the spectrum of mental illness?

[quarky]

Hi, good people.

A recent thread about obsessive/compulsive "disorder" got me to thinking about human whackiness, in general, versus specific whackiness, and how it relates to the general consensus of opinion.

I used to work with autistic kids, care-giving in a group home.
Some of them may as well have been from another planet, in terms of me knowing what they had going on in their minds. I used the word 'minds' instead of 'brains', to differentiate between the hardware of the brain and the thoughts it generates, privately...that internal dialog we all have to remind us that we are, in fact, Henry P. Townshend, that we feel this about that, and we need to pick up milk on the way home and the boss is a jerk, etc., I call 'mind'. I hope that's cool; not trying for wooishness.

I have severe arthritis. Its quite painful to walk. I recall when it wasn't; therefore I see it as a malady. Its a disorder. With mental states, things get more subjective and more subtle...the lines can get blurry, at least to me. I wonder what sense of their own malfunction various types of the mentally 'challenged' feel?

So, I wanted to start a discussion to help educate myself, and maybe get a heated debate going. I don't think I have a horse in the race, except possibly some negative feelings toward psychiatry/pharmacy related stuff, and some feelings about the craziness of humanity and how to define sanity within that framework.

First question:

Are mild neurotic tendancies; OCD; Asperger's: Autism: psycopathy...are these degrees of the same thing? Same area of malfunction? Or, are they unrelated?

The second:

Have their been successful cultures, that by today's standards, would have qualified as mentally impaired? As in, could a tribe of Aspies function cohesively and competitively in a hunter-gatherer situation?
What about ADDH?

(Sorry about the too long o.p. I've got a bunch more questions. I'm sure this has all been discussed before; a lot, even, but wtf, can't hurt for an update.)

 

[rjh01]

A good starting point would be this thread Anyone here with OCD?

 

[Trish Randall]

glad you asked

I think the whole idea that people can have diseases that affect mental functioning without any physical malfunction causing the disordered thinking &/or behavior is highly unlikely.

We now know that schizophrenia has a strong co-relation with being born with toxoplasmosis infection, and even if the toxoplasmosis itself turns our to be not the cause, but merely coincides with schizophrenia, there are studies of living brains of schizophrenics that show over time that the temporal lobes reduce in size.

Thanks to antibiotics, we no longer have huge mental hospitals full of people with tertiary syphilis.

Capgras syndrome, in which a person insists that people they know are replaced with replicas, was in Freud's day was considered a form of confabulation, but thanks to the work of Dr Ramachandran, and the stroke of insight of a mother of a Capgras patient, it was discovered that a lesion between the sight function of the brain & the amygdala causes a person to lose the emotions that they should feel when seeing someone they know, causing the person to conclude there has been some sort of switcharoo. For a long time, psychiatrists & psychologists searched for an emotional problem between the Capgras sufferer & the person they claimed to be replaced, but it turns out to be a physical lesion.

We should consider that the malfunctions may not always be found in the brain - diseases affecting endocrine organs can affect people's thinking & behavior, and there's some evidence that digestive diseases can cause people to feel gloomy.

In light of the fact that people can be functioning normally, get involved with a group or philosophy that inspires them to bizarre behavior, and later return to normal behavior, it's possible that people can easily acquire reasons to engage in weird behavior & continue that behavior for as long as they believe they get a benefit from that behavior.

People's views of their past experiences & behaviors are colored by their current feelings &/or circumstances, and people can even explain to their own satisfaction the same incidents/feelings/memories in different ways depending on when & how the question is asked, & what the person expects to get from the answer. And yet, people will readily offer explanations for their behavior, even though the explanations change with the changes int heir own lives.

I think if we are to discover actual nonphysical mental diseases, it won't be by people who think they are suffering from such diseases talking about their own pasts. I highly doubt that even the most persistent disordered thinking &/or behavior occurring in the absence of a physical defect of some sort. For the concept of a nonphysical mental "disease" to be convincing to me, it would have to involve thinking & behavior that did not benefit the supposedly mentally person.

