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bougainvillea
November 27th, 2016, 07:44 AM
In the modern day, we seem to have a medical condition for everything under the sun. A plethora of new diseases and psychological/mental illnesses have surfaced over the last half-century or so.

I was conversing with someone once, who believed that conditions such as ADD/ADHD have wildly become a regular occurrence in the last couple of decades, and it was nowhere near as commonly known a few decades ago. The same can go for other mental illnesses I imagine; it was just the example they gave.

Another example could be a woman's "hysteria", in the early 20th century it wasn't uncommon for women to be known as mad/hysterical. This isn't really a part of the overall discussion, but I thought it would be something that could come into play.

I digress: what's your opinion? How have these conditions come about? Is it through scientific advances, society, etc.?

bentheplayer
November 27th, 2016, 11:14 AM
Wow. This has to be one of the hardest question to definitively answer in medical epidemiology bu I will try anyways. Firstly, psychiatry has been a relatively new and rapidly expanding field in medicine so naturally we can expect better access to such doctors now compared to the past. With better access obviously under diagnosis will decrease and awareness will rise. In the past it was deem as socially taboo to be diagnosed with a mental illness so many people may choose not to see treatment and be labelled. In this scenario, its possible that people in the past with mental illness were simply not diagnosed.

In terms of technology, there has been loads of new fancy imaging techniques that allow doctors to better understand the basic science of how our brains function. A natural result of that is the supposed normal can now be separated from abnormal aka new pathological conditions are found. Also there has been more studies done by clinical psychologists who seem more inclined to broaden the diagnostic criteria especially for the spectrum disorders. Hence more people can now be included according to the new ever expanding diagnostic criteria.

In terms of environmental factors, I think the urban environment has become increasing stressful and this increased pressure is affecting our mood and mental health. Did you know that some 15% of the population is expected to experience severe depression at least once in their life time? This seems like pretty high figure to me. The thing to note is here is that some mental diseases can be transient and could potentially resolve without seeing the doctor.

For kids, parents are expecting their kids to perform well and when their kids fail they expect it to be medically explained so that they can console themselves that it isn't their kids fault. Such a diagnosis may be used as a reason for their kids be allowed special consideration especially if their kids marginally under-perform in standardized testing. Kids may also want such a diagnosis as it will allow them to get a supply of adderall, the study drug, causing them to over inflate their true condition.

Another group claims that this is due to over diagnosis caused by over pathologizing normal behaviors, big pharma's corruption in psychiatry and ironically by side effects of psychiatric medications. Clinicians may also feel pressured to diagnose kids taken in by the social services who are borderline cases as a way to circumvent the bureaucratic process in a bid to allow kids access to therapy. Broadening semantics are also thought to be part of the problem here.

Personally I think there are many factors at play here and there are probably more reasons other than the above that I can think of so far.

HououinKiyoma
November 27th, 2016, 11:40 PM
I guess it was (and still is in some places) a social stigma to visit the psychiatrist. Depression and other such mental health issues weren't highlighted as much even 20-30 years ago.

Plus I'm pretty sure no one would wanna visit the psychiatrist since lobotomy was administered as a cure for everything from depression to dementia.

Microcosm
November 30th, 2016, 06:19 PM
I'd like to say that I enjoy @bentheplayer (http://www.virtualteen.org/forums/member.php?u=124549)'s posting style and look forward to seeing more posts from him. Love Tokyo Ghoul btw. :D

In the 1800s, Dorothy Dix set up some of the first mental asylums in America. She helped to popularize a focus on the mentally ill and I think this culminated into a generally stronger interest in mental health study later on.

Also, movements towards individualism and a focus on individual health and safety that characterized the 20th century, a reaction perhaps to the industrial revolution and the horrendous living conditions that people dealt with, sort of contributed to further developing medical science in general. People figured that if individuals were happier and healthier, then society as a whole would benefit. Now, it has developed even further to point that it is widely agreed upon that individuals deserve the right to a healthy mind regardless of whatever societal effects that has. For what it's worth, I agree with both.

bentheplayer
December 1st, 2016, 10:27 AM
Microcosm what do you mean by my posting style, care to elaborate? Tokyo Ghoul is amazing. Can't wait for season 3.

Thought I should add that in the past most people with innocuous symptoms were assumed to be normal and were thought to lack self control. It was the imaging and research on brain functions that proved otherwise. Back then some doctors even blamed parents for the kids "mental" behavior. Check out the refrigerator mother theory.

Those with violence tendencies or grossly different from normal were usually institutionalized like prisoners who were on life without parole. It was simply an area where there was little money to be made and where healthcare professionals usually actively avoided. The idea was mixing too much with these people might get them mad too from the sheer stress and craziness.

candorgen
December 1st, 2016, 05:13 PM
Microcosm what do you mean by my posting style, care to elaborate?

You were very clear and in-depth, basically. :D

- - - - - - - -

Aside from that, my apparently short answers are actually me getting back into the swing of things here. I will eventually (hopefully soon) have enough drive to actually properly contribute in threads.

