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Re: Started Vyvanse today/FB » hrguru

Posted by chujoe on May 8, 2010, at 8:32:29

In reply to Re: Started Vyvanse today/FB » stargazer2, posted by hrguru on May 8, 2010, at 3:40:19

This is more "philosophical" than practical, but I think pdocs are generally working with a system of categories for something called Mental Illness that does not fit very well with the actual experiences that people have. It's as if all their diagnostic tools are designed to help them decide whether patient X fits into box 1 or box 3; sometimes, it turns out, they have to slice their patients into pieces and put part in one box and part in another. Which is not very good for the patient!

But patients are also persons and we know from recent research that persons daily modify their brains by having experiences; the brain is "plastic," as they say, and responds to what happens to the person. This is not all that surprising when you think about it: If you have the experience of smoking, you are more likely to get lung cancer; if you have the experience of drinking too much alcohol, you are more like to have cirrhosis of the liver, etc. We even know, now, that the experience of being poor, or a minority, or socially marginalized is bad for your "physical" and "mental" health. (I put those words in quotes because I don't think those labels are very useful or true to the actual experience of persons.) Those of us suffering from the sorts of issues discussed on this board would do well, in my opinion, to resist becoming patients and insist on remaining persons, even when consulting with our physician, psychiatrist, therapist, etc.Our experience counts. Of course, such an attitude also requires us, as persons, to take responsibility and to make decisions that give us the sorts of experiences that will get us where we want to go -- and that may not be some other person's idea of perfect, normal, "mental health." (I actually don't think there is such a thing.)

So maybe the box model needs to be replaced with a kind of cluster diagram in which some primary problem is put in the center and then other problems are clustered around it. And that center will almost certainly change over time as our experiences change. No diagnosis is completely stable over time. If lung cancer patients stop smoking, I read in the Times yesterday, their survival rate doubles. Just because you're DXed with BP when you're 20 doesn't mean that you will always be BP, though the box model tends to force you to keep your diagnosis, to stay in your box.

The cluster diagram way of looking at "mental illness" is supported by recent studies that suggest that various diagnoses once considered separate diseases are better understood as related symptoms that shade into each other and that are modified by the person's psychology and experiences, as well as by his or her brain chemistry.

[Note: My thinking about these issues has been strongly influenced by Richard P. Bentall's book, Madness Explained: Psychosis and Human Nature, which cites dozens of studies and draws on the history of psychiatry in making its arguments. The book is sometimes technical, but never incomprehensible to the non-expert reader.]


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poster:chujoe thread:944334
URL: http://www.dr-bob.org/babble/20100504/msgs/946767.html