P.S. I think that one of the worst things that really muddies the waters in discussing the nature of mental malfunction is the uses of psychology in our justice system.

Problem #1 is the M'Naughten rule, where our justice system says a person is "not responsible" for a crime if they didn't understand the wrongness of their actions *at the time of the crime* - this has allowed defense attorneys & defense psychologists to claim their clients have all sorts of exotic mental malfuctions that are as unpredictable & impermanent as cloudy days, supposedly deep depressions that are invisible to the people who know the client best & delusions that consume the client, but which the client never discusses with another person until after being caught for a crime. Since it is often in the context of sensational crimes, the public's view is skewed toward the belief that people with mental problems are inherently more violent than the population overall (actually, they're more likely to be victims than perpetrators).

Problem #2 is the current use of "victim impact" in trials & sentencing hearings. Victims of crimes are encouraged to view themselves as permanently damaged by the crimes they've suffered because the display of suffering & the assumption of the permanence of the suffering is used to justify more harsh sentences.

Problem #3 is the use of AA/NA in the justice system. Instead of using perfectly reliable urine or blood tests to make sure someone ordered to not consume alcohol or substances to demonstrate compliance with such an order, courts regularly require attendance at AA/NA meetings - which means our court system is requiring that people not just change their behavior, but conform to a series of beliefs that has no demonstrated effect on drinking levels (in fact, studies show the level of drinking isn't reduced, but the chances of death are increased when people attend AA). I watched some parole & clemency hearing held in my state on cable access recently & saw inmates claiming to take control of their lives by claiming to have discovered thru the 12 steps that they have no control over their drinking/drug use.


I could probably say more - these are just initial thoughts on the subject.

 

[Dancing David]

Hi, good people.

A recent thread about obsessive/compulsive "disorder" got me to thinking about human whackiness, in general, versus specific whackiness, and how it relates to the general consensus of opinion.

I used to work with autistic kids, care-giving in a group home.
Some of them may as well have been from another planet, in terms of me knowing what they had going on in their minds. I used the word 'minds' instead of 'brains', to differentiate between the hardware of the brain and the thoughts it generates, privately...that internal dialog we all have to remind us that we are, in fact, Henry P. Townshend, that we feel this about that, and we need to pick up milk on the way home and the boss is a jerk, etc., I call 'mind'. I hope that's cool; not trying for wooishness.

I have severe arthritis. Its quite painful to walk. I recall when it wasn't; therefore I see it as a malady. Its a disorder. With mental states, things get more subjective and more subtle...the lines can get blurry, at least to me. I wonder what sense of their own malfunction various types of the mentally 'challenged' feel?

So, I wanted to start a discussion to help educate myself, and maybe get a heated debate going. I don't think I have a horse in the race, except possibly some negative feelings toward psychiatry/pharmacy related stuff, and some feelings about the craziness of humanity and how to define sanity within that framework.

First question:

Are mild neurotic tendancies; OCD; Asperger's: Autism: psycopathy...are these degrees of the same thing? Same area of malfunction? Or, are they unrelated?

Hi!

No autism and OCD are not related, while people with autism may have eprseveration, the mechanisms are different.

Autism is a developmental disorder and only palliative treatment si available.

The second:

Have their been successful cultures, that by today's standards, would have qualified as mentally impaired?

Cultures can not be mentally ill.

As in, could a tribe of Aspies function cohesively and competitively in a hunter-gatherer situation?
What about ADDH?

It really depends on the functional levels of the individuals, but ADHD would be less debilitating in a non industrial society.

(Sorry about the too long o.p. I've got a bunch more questions. I'm sure this has all been discussed before; a lot, even, but wtf, can't hurt for an update.)

And again, autism is not a mental illness.

 

[quarky]

From my observations, all anecdotal, Asperger's seems like autism light, and OCD seems like Asperger's light, and basic neurotic behavior of the sit-com variety seems like OCD light.

