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Tuesday, February 2, 2010

Mental Diseases versus Mental Illnesses

Recently one of my last patients of the day told me "I feel so much better." I was writing, not directly looking at her and I said "What did you think, you weren't?" When I looked up at her, there were tears in her eyes. "Honestly," she said, "I thought that I was crazy, you know, mental illness, something is wrong with you if you're mentally ill...you're defective. You're never better."

This was just one more point of realization for me. In my last post, I used the term mental disease as opposed to mental illness. The term illness is archaic and references ideas of deviance, defect or crazy. No physician colleague of mine says heart illness or kidney illness; it's heart disease or kidney disease.

I specialize in the treatment of mental diseases which I define as abnormal thoughts, emotions or behaviors that interfere with daily life function. An abnormal heart beat would lead to ischemia (lack of oxygen) to vital organs, which would affect everything in your daily life. Normal heart beats are essential to normal function of the entire person. Normal brain function, like wise, is necessary for a healthy life.

Psychiatrists can diagnose and effectively treat abnormal thoughts, emotions and behaviors. Abnormal emotions such as constant worry or sadness, abnormal thoughts like obsessions and abnormal behaviors such as poor sleep or weight gain are highly treatable and curable.

I don't think most people would think that they were awful, defective people if they were diagnosed by their doctor with high cholesterol. In fact, most people would start cholesterol lowering medication and try to cut back on fatty foods and exercise. Hypercholesterolemia is usually a chronic condition that can be improved with treatment that is necessary for a healthy life. We all know this.

It's the same for the diseases that I treat. Medication can alleviate the actual abnormality and psychotherapy rehabilitating you to normal function.

I say this because a poll in Business Week showed most workers fear stigma or a change in their work status when seeking mental health care versus seeking treatment for other diseases such as diabetes. This poll was news in conjunction with a new law that requires parity or reimbursement for mental health. This law now requires that psychiatric treatment be allowed and reimbursed by insurance at the same rates as medical illnesses like heart disease treatment.

Disease is disease. If you're sick it's your responsibility to get well. With mental diseases, treatment is highly effective, safe and affordable. There is no such thing in psychiatry that you don't get better, like my patient found out earlier. Mental illnesses are not character defects, they're diseases; get treatment.

My next post will start to cover these topics.