Mental illness

“ One of the most widely believed and most damaging myths is that mental illness is a personal failure, not a physical disease. A recent study shows that the majority of Americans don't believe that mental illness can be accurately diagnosed or treated. ”

“ Once shrouded in mystery—and spoken of only in sad, hushed tones—mental illness is becoming more widely understood. Thanks to dramatic advances in basic biomedical research and in the behavioral sciences, we have been able to achieve significant improvements in the diagnosis, treatment, and prevention of emotional and mental disorders. Scientific progress has also helped to alleviate the stigma associated with mental illness, as more and more Americans learn about its origins and effects. ”

“ Though unpleasant and profoundly disappointing, my experience as a mental hospital psychologist was, like being in nursing school, also very valuable. Not only did I learn how to diagnose, and evaluate the severity of mental illness and assess the dangerousness of the mentally ill, I learned to understand them, to feel comfortable with them, and found that I was never afraid of them. Fearlessness is a huge advantage. The mentally ill seem to have a heightened ability to spot fear in others. If they sense that you are afraid they frequently enjoy terrorizing you. ”

“ There is no new mechanism introduced to produce a mental illness, but a putting out of gear of those common to the race and their disturbance is the result of the action of influences which may befall any one of us, unbearable ideas with which some intense emotional state is intimately associated. ”

“ Speaker, October 3-9 is Mental Illness Awareness Week. During any one-year period, up to 50 million Americans--more than 22 percent--suffer from a clearly diagnosable mental disorder involving a degree of incapacity that interferes with employment, attendance at school or daily life. Like so many disorders, mental illness does not discriminate and affects every age, ethnic, and socioeconomic group. ”

“ Mental illness can affect people of any age, race, or walk of life. For example, many elderly Americans are vulnerable to depression and to other illnesses that can threaten their independence and security. Many youngsters who are affected by phobias or other mental disorders continue to suffer when their symptoms are mistaken for passing behavioral problems. Left untreated, mental illness not only leads to lost productivity in school and in the workplace but also damages its victims' self-esteem and personal relationships. ”

“ Though there is no unanimity about this among health care professionals, we will distinguish between these two kinds of problems by calling a psychosis a mental illness, as opposed to an emotional disorder. It is a matter not only of degree but of kind. A person who is severely depressed or extremely anxious is usually still able to communicate rationally, and distinguish what is real from what is fantasy or delusion. ”

“ The American Psychiatric Association tells us that "severe mental illness can seriously impair a sufferer's ability rationally to appreciate the wrongfulness of conduct." Brief for American Psychiatric Association et al. ”

“ So often they appear to be mere rationalizations, mere false judgments on the part of the patient; they thus form subjects for investigation rather than fundamental constituents of the illness.
We, therefore, must not accept the outward and visible signs at their face value but attempt to discover what past experiences in the life of the patient have led to such disturbance of function, to such a change in his mental activity. ”

“ The real is confused with the false. In business the patient becomes careless and unreliable, overlooks important transactions and forgets appointments. There are often subjective feelings of impending illness. The mood becomes depressed, whining and tearful. Irritability and outbursts of anger occasionally appear, characterized by a marked emotional instability, varying rapidly from tears to laughter. ”

“ With mental hygiene becoming firmly established as a practical field of preventive medicine, another group of persons not directly concerned with the care of the mentally ill has become deeply interested in the forms, types and causes of mental illness. It is by such readers, quite as much as physicians, medical students and nurses, that Dr. ”

“ We must understand that mental illnesses are real-not imaginary or self-inflicted-and that some are caused by biochemical or brain dysfunctions that require medical attention in addition to supportive services. ”

“ The events of the last hundred years include more particularly the delimitation and complete differentiation of general paresis, the rise and fall of the paranoia concept, the description of the traumatic psychoses, the establishment of the alcoholic insanities as clinical entities, a study of the mental diseases due to endogenous and exogenous toxins, the recognition of the neuroses and psychoneuroses in their modern sense, the addition of the psychopathic personalities to our classification and the definition of manic-depressive insanity, dementia praecox and involutional melancholia. ”

“ Some cases terminate in a chronic condition which may improve somewhat in time. There may be a persistent emotional and mental enfeeblement with indifference, loss of memory, lack of judgment and impairment of will. ”

“ The type of behavior disorder, the social reactions, the trends of interests, etc., which psychopathic personalities may show give special features to many cases, e.g., criminal traits, moral deficiency, tramp life, sexual perversions and various temperamental peculiarities. ”

“ But perhaps we have not sufficiently indicated a diseased state of consciousness, from which most intellectual men have suffered, many have died, and all should be warned,--the disease, namely, of mental disgust, the sign and the result of mental debility. ”

“ The effort to work becomes daily more laborious, the task of fixing the attention grows increasingly difficult, thoughts wander, memory fails, the reasoning power is enfeebled; prejudice—the shade of defunct emotion or some past persuasion—takes the place of judgment; physical nerve or brain disturbance may supervene, and the crash will then come suddenly, unexpected by on-lookers, perhaps unperceived by the sufferer himself. This is the history of "worry," or disorder produced by mental disquietude and distraction, occasionally by physical disease. ”

“ CAUSATION.—It is clear that only a small proportion of the human race is liable to become insane, and one can only wonder that so few brains are overthrown by the multiplicity of causes in modern life which tend to disturb those “invisible thoroughfares of the mind which are the first lurking-places of anguish, mania, and crime.” When we come to investigate the causes of mental disease, we find that they are of two kinds—remote or predisposing and immediate or exciting. ”

