What Do You Think Of "traumatic Psychiatric Injury" Versus "mental Illness"?

[Freedomfighter]

I assumed I was "crazy" aka mentally ill for a while a couple years ago when the s hit the fan. I was...

I would agree that it is an injury. After all before the patient has the injury and the resulting PTSD the brain is o.k. The injury causes the health condition. A mental illness the patient is born with.

 

[Friday]

Actually according to the Journal of affective disorders, there is a definitive link in those who suffer repeated trauma PTSD-like those from war zones-with shrinkage in the hippocampus

That would fall completely in line with what I was saying. Some PTSD, sometimes.

Correlation isn't causation.

 

[Sideways]

It *is* an actual injury. Your brain suffers physical symptoms as a result.

But differentiating PTSD from other mental health conditions and calling PTSD a "mental injury" would suggest that other mental health conditions are not the result of an "injury", or that the brain hasn't been "injured"..?

But the reality is, for many of the psychotic, mood, anxiety and personality conditions identified by the DSM, we are often, at best, only guessing at the cause. Those conditions might be genetic, the result of upbringing, brought about by drugs, medication or other illness, brought about by trauma, or just be the result of bad luck. We don't really know. But we do seem to be slowly starting to recognise that external factors can change the brain (or "injure" the brain) and mental health of a person, and lead to a variety of different mental illnesses, not just PTSD.

Certainly based on my experience with brain injury patients, PTSD has way more in common with the term "mental illness" than "brain injury", so I struggle to follow the argument that the brain has been "injured"...

Sometimes we change the name of illnesses when we start to under them better, but we don't seem to understand PTSD all that well yet, let alone whether it is innately different from other forms of mental illness. We seem to be able to identify ways that the brain adapts to cope with chronic trauma, but that's not really an injury so much as the brain 'adapting', which is really pretty clever. And neuroplasticity doesn't seem to be far off showing us that the brain can adapt right back again once the trauma is over.

Personally, I don't see what a new label would achieve, other than to make PTSD seem like something "different" to other forms of mental illness, which at best seems to misunderstand (and if not unfairly stigmatise) other forms of mental illness and what causes them.

PTSD is not the only mental illness that can be caused by an external event, nor is it the only condition where there can be changes to the brain from that external event.

My experience of PTSD, for what it's worth, is very much like I have an illness and, more particularly, a mental illness to the extent that that term is used, particularly in its social context.

 

[J'qel]

Most "mental illness" actually does have a physical component-even if it is "only" chemical rather than tissue related.

In fact pretty much everything impacts your body on a physical level, down to the food you eat and the air you breathe.

I'd like a term or a push towards recognizing mental illness as not an "illness" that is "mental", but pushing it even more towards: "Look, this is an actual disease or injury. This is what has happened and this is why it occurs".

I know there are a few fighting the good fight-but it seems lately accurate information is falling by the wayside to slogans and easy soundbites that may or may not have any relation to the actual literal truth.

The idea that mental illness is purely "in your head" is an extremely harmful and negligent one that should be fought against. The more dignity and respect that can be afforded sufferers, the more accepted it will be, the more who will get the treatment they need, rather than going untreated and passing the abuse or damage on to others.

Having abuse minimized and mental health addressed would solve a great many issues we have in our society, or at least allow proper redress for when such things do occur.

I don't think I need to further explain why having better mental health (particularly in our positions of authority and power) would be a huge benefit.

 

[Sideways]

@J'qel - I think I'm lucky that I mostly move in circles of people who are reasonably well informed about mental illness. You've also hit on social aspects, and my guess is that the social climate here is quite different to what you're living with.

There's been quite a big social education movement here for some time now about what mental illness is, and what it isn't, and I think we've been quite fortunate here in the way that's been received by he public. It does happen on ocassion that someone with a mental illness goes berko and it gets sensationalised in the media, but for the most part, I think the media here usually deals with mental illness quite compassionately, and that is definitely influencing my attitude to the use of the phrase 'mental illness'. It's appalls me that in the developed world, there are places where this is not the case.

I don't know what the answer is, but I'm sorry that you've had the experiences you've described.

 

[joeylittle]

It is located in the brain. Head. Mind. Mental.

