Organic dementia. I think this is the mental illness that is a mental
illness like in the biomedical model, i.e. a real medical illness. It's
also part of life that as the human body ages the brain deteriorates and
it's untreatable as far as I am aware.
Well.....the mental illness isn't treatable at a biological level,.
Demented people are problematic though so let's use the word mental
health problem to describe the medicalisation of problematic states of
mind. Honest is so much better don't you think? The problematicness of
the old people with demenita can be treated by antipsychotics, but they
don't address the biological illness.
I remember a conversation with my poor, poor younger sister. She works
in geriatrics. She's going to be one of the best doctors ever, but don't
you dare tell her that. We had a conversation (one of very few) about
one of her patients. Her patient was an elderly man close to death. He
didn't know what was going on around him. His sense of the external
world and what was happening around them had been shattered through the
organic degeneration process associated with the human animal reaching
the end of it's life.
She was in tears and as usual I was a bit of a cunt. She was in tears
because the man had thrown hot coffee on her. The reason why I think my
sister is going to be a great doctor is because she's got a heart bigger
than her brain, and she's fucking smart. Even the most challenging
patient wouldn't be aggressive to my sister. Trust me on that.
I ended up trying to persuade her that the guy was lost and it was time
for a alternative intervention. Anyway, I suggested getting in some
homeopathic or alternative healer since she'd reached the point where
there was nothing she could do medically (apart from dose him up on
antipsychotics). Of course she was cynical at her non-medical profession
brother's idea but I explain that an alternative healer might look at
other things.
The patient who had spent most of his life working and being useful,
surrounded by friends and family and familiarity was suddenly in
hospital surrounded by doctors. He didn't recognise his family
consciously and may not have recognised his environment. It was my
belief that the man was still there, confused and trapped and suffering.
He was confused and that was why he got angry and tipped hot tea on my
sister. My sister told me he'd been a mechanic or an electrician and I
suggested giving him a screwdriver (which may not have been safe) or
something so he had a handle on who or what he was even if he was
confused and in pain.
Anyway, what was I talking about? Or yeah. There are real mental
illnesses in the truest sense of the word. The modern use of the term is
far wider and encompasses many things that are not really medical
illnesses however medicine now considers the obesity an illness..
However this difference has been somewhat been observed throughout the
history of psychiatry. I keep name dropping Kraeplian but many other
people had a significant influence on the development of the idea and
the concept of mental health and mental illness and what it has become now.
The biomedical model of mental health problems is the only way they can
be accurately seen as an illness however the idea of prognosis, i.e. the
poorer outcomes, is used to justify the alternative model of why they're
illnesses.
The rest is a necessary metaphor or way of understanding, because
without the social model of mental ill health and disability many, many,
many people who are disadvantaged because their emotions or their
behaviour is not cool or socially acceptable at the present time.
It's where the benefits system comes from. The privilege of the invalid
isn't extended to malingers. It is considered important that doctors
could identify the difference between depression and malingering or
laziness. One is genuinely an illness and that's why the privilege of
the benefits system is extended to them. That's why the cluster of
symptoms approach and operational definitions are useful. I'll use
myself as an example. Poor appetite alone, even if it's been going on
for a long time and is causing biological problems that look like
depression, is just one of the cluster of symptoms for depression. It's
not based on body image because I'm well aware I'm too thin and that's
not attractive in men. I eat kebabs when I'm drunk and I started to eat
meat again to try and boost my food intake so it's definitely not like
any of the other eating disorder/body image disorders that I've heard
of. It's killing me slowly though.
Anyway, it's my hope that one day mental illnesses like organic dementia
may be able to be reversed. It's a scary thought because it'll mean
people will be functioning past 100 years old. Until that day arrives
the problematicness of the mentally ill and the techniques society uses
to 'treat' the mental health problematic people are important.
Antipsychotics became used to treat the problematicness of old people
with dementia because these drugs make them easier to deal with for
carers and doctors. A significant study which thankfully prompted the
government to review its dementia strategy showed that the use of
antipsychotics in dementia reduced the life expectancy of old people
close to death by 50%.
That effect on life expectancy might be considered ok if the treatment
was genuinely treatment. Society leaves doctors to get on with making
good treatment decisions based on the evidence. Sadly the case was many
people in the UK were unnecessarily killed through the misuse of
antipsychotics because of that prized but little acknowledged effect
they have, the effect that's so well expressed by the term "chemical
cosh" though I still like the term chemical straightjacket.
I wonder how many people died for society's convenience?
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