What is Mental Illness?

What is Mental Illness?

• Not just highs & lows in feelings

• Disease of the mind

• Disorder of thought, mood, perception, orientation and memory

Classifications - DSM-IV

1. Disorders of Childhood or Adolescence

2. Dementia & Cognitive Disorders

3. Disorders Due to a Medical Condition

4. Substance-Related Disorders

5. Schizophrenia & Other Psychotic Disorders

6. Mood Disorders

7. Anxiety Disorders

8. Somatoform Disorders

Classifications (cont’d) 9. Factitious Disorders10. Dissociative Disorders11. Sexual & Gender Identity Disorders12. Eating Disorders13. Sleep Disorders14. Impulse Control Disorders15. Adjustment Disorders16. Personality Disorders17. Other

Anxiety DisordersAffect 1 in 10 people (Somers et al 2006)

• Chronic, overwhelming anxiety and fear

• Phobias, Panic Disorder, and Obsessive Compulsive Disorder (OCD)

Symptoms:

• Body: heart palpitations, shortness of breath, dizziness, nausea, chest pain

• Thoughts: irrational fear/worry, fear of losing control or dying

Treatment:• Medication, therapy, and stress management

DepressionAffects 8 in 100 people

• Affects the body, mood and thoughts

• Symptoms last for weeks, months or years

Symptoms include:

• Body: appetite changes, weight gain/loss, sleep disturbance and fatigue

• Mood: feeling sad, empty, hopeless, worthless, guilty or trapped

• Thoughts: difficulty concentrating/thinking, loss of pleasure in activities, thoughts of death/suicide

Treatment: Medication, therapy, or stress management

Reverend Isabella Ross - Depression

“When I’m really ill, I hear what’s like a tape recorder in my head saying really horrible negative things: Your life isn’t worth anything. It would be better if you weren’t here any more. You’re destroying other people’s lives. You’re worthless. That’s what consumes me. I don’t have any ability to shut it off.”

Bipolar Affective

Disorder

• Extreme, spontaneous, mood swings alternating between depression and mania.

• Mania: elated, euphoric mood, increased energy, rapid thoughts and speech, lack of inhibitions, grandiose beliefs.

Treatment: Medication, therapy, and stress management

Affects 1 in 100 people

Andrea Woodside – Bipolar Disorder

“I wake up – maybe weeks, sometimes months later – I wonder if I’ll get a Visa bill informing me that I am the owner of four new dishwashers and $1,800 worth of shoes. All inhibitions, all sense of self-preservation, go out the window when I am manic.”

SchizophreniaAffects 1 in 100 people

Symptoms include:

• Mind: delusions, hallucinations – auditory/visual, lack of insight into illness

• Thought: disorganized thought and/or speech, flat affect, reduced speech, low energy

Treatment:

• Medication, therapy, and stress management

Diane F. - Schizophrenia

“During my second semester, I went on an out-of-town trip with my boyfriend. As we were driving back home, I started seeing animals leaping out in front of the car. A few weeks later, I was walking on campus and saw people in front of me suddenly disappear.”

Quick Facts

• 24% of boys and 17% of girls between the ages of 4 and 11 have one or more emotional or behavioural disorders

• Estimated economic burden of $14.4 billion puts mental health problems among the most costly conditions in Canada (Health Canada)

More Quick Facts

• Mental illness knows no boundaries. Anyone can develop a mental illness regardless of age, gender, economic background, geographical area or race.

If you have a BRAIN…you can have a mental illness.

Trephination (or Trepanation)

• Driving out the evil spirits and demons from the ill (Bard & Bard 2002)

• First surgery ever done (In the Late Stone Age)

• Cut, scrape or drill skull with hard, dense obsidian (volcanic) rock

The Witch Hunts(15th –19th Centuries)

• Girls’ symptoms of convulsions, contortions, and outbursts of gibberish were determined by their doctors to be caused by witchcraft (nationalgeographic.com)

• Demon possession as explanation for mental illness

• Witches not mentally disturbed, confessions likely due to torture

“Madhouse” 16th-18th Centuries

• “Lunatics”

• Shackles

• Secure cells

• Beatings and starvation as a means of sedation

• Sunday penny tours for the public

London Hospital of St. Mary of Bethlehem - “Bedlam” 1547

(LaJeunesse 2002)

“Asylum: Place of Peace, Shelter”

18th – 20th Centuries

• Medical “treatment” more like punishment until early 1800’s

• Moral treatment – Philippe Pinel

• Madness caused by disease of body or brain or social and personal problems “Unchained” in Paris

(Davison et al 2002)

New Brunswick 1834

• First Canadian institution

• “…put to bed in boxes filled with hay; wooden slats nailed on top.” (LaJeunesse 2002)

• Two patients as “trustees” left to quiet noisy inmates at night by urinating on them

Brandon, Manitoba 1906• Known as “The Mental”

• Physical restraints

• Locked in cupboards

• Straightjackets for days

• Shackled in chains

• Metal grills over beds

• Overcrowding = forced to sleep on wooden shelves

(LaJeunesse 2002)

Medical Model 1945

• Insulin shock therapy, 1938

• ECT, 1945

• Psychosurgery, 1950 -1968

• Sexual sterilization, 1928 -1971

• Medications, 1950’s

(LaJeunesse 2002)

ECT: Electro-Convulsive Therapy

• Cerletti & Bini, Europe 1938

• No standards or controls over voltage levels

• ‘Ticklers’ – small jolts to make patients behave

• Caused seizures

• Still used today – voluntary as a last resort

• Memory loss biggest side effect

Frontal Lobotomies• Egas Moniz, Portuguese

Neurologist, 1936

• Surgery with ice pick-like instrument

• Severed nerves of frontal lobe by going through eye socket

• Caused brain damage – unable to speak or think clearly

• Moniz received Nobel prize (LaJeunesse 2002)

Medications

• Anti-psychotic drugs, 1950’s – caused disabling side effects

• Patients discharged after 3 months

• “Revolving door” syndrome as patients would stop meds and end up back in asylums