Mental illness wasn't considered a biological illness really until the time of psychiatry's inception. I don't know enough about the history of psychiatry to comment any further.
There's the concept of Kraeplinan ostensiveness or ostensivity which is meant to mean real mental illnesses fit the prototype of Kraeplin's idea which is biology and prognosis.
People with severe mental illnesses die on average 20 years earlier so it is possible to say doctors can treat this as an illness. I'm not sure it is correct to do so but I don't quite understand why. I think it's because doctors are biological, I.e. they're taught and deal with biological problems. The life expectancy thing is primarily caused by things not directly related to suffering but to human behaviour and patterns as well as social factors.
The question of what is illness and what is behaviour is seen in obesity. This wasn't thought to be an illness but a problem of affluence and addictions. It is a problem in developed world nations, particularly the US. An obese person will die earlier and be more ill.
It could be seen as a mental illness but it is treated and accepted more as a physical illness. The change in acceptance grew as treatments grew. These were mainly biological treatments and as they developed doctors in general began to accept it was an illness. The point is as treatment becomes possible doctors are more ready to consider something which wasn't an illness as an illness.
This discussion relates to a long standing debate about personailty disorders and whether they are mental illnesses. I have to say I don't understand a lot of it but it is about the finesse of what is a mental illness.
Personality disorders weren't considered strictly as a mental illness. Mental illness was considered abnormal whereas PDs were considered extremes of normal human behaviour. Essentiallu everyone has a psychopath in them but in real psychopaths these tendencies present as an extreme. Bipolar and schizophrenia were considered totally abnormal.
PDs have high levels of disability and poor clinical outcomes. The prognosis exists. There's the issue of the biological differences. Here is another grey area for me. I thought that PDs weren't associated with biological differences but there are studies which show or seek to show biological differences in people with PDs. Not read a review or a systematic review on the subject though. (Btw - I'm talking about brain biology rather than the rest of the body)
There's a paper written by louis appelby, now the UK's mental health tzar, about how PDs shouldn't be mental illnesses published ten to fifteen years ago. He was the mental health head honcho when the Mental Health 1983 was amended and the legal definition of what the act covered was extended to personality disorders.
It is this area of neurobiology which is where I am weakest in my knowledge. I know studies have shown there are brain differeneces and significant ones they're not conclusive for me. But I hope they do show brain differences because it sort of helps with my hypothesis.
In short what I'm questioning is the difference between difference and deficit. What if, like races, the mentally ill are simply different rather than dysfunctional or sub human. This is a difficult question to answer.
What is more difficult is if I'm right. What if the phenotype mentally ill, a construct of modern society, is no smaller a mistake than the enslavement of black people because of their skin colour.
What if difference is not an illness?
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