show that something is not normal in the mental functioning. Negative symptoms are those that "show the absence of a mental function that should normally be present." (Patient UK, 2009). The symptoms of schizophrenia are: Positive Symptoms 1. Hallucinations - hearing, smelling, feeling or seeing something that isn’t there. Hearing voices that can be pleasant, or are more often rude, critical, abusive or annoying. 2. Delusions - believing something completely even though others may find the ideas strange. 3. Difficulty thinking – an individual will find it hard to concentrate and they tend to drift from one idea to another. Others find it difficult to understand the individual. 4. Feeling controlled – some people begin to think they are "possessed" by someone elses thoughts or that they are in someway being controlled by others. Negative Symptoms 1. Loss of interest in everyday things. 2. Loss of energy or flat emotions. 3. Not washing, cleaning the home or washing clothes. 4. Feeling uncomfortable with others as if they are trying to hurt them. (The Royal College of Psychiatrists, "Symptoms"). The cause of schizophrenia is unknown although there are a number of theories. Some researchers have found that there is a genetic link to the illness. In the case where a parent or a close relative has the illness another family member has a "one in ten" chance of also suffering from the illness. If both parents of a child have schizophrenia the percentage goes to one in two (PatientUK, 2009). Other researchers are finding that the brain may hold the clue as to why certain people develop this illness and others do not. Some think that it is the neurotransmitters in the brain that somehow change and become something different, though this has not been totally substantiated. Andreasen (2001) states that "schizophrenia is probably the cruellest and most devastating of the various mental illnesses." (p. 193). Most people will develop the illness when they are young and it can stop them from living a fully functioning life. Because it is such a devastating disease for so many people it costs the United States billions of dollars each year (Andreasen, p. 193). Andresens study found that there were subtle indicators that showed that some people had that pointed back to the brain: "abnormality in brain/mind development that may begin well before the person develops obvious symptoms" (p. 194). No one knows the exact cause of schizophrenia but there are many theories. Some researchers think it can be triggered by high levels of stress. Others think it may come from a viral infection that a foetus acquired during a mothers pregnancy. Some studies show that a lack of oxygen to the brain during the process of the birth experience may be a cause. The most current information today is about the brain and how it may be affected to create the illness later in life. Research on Schizophrenia Many psychiatrists have studied schizophrenia to try and discover similarities that occur in all schizophrenics. Roger Brown, a Harvard social psychologist attempted to find similarities between several schizophrenics. What he found was that they were as varied in what happened to them as "normal" people (as cited in Shean, 2004, p. 57). Although there were no real similarities the one common factor was that everyone went into some sort of delusion that would come when he was talking to them. This was the only similarity that was found. Andreasen (2001) has been a major contributor to the area of schizophrenia because she has done major research on the effects of the brain. She suggests that there is a different way to look at the brain. She suggests that unlike other diseases like Alzheimers where there is a concrete change within the brain, schizophrenia does not seem to have a specific neurological pattern. There is no one region affected by the illness and this is why it is difficult to see what is going on within the person. Poland also did research on the brain and contradicts Andreasen by saying that schizophrenia is a brain disease. He researched several schizophrenics studying the family history and the criteria from the DSM-IV (Poland, 2007, p. 176). Some of the criteria for schizophrenia he found include: 1. Genetic and non-genetic predisposition to the disease 2. Disruptions in the prenatal neural development of the foetus. 3. Neuropathology 4. Information processing problems. 5. Psychopathology (the challenges in cognitive, perception and other aspects of dysfunction). 