On
the surface categorising and labelling of mental illnesses seems like
a logical thing to do, after all there are different sub types of the
very general term 'mental illness' and just as like other illnesses
are labelled e.g. common cold, flu, ear infection, tonsillitis etc.
we know what causes such illnesses,how to treat them and sometimes
avoid them.
However
mental illness is much more complicated when you start exploring the
underlying issues of why an individual suffers from such a illness.
We
all experience the world in our own way and there are limitless
incidents and experiences, which are unique to each individual, that
can contribute to the development of mental illness.
So
is there a benefit in having a label for a mental illness? Possibly.
For starters the label can help you to understand that you are not
weak, stupid, immature or just a miserable git, as a matter of fact
you are suffering from an illness and you did not realise it until a
medical professional says to you that you have been
behaving/thinking/feeling this way because of this particular thing.
Okay,
we have a diagnosis of an illness, now that we know what it is, how
do we treat it and for how long? When can I get back to work/college?
When can I get back to 'normal'?
Having
the illness diagnosed may offer some answers to the above and some
have said it is a relief to finally know what is wrong, no longer do
they have to keep asking themselves 'what the hell is wrong with
me', you have a answer.
Some
of the disorders (like depression) are very common throughout the
world and so it might offer some reassurance that you are not in fact
alone with what you have to deal with. Also it helps the medical
professionals to categorise your illness to simplify the recommended
course of treatment.
There
is a flip side. Probably one of the biggest issues of being labelled
is being defined by the illness;
Person
A: Hey how is C doing these days?
Person
B: Oh you didn't hear? C is a schizophrenic.
Whether it is schizophrenia, clinical
depression, bi-polar disorder, a personality disorder or whatever
disorder someone may have, often the individuality of a person gets
stripped away and is replaced by the disorder.
This can lead to the person in
question being discriminated by employers (in fact recently a friend
of mine lost his job after having time off due to depression),
friends, family, partners etc. and once a diagnosis is made it will
stick with you for the rest of your life regardless of whether you
become ill again or not.
Usually
having treatment takes a fair amount of time in which you may not be
able to do anything and so if you look to get back into employment
you may well have to disclose your illness and subsequent treatment
to a potential employer to explain why you have had an unemployment
gap of x time.
Being given a label of a disorder
could induce a sense of hopelessness especially if the illness is
severe, there are times I feel my life will never get better because
I have depression and sleep terror disorder both of which cannot be
cured and will continue to undermine me. Others may feel as I do,
that it will never better and its all about containing the illness as
best you can but it won't go away.
The label is for life, the illness is
for life...your life.
Not to mention that some disorders
share a crossover of symptoms, like schizophrenia and bi-polar
disorder which share psychosis, depression (an illness with its own
category but is a major feature of bi-polar disorder and often
affects those who suffer from schizophrenia) cognitive impairments
and so on.
The diagnostic criteria gives a
general outline of a disorder, however it does not help with subtle
differences and variations between people who might be classed as
having a certain disorder.
Therefore confusion and misdiagnosis
can happen, even worse it is possible in some instances for some to
move from one disorder to another (schizophrenia alone has a number
of sub types, paranoid, disorganised, catatonic, undifferentiated,
residual), thus incorrect treatment can be given, causing more harm
than good.
So what is the alternative?
There is a debate going on about the
ethics of labelling within the psychology and psychiatry fields and
some call for it to be abandoned altogether, after all the one size
fits all approach is fraught with difficulty if you consider that you
are dealing with people who all have unique experiences and reasons
for their illness.
For me when I sought help for my
issues I was never diagnosed with a particular disorder, instead my
symptoms were the focus for treatment. It is clear I get depressed,
anxious and angry a lot of the time, so I was referred to a group
psychotherapy sessions and here they explored my past and how that
past affects the way I think and behave now.
So here the reasons for my
depression, anxiety and anger were looked at, basically they noticed
that whenever people tried getting close to me emotionally in the
group I become hostile and pushed them away by getting angry, making
them afraid to approach and challenge me.
The reason for that is I had been
badly treated in the past, enough so that I became depressed as my
self-esteem, self-worth was low and often attempts at increasing it
was rejected by others and so I pushed people away before they had
the chance to reject me.
Once it had been established how I
think, feel and behave and why I do so, the therapists seek to
address what they believe is unhelpful way of thinking and behaving
on my part that can actually be part of a vicious cycle with my
depression, for instance when I pushed people away to stop them
having the chance to reject me in some way I was also pushing away
the chance of something good, like making a friend.
In my case it was easier to focus on
what symptoms I displayed and the underlying reasons for their
existence and what I could do to help alleviate what issues I faced.
By addressing the symptoms themselves
it will help in avoiding to a certain extent at least the stigma that
may follow from being labelled with a disorder, some people won't get
help due to the fear of stigma and discrimination associated with
mental illness.
Also dealing with the symptoms alone
means the individual's circumstances are more likely to be taken into
consideration as it will not be as necessary to look up the DSM as
often for the guidance of a diagnostic criteria.
I hope one day the labelling will be
scaled back enough that it is nothing more than a very broad term
which does not stick with a person for life.
Thursday 16th February, the journey continues.
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