People who can't understand that 'mental' doesn't mean 'imaginary' aren't necessarily going to do better by having it called 'brain damage' instead.

Of course it's physical. Everything about it is connected to the functioning of multiple organ systems - and how that all is manifest in the mind. Brain. Head. Mental.

I'd rather educate people on their simple assumption - that 'mental' doesn't mean 'imagined' any more than to have, say, phantom limb syndrome refers to a body part that wasn't there to begin with.

 

[theshadowoftheliving]

I think that the terming PTSD as injury does do something really important - it shifts responsibility.

I don't want to indicate that I believe that we are not responsible for how we act. We are. We very much are. But the cause? The cause of all of this wasn't my fault. And I do really appreciate that distinction.

Yet, I agree with @Ragdoll Circus that PTSD seems so very, very different from brain injury, and I think that, in that sense, it is a mental illness, just one that isn't our fault.

 

[scout86]

Isn't any 'mental illness' not the fault of the person who has it? Even a narcissist, who thinks they're perfect, doesn't really CHOOSE to be a narcissist, do they?

 

[Sighs]

Hmm - and now we've reached the murky world of free will. For example, what about drug induced psychosis? At first glance it kinda looks like a mental illness caused by the sufferer. But if you dig a bit deeper there is most likely a reason they turned to drugs - whether that be a personality disorder, or a neglected childhood or boredom.

I'm never sure that its helpful to talk about fault. I guess taking personal responsibility for actions and choices is helpful, but again gets murky quickly. My vet has PTSD, I suspect a TBI - based on the actual battle scars on his face and head, was given a medication now known to have permanent psychiatric effects and was exposed to blasts many many times which are now known to cause physical changes in the brain. How much is he personally responsible (or at fault) for his actions? Buggered if I know!

 

[Sideways]

The cause of all of this wasn't my fault.

I suspect that this is the feeling that is fuelling a lot of this debate. But like @scout86 said, so many instances of mental illness are not the sufferer's fault. Depression, anxiety, personality disorders, psychotic disorders, developmental disorders.

If we take an even-handed approach, not all PTSD is the consequence of another person's actions (people living through weather related disasters?), and plenty of other forms of mental illness can be caused by another person's actions - one that some members might relate to is Borderline Personality Disorder that was caused by abusive parents.

I think I understand the sentiment, but I still don't see PTSD as being "inately" different to other forms of mental illness.

 

[joeylittle]

I think that the terming PTSD as injury does do something really important - it shifts responsibility.

I understand this. When I learned about the potential genetic connections in mental illness -the way depression runs in families, for example - I felt like it somehow wasn't all my 'fault'.

Again - this really comes back to the fear humans innately have about something going wrong with the control center - the brain. We don't want it to be 'us', somehow - so, if there's an outside cause: I was traumatized, it runs in my family, someone gave me bad drugs, etc... - we feel somehow better about ourselves.

My point is that the feeling of 'it's not my fault' is not really relevant to the disorder. It's incredibly relevant to recognize that trauma that was inflicted on you is not something you are responsible for. That's super-duper-vital. But that doesn't need to relate to the PTSD itself.

Because those two things are tied together so closely, it's understandable why it's difficult to separate them. I think if I didn't have a co-morbid disorder, and if mental illness (in multiple forms) didn't ruth throughout both sides of my family tree, and if I didn't know as much as I do about the various research approaches into understanding mental illness/mental health - I'd be much more likely, personally, to push back against the idea that PTSD is in the same category as, say, a schizoaffective disorder. We call both of those things mental illness. That upsets a lot of people.

The bottom line is - science doesn't truly know. Science knows an awful lot more than it used to, and I think we can all be grateful for that. We know there's a connection between how our synapses function and how we feel. How trauma can sometimes leave a lasting and damaging imprint. How physical damage to the brain affects mood. Science is getting better and better at observing how interconnected the human system really is. The best we can say right now is that: it's all connected.

Beyond that, I think putting too much energy into trying to re-conceptualize terms for mental illness, would be better spent coming to terms with the root of that drive - which in the case of PTSD has a lot to do with absolving oneself of the trauma guilt.