Flapjack
December 4th, 2016, 01:44 PM
I do believe it is possible to over diagnose and this obviously does happen sometimes but I don't think it is as widespread as many people claim. I think more people are being diagnosed with mental disorders because more is known about them and I believe this to be a good thing. This could also be caused by bad lifestyle choices of our previous generations in altering our epigenetics, although not much is known about this yet but I thought I would throw it in because it is interesting.

benbeny
December 6th, 2016, 05:15 AM
Wow. This has to be one of the hardest question to definitively answer in medical epidemiology bu I will try anyways. Firstly, psychiatry has been a relatively new and rapidly expanding field in medicine so naturally we can expect better access to such doctors now compared to the past. With better access obviously under diagnosis will decrease and awareness will rise. In the past it was deem as socially taboo to be diagnosed with a mental illness so many people may choose not to see treatment and be labelled. In this scenario, its possible that people in the past with mental illness were simply not diagnosed.

In terms of technology, there has been loads of new fancy imaging techniques that allow doctors to better understand the basic science of how our brains function. A natural result of that is the supposed normal can now be separated from abnormal aka new pathological conditions are found. Also there has been more studies done by clinical psychologists who seem more inclined to broaden the diagnostic criteria especially for the spectrum disorders. Hence more people can now be included according to the new ever expanding diagnostic criteria.

In terms of environmental factors, I think the urban environment has become increasing stressful and this increased pressure is affecting our mood and mental health. Did you know that some 15% of the population is expected to experience severe depression at least once in their life time? This seems like pretty high figure to me. The thing to note is here is that some mental diseases can be transient and could potentially resolve without seeing the doctor.

For kids, parents are expecting their kids to perform well and when their kids fail they expect it to be medically explained so that they can console themselves that it isn't their kids fault. Such a diagnosis may be used as a reason for their kids be allowed special consideration especially if their kids marginally under-perform in standardized testing. Kids may also want such a diagnosis as it will allow them to get a supply of adderall, the study drug, causing them to over inflate their true condition.

Another group claims that this is due to over diagnosis caused by over pathologizing normal behaviors, big pharma's corruption in psychiatry and ironically by side effects of psychiatric medications. Clinicians may also feel pressured to diagnose kids taken in by the social services who are borderline cases as a way to circumvent the bureaucratic process in a bid to allow kids access to therapy. Broadening semantics are also thought to be part of the problem here.

Personally I think there are many factors at play here and there are probably more reasons other than the above that I can think of so far.

I really agree with this. As a medical student myself, I am starting to question the real need of psychiatry, does it really help us, or making us a dumb and happy society?
But, the opposite is true. In here, despite the access to government-supported insurance with very low premium ($1.5-$6 per month) people still chained for having mental disorders, which are actually can be helped with psychiatric service.
Overall, autistic spectrum disorder is increased worldwide. There are some discussions whether this is the effect of overdiagnoses or actual increase in incidence rate. Because ASD can include high to low functioning autism, I personally believe better diagnostic criteria is very needed to precisely determine what kind of disorder a kid have.
I firmly believe urban factor also plays a part, because of higher stress level and higher mutagenic levels in form of worse environmental condition than decades ago. Higher mutagenic levels will be correlated with higher level of mental disorders, both through spontaneous mutation or hereditary.

bentheplayer
December 6th, 2016, 06:06 AM
I really agree with this. As a medical student myself, I am starting to question the real need of psychiatry, does it really help us, or making us a dumb and happy society?
But, the opposite is true. In here, despite the access to government-supported insurance with very low premium ($1.5-$6 per month) people still chained for having mental disorders, which are actually can be helped with psychiatric service.
Overall, autistic spectrum disorder is increased worldwide. There are some discussions whether this is the effect of overdiagnoses or actual increase in incidence rate. Because ASD can include high to low functioning autism, I personally believe better diagnostic criteria is very needed to precisely determine what kind of disorder a kid have.
I firmly believe urban factor also plays a part, because of higher stress level and higher mutagenic levels in form of worse environmental condition than decades ago. Higher mutagenic levels will be correlated with higher level of mental disorders, both through spontaneous mutation or hereditary.

Forgive me for being pedantic but since you are a medical student I thought that you should know that ASD is currently deemed as a developmental disorder and not a mental illness. (OP was asking about mental illness) That said people with ASD are more likely to suffer from mental illness. The latest paper I came across suggested that epigenetics could be the cause of ASD but no one seems to know the exact cause.

Personally, I believe that with each consecutive generation genetic mutations will increase as genetic fidelity mechanisms are not perfect. Somehow humans seem to get weaker with each generation.

benbeny
December 6th, 2016, 06:14 AM
Forgive me for being pedantic but since you are a medical student I thought that you should know that ASD is currently deemed as a developmental disorder and not a mental illness. (OP was asking about mental illness) That said people with ASD are more likely to suffer from mental illness. The latest paper I came across suggested that epigenetics could be the cause of ASD but no one seems to know the exact cause.