6. Psychotic episodes/symptoms 7. Disruption of social or adaptive functions (Poland, pgs. 176-177). The core challenge that schizophrenics face according to Poland is that there are problems with the neurotransmitters in the brain and that these cause disconnections to certain other parts of the brain. He suggests that researchers need to see a different "concept" of schizophrenia and treat it as a brain disease rather than a mental illness (p. 177). Treatment of Schizophrenia Foucaults work spoke of the way mental illness was treated in the Victorian ear and gave a bit of history on the various ways that mental illness was treated within the prison like walls of the asylums. He suggests that the mental patients were treated very poorly and that the doctors manipulated patients with psychoanalysis: The doctor, as an alienating figure, remains the key to psychoanalysis. It is perhaps because it did not suppress this ultimate structure... Psychoanalysis has not been able, will not be able, to hear the voices Of unreason, nor to decipher in themselves the signs of the madman. (Foucault, p. 278). Therapy was just one way that the mentally ill were treated and it remains a primary treatment today. Other researchers have looked at the same era of mental illness and have also found that the doctors sometimes created more problems for the patients. Mentally ill people in asylums were treated to beatings and were often chained in their rooms. In many cases this created more insanity. According to Scull (1981), "the madmen were chained and whipped in asylums in the 18th Century" (p. 107). Many were made to perform in front of the masses because madness was also a flourishing business. This is the backdrop that all mental illness treatment was built upon. As more became known about the illness, humane societies created petitions and started doing more for the mentally ill. Today there are many treatments for schizophrenia with many of them being a combination of therapy and pharmacology. Antipsychotic medicine helps stop or weaken the delusions and hallucinations. These are kept under control if the individual takes their medication regularly. They have used both older and newer types of antipsychotics because they do different things. The older antipsychotics reduce dopamine in the brain and they can cause harmful side effects. The newer antipsychotic drugs work on different aspects of the brain and are less harmful than the older ones (The Royal College of Psychiatrists, 2008). With these drugs it can take 2-4 weeks before the individual sees a difference in their symptoms and there are side effects to any drug (PatientUK). In terms of therapy Cognitive Behavioural Therapy has been the most effective in this treatment because it helps the individual find the triggers that started the episodes. During therapy the individual can find new ways to deal with situations that previously trigger a psychotic episode. It is also important for the individual to have a support group that is comprised of family and friends. This often helps the individual recover quicker because they know they have the support. Once the individual is in the mental health system there are often programs to help them find a job and possibly housing where necessary (The Royal College of Psychiatrists). Schizophrenia is a difficult illness but the doctors today assist the mentally ill so that they can live a full life. If they are able to continue on their medication they have a better chance of full recovery than if they get off. Cognitive Behaviour Therapy can be one of the roads back to health in this illness. References Andreasen, N.C. 2001. Brave new brain: conquering mental illness in the era of the genome. NY: Oxford University Press. Claridge, G. 1995. Origins of mental illness: temperament, deviance and disorder. MA: ISHK. Foucault, M. 1965. Madness and civilization: a history of insanity in the age of reason. NY: Random House. NPR Streaming Video. n.d. Interview with John Nash. Accessed 12 April 2009 from http://www.schizophrenia.com/famous.htm#john. Patient UK. 2009. Schizophrenia. [WWW] URL:< http://www.patient.co.uk/ showdoc/23069111/. [Accessed 8 April 2009] Poland, J. How to move beyond the concept of schizophrenia in Chung, M.C., Fulford, K.W., and Graham, G. 2007. Reconceiving schizophrenia. NY: Oxford Press. Pletson, J.E. ed. 2007. Psychology and schizophrenia. NY: Nova Science Publishers, Inc. Scull, A. 1979. Moral treatment reconsidered: Some sociological comments on an episode in the history of British psychiatry in Scull, A. ed. Madhouses, mad-doctors and madmen: the social history of Psychiatry in the Victorian era. PA: University of Pennsylvania Press. Shean, G.D. 2004. Understanding and treating schizophrenia: Contemporary research, theory and practice. NY: Haworth Clinical Practice Press (no state given). The Royal College of Psychiatrists. 2008. Schizophrenia key facts. [WWW] URL: < http://www.rcpsych.ac.uk/mentalhealthinfoforall/problems/schizophrenia/schizophreniakeyfacts.aspx [Accessed 8 April 2009]. Torrey, E. F. and Miller, J. 2001. The invisible plague: The rise of mental illness from 1750 to the present. New Jersey: Rutgers University Press. Wu, EQ, Birnbaum, HG, Shi L, Ball, DE, Kessler, RC, Moulis,M. and Aggarwal, J. 2005. The economic burden of schizophrenia in the United States in 2002. J Clinical Psychiatry. 66(9):1122-9. Read More