BLOGS: World Mental Health Day

Psychologist Deb Serani informs me that it’s World Mental Health Day.  Go to her blog to see more, and no snide remarks about which of our nation’s leaders this is aimed at!

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  4. The world does celebrate mental health day but how awareness and concern and importance is given to such children needs to be seen. The media does not highlight the achievements of the special children at all.However, in the West there is still a lot of sympathy and care but in the East, such as places like India, there is no such opportunities and there are hardly any resources available too.These children are treated like outcastes and they do end up as being objects of ridicule. For more news on mental disabililty please see http://www.medicow.com/topics/Mental-disability

  5. //you’re against psychotropic drugs.//
    I’m against them for the general population, but I do think they are appropriate for some conditions, such as schizophrenia. I just think it’s important to really diagnose those conditions – using brain scans, biochemical indicators, etc. Otherwise, I think the price in side effects and impact on quality of life is too high.
    //people who want therapy shouldn’t be able to get it?//
    I have several thoughts about this. First, medical care is about what people need, not what they want. Therefore, some sort of diagnosis should come before therapy allocated by the health system. I don’t want to dismiss therapy as frivolous, but if it’s about equal access and making people feel better, then I think it would actually do more to give people access to dermatology and plastic surgery first. Why is our society willing to pay for therapists to change peoples attitudes but not for things that will help people change the way society treats them?
    Second, I think people seek out therapy without an overview of all the potential consequences. I also think there’s a lot of social pressure that causes people to internalize problems, and then they seek therapy to prove to themselves and/or others that they are taking action to solve the problem. There are other factors from depression as a self-image to access to services to just not being able to figure out what else to do.
    Please don’t think I’m trivializing depression in any way. I’m pretty damned depressed in the barely-functioning clinical sense right now. I really wish I was living a life where I could be happier. However, at this point I’m aware that the decision to allow myself to be formally labelled as depressed comes with a lot of consequences. There are economic consequences, re: access to health insurance and even jobs. There are legal consequences where things can be “explained away” as factors of depression (it has also occured to me that this is a no win situation as far as defining depression as a disability: it’s illegal to discriminate against people for a medical condition, but it seems like common sense that employers would want to find ways of getting rid of people who have a mental disorder.). There are social consequences to being “marked” in any way: if people don’t think you’re trying to be special or trying to get attention, they will think you’re incompetent. Markers cue hierarchization: people inevitably use them to figure out whether they are above you are beneath you in some way. Also, there are physical drawbacks of taking any drug. The reigning issue for me, though, is the focus on screening the poor. It sounds like this is a generous attempt to keep the poor from being cast out of therapy-topia, but it may not actually be in their interest to regard their problems as internal disorders or to ease their pain by doping them up. Using the same money to keep people in work, able to take care of the needs of their family, and perhaps develop some of their personal potential might do more wonders for their depression than access to mood-altering pills.

  6. So, gadfly you seem to be saying that you’re against psychotropic drugs. I can’t agree, because I’ve known psychotic people and schizophrenics whose lives could have been great if they weren’t so dysfunctional. BUT, are you really saying that people who want therapy shouldn’t be able to get it?

  7. //people who knew, without the benefit of a screening, that they were depressed can’t get in to see a social worker, psychologist and/or psychiatrist for weeks.//
    I have mixed feelings about access to treatment. Around the time I was making the decision to leave graduate school, I was very depressed. It was easy to get a prescription for Zoloft. I’m not sure how easy it was to get therapy: it was never even recommended to me. Medication didn’t help. My mood didn’t change. The circumstances that I was responding to didn’t change. I did end up paying several hundred dollars for the prescription because I was too depressed to get on top of the insurance paperwork, lol.
    I would say I’m extremely depressed now. My only complaint is that I don’t think that emotional/circumstantial factors need to be de-stigmatized by focusing on the concommitant physiological changes. I think the emotional/circumstantial factors themselves need to be de-stigmatized. It needs to be okay to say that people get hurt by events: that they feel that hurt and that the way they adapt to it is reasonable/learning-based even if it’s not the result the rest of society wants. Helping people solve basic problems might do wonders for the incidence of depression.
    I do think diagnosis of depression creates more problems than it solves. It is more useful as a negative label than a means to hook people up with services. When I worked for Kaiser, the doctor got my medical records with my Zoloft prescription on it. When I complained about a bad reaction to some current medication (for a genetic disorder – not psychiatric), the doctor asked me if I wanted therapy!!! He did not believe me about the medication problem, and he did not act to adjust it any way. I never did get to address this, because this all occured during my last couple weeks of work, and it played a major role in how I lost my job (mistake of disclosing to manager). What is obvious to me is that the “defensive medicine” involved here is that any complaint I have about either the doctor’s malpractice or my job sitution can be attributed to some mental issue on my part, because the doctor has noted “depression” on my medical record. Never mind that this was the happiest point in my life (before losing my job): I’ve been “documented” as depressed. This is why I passionately believe that society should stop encouraging people to diagnose themselves with depression and herding them toward psychotropic drugs. It’s just a form of documentation to be used against people. If we as a society are worried about physiological brain damage, we should be screening for that with MRIs, and prescribing only in response to potential brain damage. Everyone else who suffers from depression should be looking for ways to alleviate their suffering and perhaps push along some progress in our civilization.

  8. I do think there’s a real problem when college campuses operate these sreenings, but people who knew, without the benefit of a screening, that they were depressed can’t get in to see a social worker, psychologist and/or psychiatrist for weeks.

  9. I’m concerned such screening targets the poor. It’s offered free in poor neighborhoods, where people live in depressing circumstances. It will be based on what people report as opposed to any test of brain functioning. The diagnosis will be used to place people on pacifying medication, providing an “explanation” and reducing people’s chances of engaging in strong opposition to their condition. Furthermore, such diagnosis attaches a stigma, and will either exclude or make independent insurance more difficult for these people. Like high interest rates, transferring regular medical billing to collections agency, and financially-based barriers to the work place (credentials, maintaining a suit wardrobe, etc.) the effect of screening the poor for depression is to heap yet another burden on people who already have very little to work with.
    I realize there’s a big war to get society to see depression as something physiological so they won’t dismiss depression as “emotional”, but until the screening is performed on physiolgogical basis, this sort of “awareness day” will just pick up what people self-report, which is subjective and often carries a strong emotional component. Diagnosis of depression, like any diagnosis, leads to a complex array of consequences. These consequences can be beneficial and harmful – the point is that this is one of those non-transparent things that people won’t be able to reason out before they go and seek a diagnosis.
    I strongly object to the medicalization of poverty, which only serves to entrench and reproduce poverty.