That's an amazing idea. But Markram said something else even more astonishing, which, for some reason, has not got nearly as much attention:
"There are two billion people on the planet affected by mental disorder," he told the audience.Two billion people. One in three.
This was presumably a throw-away remark, something he said in order to emphasise the importance of understanding the brain. But this makes it even more amazing: we have reached the point where no-one bats an eyelid at the idea that mental illness affects one in three people worldwide.
Well, if this is what we believe now, I think we need to stop beating about the bush with numbers like one in four or one in three, and admit that we now are now using "mental illness" as a synonym for "the human condition".
After all, once you pass the point where one in two people have something, you are saying that it's normal and not having it is weird. As I've written before, if you take the evidence seriously, more than 50% of people are indeed "mentally" ill at some point. So let's just say that everyone is mentally ill and have done with it.
Or we could reassess what we mean by "mental illness" and stop medicalizing human suffering. Hey, we can dream.
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Well, strictly speaking, you could have a disease process that was widespread, even found in the majority, and it still be pathological (e.g. cancer, heart disease and atherosclerosis, etc).
But, perhaps a more sensible way of looking at mental distress is to ask if it warrants medical/psychological intervention. If not then we ought to be careful about labelling it as illness.
I think it's debatable whether, if everyone got (say) atherosclerosis, it would properly considered a disease?
We don't consider old age a disease, although if everyone lived forever and then suddenly people started aging and dying, we would see it as a disease with a distinct course, symptoms, pathophysiology and we'd start searching for the cause...
But I agree that we should be asking the pragmatic empirical question of "Can we usefully treat this?" rather than "Is this an illness?" which is really just a matter of semantics.
One man's "illness" is another man's "normal variation", but if a treatment helps people that's a fact.
Everyone suffers through down times in their lives: mild depression, anxiety, etc. Everyone also goes through wonderful times: joy, happiness, anticipation.
So since everyone has ups and downs does this mean everyone is bipolar?
The term "mental illness" should only be used for those whose mental state severely interferes with one's functioning in life and requires medical treatment.
A mental illness is a medical disorder that requires medical treatment.
The "human condition" is just that: the human condition. Not everyone in the world needs medication for a severe medical disorder but some do.
"the pragmatic empirical question of "Can we usefully treat this?" rather than "Is this an illness?" " Hm, but on that argument malaria wasn't an illness until someone discovered a treatment.
Good point, but actually my argument is that we shouldn't care about whether something is "an illness" or not.
Rather we should care about what we can usefully treat, because that's what allows us to decide what to do.
If you lived in a country where malaria was endemic, and untreatable, it would just be a fact of life, something to deal with. You might or might not think of it as an illness. My point is it doesn't matter either way.
According to mental health services I am not ill. Just not yet recovered!!!!!!
"Rather we should care about what we can usefully treat, because that's what allows us to decide what to do."
I thought the "treat the symptom" approach was already pretty well established among psychiatrists since many symptoms of many different illnesses overlap (i.e. schizophrenia and bipolar, personality disorders, autism.)
Sometimes it's much more trouble figuring out what "disorder" a person has than treating the symptoms.
Than again, it also might depend on where the symptoms stem from in order to treat the symptoms. The mood swings seen in bipolar disorder and borderline personality disorder stem from very different sources and cannot be treated the same way.
So, in this case and many others, the "treat the symptom and not the underlying disorder" doesn't work too well.
Yeah, that's possible. Migraines and dementia affect a lot of people.
Claims of 1 in 3 and higher mental illness lifetime prevalence are routinely made in the literature, though, so whether Markram actually meant it is a bit moot. Other people have said it and meant it.
EXcelent, I just commented that in my blog:
Some people think of themselves as depressed simply because other people have positively reinforced that they are. You shouldn’t underestimate the level of hypochondria surrounding mental conditions. There is a mental illness for just about every emotion these days. You imply that depression may necessarily follow from stress and the conditions of our society. That is hardly the case. Depression as mental illness/disease is just one (metaphorical) way of looking at an individual's circumstance. It is a convenient diagnosis for doctor and patient, because there is little resistance to the diagnosis, it's a popular diagnosis, and there are prescribed courses of treatments (drugs and counselling) available.
http://singyourownlullaby.blogspot.com/2009/06/depression-and-culture.html
The Black Death killed perhaps a third of the population in Europe when it came. Yet most people still consider it a disease.
Yes, because while it killed a third of the people at that specific time, most people (across all time periods) don't get it.
Getting it is unusual.
Which is why it was recognized as a new outbreak when it happened.
As I said, if people normally didn't age and started aging, we would consider old age a disease. we don't because we're used to it, it's not unusual.
Well, it's sort of hard to consider the unnecessary suffering human beings have inflicted on each other (and the planet) throughout history and not think something's a little "off," don't you think?
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