It feels like a continuum to me, though, in my school days, all this was poorly defined.
I had a psych professor that wore gloves to class, to avoid direct contact with doorknobs, yet he could make a living as a teacher. I knew kids that had to count all their steps and do bizarre ceremonies that baffled me and others. I'm not sure if they made a living. I chewed my finger cuticles bloody, all through high school, which seemed quite insane to me, yet somehow passed the grade. Adults that were well adjusted in the 50's and 60's smoked tobacco. It was the sane thing to do. Sports stars did cigarette commercials.

Is there no continuum of the obsessive/compulsive disorder?
Where does brain damage begin and mere nuttiness end?

Trish, enjoyed your feedback!

 

[Dancing David]

Well yes, aspergers is now in fact referred to as 'high functioning autism'.

However a couple of point, autism is a developmental disorder caused by brain growth patterns that are 'not normative'. And there is a spectrum of the effects of autism as well as clusters of variation is expressed symptoms.

please note, not all people with autism have obsessive traits, unlike OCD.

there is no evidence that ties brain damage to mental illness in all cases, in OCD there are many who have suffered closed head injuries. But it is again not true for even the majority of people with OCD. So while brain damage may mimic the symptoms of many mental illnesses, it is not shown to be causative.

And yes OCD does occur along a spectrum as do all mental illness, there is a variety in the manifestation and expression of symptoms. Some (like myself) tend to have obsessive traits:mainly repetitive and intrusive thoughts. Others have more compulsive traits (which I do as well, just not as dominant). For some there is a mix.

People will also vary throughout their lives in terms of symptoms and severity.

The definition of an actual mental illness is that it causes 'significant impairment in functioning', so the vast majority of people who may express these traits do not rise to the level of dysfunction.

 

[quarky]

Thanks, D.D.

I guess my o.p. was a bit vague and silly.

 

[Dancing David]

No, these are great question, the manifestation of OCD (and others) does fall along a spectrum. From people who just are very succesful to people who can't go out the door without checking it twenty times. (Fortunately one check was enough for me, sometimes two).

Autism is confusing as is OCD, OCD is mlot like psychosis at times,e xcept teh person knows that teh intrusive thoughts are not real. Autism often looks like something else, anxiety, depression, and it can also be co-occuring with mental illness.

 

[Madalch]

Why do I get the feeling that violence and ultraviolence should be on the spectrum somewhere?

 

[quarky]

Why do I get the feeling that violence and ultraviolence should be on the spectrum somewhere?

Non-violence is.
My commitment to that is what landed me in the loony-bin.

 

[marplots]

My car is broke.
If I can fix it, it matters the type of broke and the details.
If I can't fix it, I am more concerned with how to deal with it.
If I can't fix it, I have a different car than before, maybe even better in some ways. It might not be as nice as your car, but it never was.

My brain is broke. Or it's just different.

 

[Loss Leader]

Have their been successful cultures, that by today's standards, would have qualified as mentally impaired? As in, could a tribe of Aspies function cohesively and competitively in a hunter-gatherer situation?

I had heard that if regular people today took the first MMPP as it was originally normed, we'd all test as pathologically neurotic.

 

[fuelair]

Thanks, D.D.

I guess my o.p. was a bit vague and silly.

Until you decline the information or merely want people to comment so you can argue some specific point(s) It is not at all vague or silly. I am not a psych/ologist or iatrist so I cannot answer with any authority, but your questions sound quite reasonable to me...

 

[quarky]

Until you decline the information or merely want people to comment so you can argue some specific point(s) It is not at all vague or silly. I am not a psych/ologist or iatrist so I cannot answer with any authority, but your questions sound quite reasonable to me...

Thanks. That was very sweet.
I'm just run of the mill damaged goods, trying to comprehend the incomprehensible world that surrounds me.

Human kindness doesn't explain much, but it makes it all so much more digestible, should explanation occur.
Maybe that's all that is required.

Your post made me feel much more sane.
As did marplot's post.
And D.D.'s.

Sweet dreams, ya'll.

 

[Dr. Imago]

I prefer the model of the "mind", if you will, where it can dysfunction in three basic ways: thoughts, mood, personality.

