Mental health illnesses, particularly depression and anxiety are viewed in a variety of different ways and there are lots of things that need to be considered when diagnosing and treating a possible mental health condition. This essay will look in detail about the history of diagnosing mental health illnesses and the stigma that is attached with a diagnosis, formulation and the biopsychosocial model and finally the use of prescription drugs.
In article 1, Jones, S (2016) suggests that close to 1 in 10 people are suffering from mental health issues – rising upwards to almost 1 in 20 during times of War and Humanitarian Crisis (World Health Organisation – WHO), this the WHO suggests is the cause of a possible 50 million years of lost work before 2030. Jones expresses that all nations, paying little heed to riches levels, need to put more into treatment of these issues, especially for those requiring it most urgently. Jones continues to say this would prevent a number of unnecessary deaths and become more financially practical for the worlds economy. In my opinion therefore implying perhaps prevention would be considerably more cost effective than cure.
Secondly in article 2, Hughes, T (2016) suggests that depression is caused by episodes that have happened within ours lives, including our childhood and not our genetic make-up. He states that almost 50% of adults may suffer with their mental health, with 25% receiving a diagnosis. Hughes believes more money should be spent looking at environmental triggers rather than how money is currently spent looking into genetic causes but believes it is hard to get funding for such research. The article communicates that it is possible for different types of depression to exist dependant on their cause and that if we accept the variables and the initial causes; we can diagnose and treat patients more effectively and appropriately.
In Article 2, Hughes, T (2016) states, “Experts say mental illness is mostly caused by life events and social crisis.” Against this statement, as described by David Pilgrim (2016), is the work of Emil Kraepelin, a German psychopathologist, who was an advocate of selective breeding for bettering society, using Victorian Eugenics. “It was assumed, simplistically, that physical and mental strengths and weaknesses were all, and always inherited” (Pilgrim, 2010, p. 24).
The beliefs of Eugenics regarding the causes of mental health were criticized during World War One, when officers not only experienced the physical wounds of war, but fear and anxiety were also common on the front lines of battle. “The core eugenic– genetic assumption of the late Victorian era was challenged.” (Stone, 1985 cited in Pilgrim, 2010, p. 25).
In article 1, Jones states, “Wars and humanitarian emergencies, which bring trauma, depression and anxiety – and make existing psychotic disorders such as schizophrenia harder to treat – only add to the urgency to act. According to WHO estimates, as many as 20% of people are affected by depression and anxiety during emergencies.”
Mental health establishments have dramatically changed since WW1. They now offer counselling, drugs, and support through the development of the understanding of mental illnesses; however, as article 2 suggests, “Funding bodies such as the Medical Research Council (MRC) have spent hundreds of millions on genetics and the biology of mental illness with limited success and not enough on understanding social factors.” (Hughes, 2016). This suggests money is not equally spent researching causes of mental health problems.
It is Kraepelin’s theories on determining psychiatric problems that shape the premise of the major frameworks used in modern diagnosis, particularly the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization’s ICD. (Pilgrim 2016).
There are positives and negative opinions regarding a diagnosis being made, both for the counsellor and the client. Although a mental health diagnosis might lead to more readily available treatments, it can also leave a stigma of being labelled with a mental health problem. In Excerpt 2, Stephen Fry states, “it is society and stigma that I think lie at the heart of, of the problem of mental health in this country and will continue to do so” (Fry, 2015), suggesting he believes the stigma comes from other people not understanding mental health problems and how they can affect people’s lives. Yalom (cited in Toates, 2010) also points out, “there is a danger that counsellors will treat someone as a diagnosis rather than as a human being.”
Where diagnosis is not suitable, formulation is sometimes more appropriate. Formulation looks on the feelings of each individual and the challenges faced in their everyday life, relationships, social circumstances and history. Whether mental health issues are illnesses with biological causes or a side effect of modern life’s emotional rollercoaster divides opinions.
Psychiatrist George L. Engel developed a theory, known as the biopsychosocial (BPS) model. This looks at the relationship between three aspects of each individual; these are biological, psychological, and social factors. The overlap of these areas gives professionals a better understanding of how and why a person may develop a mental health problem.
Whether through diagnosis or formulation, a decision will be made with the client on the best course of treatment. Many individuals would rather not have an official diagnosis, feeling it may lead to them feeling victimised or feeling labelled; on the other hand, people who have received a diagnosis can be comforted, thinking it is not their fault, and it may help them believe they will eventually lead a normal life.
In Excerpt 3: Experiences with drug use, engineer Jim Brown, believes that, rather than thinking in terms of medical conditions, mental health should be more socially acceptable, saying, “life is a struggle for lots of people.” Stephen Fry suggests in excerpt 3 that regular exercise has probably helped ease his symptoms in several ways, including releasing feel-good brain chemicals, known as endorphins. To support this view is David Healy (excerpt 4 audio) “I think we have become scared of life in a way and transformed joys and sadnesses into an illness of one sort or the other.”
Toates (2010) backs up these opinions by saying, “Some clients practise ‘self-medication’, using alcohol and non-prescription drugs such as cannabis, and these can impact on fear and sadness as well as reacting with any medication. A councillor might be asked for advice on what to do regarding self-medication.” (Toates, 2010, p. 46) followed up by saying “medication should be combined with attempting to live well (sleeping and eating healthily, exercising and avoiding excessive alcohol or cannabis use)” (Toates, 2010, p. 47).
Fry (OU, 2014) talks about prescription drugs saying “they did something to me that I didn’t like, they did make me feel better in the mood but they didn’t make me feel better in self”. However, it appears the use of drug treatments is increasing, Healy (OU, 2014) states “I think what has changed is that generally the psychiatric profession have moved toward being much more pro the use of drugs”. However, NICE (cited in Barker et al, 2010) “concluded that psychological therapies are as effective as drug treatment in the short term and superior in the long term”. Due to people thoughts and feelings regarding drugs it would be better if health professions could offer a variety of treatment options to their clients. (Toates, 2010, p. 66) suggests that “Sometimes, GPs show a ‘knee-jerk’ reaction in prescribing drugs and might not always explore alternatives. Toates (2010).
Moreover, the perception of mental distress as being a medical problem that can be ‘treated’ by drugs or counselling is fundamental. Distress became ‘medicalised’ as people began to see emotional problems as well as physical. (Barker et all., 2010, pp. 11-12).
Drugs treatment for anxiety and depression have been developed and are now frequently used. The most popular being SSRIs (selective serotonin reuptake inhibitors) which act by blocking the reuptake of serotonin into the neuron that released it. Instead of being disposed of, the serotonin occupies receptors and excites high neuronal activity (Toates, 2010).
Healy (cited in Open University, 2010) is wary about the pharmaceutical industry, believing that pharmaceutical companies, give attention to “conditions they think are going to make money for them”, have a vested interest in increasing the number of people diagnosed with depression’ or anxiety and prescribed medication. This medication is marketed to GPs in an aggressive fashion, often with biased evidence – pharmaceutical companies can control of the data from clinical trials and unless they suit the company results sometimes fail to be published. It has been suggested that, SSRIs may only be effective for 10 percent of people taking them when the placebo effect is accounted for (Toates 2010). Healy argues that regarding mental distress, routinely prescribing medication may also lead to people having unwanted side effects or becoming addicted to them.
Self-reflection
Writing this assignment was challenging because of the variety of knowledge required – I found it challenging to link to the given newspaper articles – within a short word count. I did enjoy writing it and I am looking forward to receiving feedback to help me with the rest of D240. I also found it hard getting used to academic writing again after a long break from formal studying, this said I have enjoy the experience.