Consider for a moment that as the early stages of a mental illness are observed, it will probably not be with a qualified mental health professional. It may be a parent, teacher, guidance counselor, friend, or family doctor who are the first to see some behavior that draws attention to the "potential" patient. Or, in fact, it may be the person with the problem who self-identifies and seeks assistance. So, it becomes very important when a problem emerges, that it is managed correctly. Unfortunately, this is not always the case.
Let us for the moment consider little Johnny sitting in the classroom. He is fidgeting, talking with other children, and not "behaving" as he should. The teacher makes an observation of the behavior and if it is occurring more than the teacher believes that it should, the guidance person is consulted. If it continues, the parents are asked to come in and discuss the inappropriate actions. And, at some point, the term ADHD (Attention Deficit Hyperactivity Disorder) may be applied as a consideration for the behavior. And, while it could simply be boredom, lack of interest, or an excess of sugar in the bloodstream, ADHD, the most over- diagnosed and over-medicated adolescent problem in the US will now be attached to this child. And, once the seed is planted, the label will stick.
Or, what will happen if an adult goes to the family doctor with symptoms of lethargy, reduced libido, and a general lack of interest in everyday life? (Recall that symptoms are what the patients describes, and signs are what the doctor observes). In this case the doctor can not see the symptoms, and can react to the report in several possible ways. The doctor can refer the patient to a mental health professional, suggest a "wait and see" scenario, or prescribe an anti-depressant. In many situations the medication approach is the easier of the alternatives and is frequently followed. Although the doctor is a trained professional, the most recent exposure to psychiatry was during a clinical rotation in medical school. So, like many doctors, the biochemistry of the patient is not considered, but, may in fact be the cause. Unfortunately, after any discussion of depression with a doctor, the seed of depression is planted in the patient's mind.
In our stress filled lives with fast cures and medication, our culture fosters many incorrect and misleading conclusions about underlying reasons for mental health problems. And although what I have presented is a simplistic and quick view of system failure, it really is a cautionary vision.
So, despite the fact that we have good diagnostic guidelines in place, we are frequently victims of the structure and the culture of our society. We need a better way of communicating the recent advances in brain chemistry to those we trust with our mental health.
The next post will begin with anxiety, one of the most perplexing and prevalent mental disorders. It can be a stand-alone condition, but anxiety also accompanies many other illnesses.