Personally, I believe that with each consecutive generation genetic mutations will increase as genetic fidelity mechanisms are not perfect. Somehow humans seem to get weaker with each generation.
Yeah sorry for that, it's a bit messing up in my brain.
Mental illness by itself is partly genetics, though we don't know yet what are the genes involved. Usually, natural selection will inhibit mentally ill people to reproduce, but with the advent of new drugs mentally ill people are able to make offspring and that disturbs the way nature eliminate dangerous genes in general population. I believe natural selection plays part in our 'weaker' gene pool too.
So yes, there are multiple factors involved in the way mental illness infused more and more into our gene pool. I'm far from advising complete lock-up for mentally ill people, but the fact is the advent of new drugs and more civilized societies (with better healthcare, more psychotherapies available and people more willing to help) creates imbalance in natural selection.

bentheplayer
December 6th, 2016, 06:23 AM
Yeah sorry for that, it's a bit messing up in my brain.
Mental illness by itself is partly genetics, though we don't know yet what are the genes involved. Usually, natural selection will inhibit mentally ill people to reproduce, but with the advent of new drugs mentally ill people are able to make offspring and that disturbs the way nature eliminate dangerous genes in general population. I believe natural selection plays part in our 'weaker' gene pool too.
So yes, there are multiple factors involved in the way mental illness infused more and more into our gene pool. I'm far from advising complete lock-up for mentally ill people, but the fact is the advent of new drugs and more civilized societies (with better healthcare, more psychotherapies available and people more willing to help) creates imbalance in natural selection.

I am not too sure if mental illness is caused by genetics(DNA sequence based causes), cause if it did then most likely people should continuously experience those effects once off their meds ie never recover. However this doesn't seem to be the case. As such I am more inclined to think that epigenetics has a greater role but of course only time and more research will be needed to get a definitive answer.

Hyper
December 7th, 2016, 08:22 AM
I don't even understand what the OPs question is.

Is it; how have psychiatric diagnosis been worked out?
Or is it; has the relatively recent increase in certain psychiatric diagnosis come naturally or artificially.

Psychiatry in truth can not answer the question of how, why or where do psychiatric conditions stem from. So any open minded psychiatrist will tell you that we can just as well consider schizophrenia to be a medical condition as well as a different way of experiencing reality.

The real problem isn't over or under diagnosis. It is the way the patient - doctor relationship plays out.

And that is vertically - the doctor is above the patient, he knows best, he makes the decisions. Same if it's a rehabilitation group with a psychiatrist, mental health nurse, therapists, medical doctor etc.

A persons mental health is treated as a condition that can be treated or managed in the best interests of society, not in the best interests of the individual, even worse many professionals from doctors to social workers (especially the latter...) believe that these problems have to be managed for the patient with societal needs & goals as the first and foremost objectives.

Uniquemind
December 7th, 2016, 07:27 PM
In the modern day, we seem to have a medical condition for everything under the sun. A plethora of new diseases and psychological/mental illnesses have surfaced over the last half-century or so.

I was conversing with someone once, who believed that conditions such as ADD/ADHD have wildly become a regular occurrence in the last couple of decades, and it was nowhere near as commonly known a few decades ago. The same can go for other mental illnesses I imagine; it was just the example they gave.

Another example could be a woman's "hysteria", in the early 20th century it wasn't uncommon for women to be known as mad/hysterical. This isn't really a part of the overall discussion, but I thought it would be something that could come into play.

I digress: what's your opinion? How have these conditions come about? Is it through scientific advances, society, etc.?


The main difference is that you're combining the last 500 years, as one giant era, of "scientific progress" and a good 440 of those years, what they called "science" in those days, was not following the modern scientific method we know today.


So it cannot be conflated and rated and critiqued the same way.

For instance "Autism" even within the last 40 years, was thought or theorized to be caused by "bad mothers" who did not show affection to their children. Today we know this to be false, but are still at a loss for the exact cause.


In other areas, you are looking narrowly at the topic, and are failing to encompass a multi-perspective approach to the causality of what there are such a rise in diagnosis of various mental disorders/disabilities.


1. What technologies hit the free market that caused environmental hazards which could've caused a rise in epidemiology in various health conditions?

2. How are each and every individual mental health diagnosis different and then also the same in terms of the symptoms shown? A lot of what doctors and psychologists struggle with is misdiagnosis, and that's because a lot of different conditions appear to be the same at face value and they're playing trial and error based on their medical education until they diagnose the problem and then provide an appropriate treatment.

3. Did you know small little facts like artificial food colorings, specifically Red and Orange (despite being approved as legally safe to eat by the FDA) have been linked to the rise of ADHD in children which then stay with them as adults?

(Follow up questions: What decades saw a spike in food color additives in our grocery stores, and when did households start buying processed manufactured foods)


4. How did each generation after eating or being exposed so such hazards (factory pollution etc.), affect the timeline that followed after the first generation of exposure in terms of generation after generation at an epigenetic level and then the grandchildren's chances of developing various health conditions?



So my point is don't trivialize this, or buy into social-darwinism rationale that the "sick" developed problems because they're inferior to those who didn't. That's a very public personal attack I saw and see in politics that disguises itself has darwinism when it's really not because their's a manmade element to the conditons of what defines "survival of the fittest".


Think wider, start connecting the dots and start looking at the past, present, and future, simultaneously.