Mood tends to be an expression of overall excitability of the organic brain. Depressive states are often the result of inadequate neurotransmission, whereas hyperexcitable states (mania) are the opposite - excessive neurotransmission. Drugs can alter this balance (anti-depressives, neurostimulants, etc.).

Thought disorders result from external stimuli that produce a response in an individual that fall outside the continuum of what would be considered a "normal" response (again, if you will) and are reflected by what and how a particular person will perceive that stimulus. Hallucination and delusions are an example of this. Psychoactive drugs also can affect this process, as exemplified by the actions of certain hallucinogens (positive actions) or neuroleptic medications (negative actions).

Personality disorders are more subtle, and are the result of how the brain has learned to process routine external stimuli. Often people with personality disorders don't see that they have a problem, and they predominately affect interpersonal interactions. They may have an organic cause, but are more likely the result of patterned behavior accumulated throughout a life of interacting with a specific environment and other individual responses to the behavior. This type of long-term patterned behavior develops as a coping mechanism.

In some cases, dysfunction can be a result of an interaction of any or all three of theses acting in concert. Other than that, structural problems (stroke, congenital malformations of critical brain structures, etc.) can have a variety of effects on the mind and present in a variety of ways.

It is hard to identify and treat specific problems sometimes with individuals because we can't often see exactly what is going on in a person's brain (i.e., even with fMRI, EEG, and other advanced tests). The hope is that with better understanding of the organic processes that result in dysfunction from a structural level to a neurotransmission and brain organization level, we will get better at treating these problems. Also, the brain possesses "plasticity" on an organizational level, which means that treating patients with drugs and psychotherapy can have positive effects and help ameliorate the dysfunction.

~Dr. Imago

 

[Dancing David]

I prefer the model of the "mind", if you will, where it can dysfunction in three basic ways: thoughts, mood, personality.

Mood tends to be an expression of overall excitability of the organic brain. Depressive states are often the result of inadequate neurotransmission, whereas hyperexcitable states (mania) are the opposite - excessive neurotransmission. Drugs can alter this balance (anti-depressives, neurostimulants, etc.).

Not to argue with a doctor, but sometimes they are the result of dysregulation in a control system, over activity in some depression and under activity in some schizophrenia.

Thought disorders result from external stimuli that produce a response in an individual that fall outside the continuum of what would be considered a "normal" response (again, if you will) and are reflected by what and how a particular person will perceive that stimulus.

Well in my experience thought disorders, especially in some forms of schizophrenia involve disorganization, loose associations or retarded cotgntions.

Hallucination and delusions are an example of this. Psychoactive drugs also can affect this process, as exemplified by the actions of certain hallucinogens (positive actions) or neuroleptic medications (negative actions).

Personality disorders are more subtle, and are the result of how the brain has learned to process routine external stimuli. Often people with personality disorders don't see that they have a problem, and they predominately affect interpersonal interactions. They may have an organic cause, but are more likely the result of patterned behavior accumulated throughout a life of interacting with a specific environment and other individual responses to the behavior. This type of long-term patterned behavior develops as a coping mechanism.

My first clinical supervisor suggested that a view the PDs as a response to symptoms of an Axis I diagnosis. They were in his mind unhealthy coping strategies that had cognitive behavioral strategies of persistence.

In some cases, dysfunction can be a result of an interaction of any or all three of theses acting in concert. Other than that, structural problems (stroke, congenital malformations of critical brain structures, etc.) can have a variety of effects on the mind and present in a variety of ways.

It is hard to identify and treat specific problems sometimes with individuals because we can't often see exactly what is going on in a person's brain (i.e., even with fMRI, EEG, and other advanced tests). The hope is that with better understanding of the organic processes that result in dysfunction from a structural level to a neurotransmission and brain organization level, we will get better at treating these problems. Also, the brain possesses "plasticity" on an organizational level, which means that treating patients with drugs and psychotherapy can have positive effects and help ameliorate the dysfunction.

~Dr. Imago

as long as that 'psychotherapy' is goal directed and behavioral!