“ The reaction from this doctrine, beginning in that higher respect for matter which modern science inculcates, professes to base itself upon the results of physiology and pathology, and propounds the view that mental disorder is in all cases simply a bodily or brain disease. ”

“ Grief, long-standing jealousy, constant care and corroding anxiety sometimes tend to develop insanity. Sick thoughts and discordant moods are the natural atmosphere of disease, and crime is engendered and thrives in the miasma of the mind."
From all this we get the great fact we are scientifically demonstrating today,—that the various mental states, emotions, and passions have their various peculiar effects upon the body, and each induces in turn, if indulged in to any great extent, its own peculiar forms of disease, and these in time become chronic. ”

“ However, you are not unknown to me. I have heard you well-spoken of; and I remember that, when you were a student in Paris, you were mentioned with honor by the college, for an able paper read before the open section upon the very subject to [13] which I now propose to direct your attention,—mental disease," he added, after a moment's hesitation.
"A case of insanity?" bluntly asked the doctor.
"Heaven forbid! And yet I must not conceal from you that I fear it."
"Give me some of the symptoms. Insanity in strong development, or aberration of faculties, or hallucination?" ”

“ Since one of these has possession of our consciousness, or is at least predominant at every point of time, whichever function of the mind happens to be that which is falling into disorder, by it the form of insanity is determined. ”

“ There will be fretfulness, or ill-nature, or selfish exactions, or mental obscurity, or unreasoning demands, or, it may be, vicious and cruel propensities, where, when the brain was undisturbed by disease, reason held rule with patience and loving kindness. If the disease which has attacked the brain goes on increasing, the mental disease which follows as a consequence of organic disturbance or deterioration, will have increased also, until insanity may be established in some one or more of its many sad and varied forms. ”

“ Such work is not only for the mentally disordered and those suffering from mental defect, but for all those who, through mental causes, are unable so to adjust themselves to their environment as to live happy and efficient lives. ”

“ Some are benefited by the habits of life that are established as a consequence of the belief that they are about to be cured, while before this they had been largely confining themselves to their houses, and had been refusing to take recreation or get diversion because of the conviction that they were ill. Finally, many of them had no real physical ills, but were suffering from mental ailments brought on by dreads and by a concentration {46} of attention on certain portions of the body which interfered with the normal physiologic action of those parts. ”

“ In conclusion, it may be said that the important etiological factors in the production of mental disease are heredity, senility, syphilis, arteriosclerosis, somatic diseases, mental deficiency, epilepsy, diseases of the brain and nervous system, alcoholism, drugs, traumatism and mental stress and shocks of various kinds. ”

“ But while affirming that the disease usually arises in the body, and even frequently in parts far removed from the brain, we must not deny nor ignore the fact that intellectual and protracted worry, or sudden and violent grief, can also be the direct cause of disturbance in the brain. For the brain is the organ not of the imagination alone, which is put to an unhealthy strain by excessive mental labor, but probably also of the passions, whose emotions when excessive may cause even permanent lesion. Hence mental insanity may and does often arise from ill-subdued passions. ”

“ It is a lower degree of the same cause which renders continuous seclusion from society so injurious to both mental and bodily health.”
“Inactivity of intellect and of feeling is a very frequent predisposing cause of every form of nervous disease. For demonstrative evidence of this position, we have only to look at the numerous victims to be found among persons who have no call to exertion in gaining the means of subsistence, and no objects of interest on which to exercise their mental faculties, and who consequently sink into a state of mental sloth and nervous weakness.” ”

“ Above all, they can in time bring the public face to face with the fact that mental diseases should be discussed, generally understood and prevented, instead of being merely concealed and misrepresented. ”

“ When the mind undergoes degeneration, the moral feeling is the first to show it, as it is the last to be restored when the disorder passes away; the latest and highest gain of mental evolution, it is the first to witness by its impairment to mental dissolution.... ”

“ It is a vain question, that which has been often stirred among men of our profession and metaphysicians, whether insanity—including under that word all the modes of derangement of the mental powers—is strictly a disease, the definition of which, according to the best authorities, is "an alternation from a perfect state of bodily health." ”

“ If this is the case with those suffering only from mental deficiency, it is evidently more likely to occur in those suffering from any form of mental disease, which is often liable to change its character, and to pass from the form of depression to one of excitement. ”

“ The more one studies the facts, the more one examines various psychopathic, functional maladies, without going into any speculations and without being blinded by foregone conclusions and pseudo-scientific hypotheses, the more one is driven to the conclusion that the fear instinct is at the bottom of all those nervous and mental aberrations, conscious and subconscious.
The infinite varieties of functional psychopathic diseases are the consequences of some abnormal association [70] with the fear instinct which alone gives rise to the infirmities characteristic of functional mental maladies. ”

“ One need not enter into a lengthy discussion in order to show that we have here a mental disorder, the origin of which can be definitely traced to psychic causes, the emotional shock accompanying the crime and conviction. ”

“ No psychiatrist will work without psychological tools when he deals with the exultations of the maniac and the depressions of the melancholic, with the hallucinations of persecution or the erotic insanities of the paranoiac. Still more the whole register of psychology has to be used, when we are to educate the idiot and the imbecile. But the disappearance of the disease or of the chief symptoms through the mental agencies is in all these cases out of the question. ”

“ Apart from certain physical defects of the nervous system and specific infections, such as syphilis, the causes of mental alienation are to be sought rather in some maladjustment to the individual's social circumstances, often the result of some emotional disturbance, even in early childhood, which created the attitude of mind that eventually determined the mental conflict expressed by the insanity. ”