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The Stigma of Psychiatry

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The Stigma of Psychiatry

Tips: 0.00 INK Postby dealing with it on Sun Apr 01, 2012 11:06 pm

Imagine that you have something judged so wrong with your brain that your right to refuse medication is taken away. Imagine that you can be taken away, with very little justification, and locked for weeks or months in a cramped hospital. Imagine the self-treachery as, after months of hating the nurses and doctors, you look back and realize that this was all a good idea and in your best interests.

How do you judge the mentally ill, when you first hear of their problems? Is your analysis fair? Can you sympathize?

And what is your opinion of psychiatry? Is it an effective way to handle the behaviors and thoughts of those who are deemed unstable? Is there an alternative?

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby NorthernSoul on Mon Apr 02, 2012 2:12 am

Having just finished my psychiatry placement (I'm a med student) I can honestly say that, at least in the UK, the regulation surrounding the Mental Health Act (which contains the sections needed to detain and treat someone against their will under law when they're suffering from a severe psychiatric illness) is pretty stringent. Not to mention that commissioning bodies are trying to move as much treatment into the community as possible (partially because it's cheaper).

I don't know if anyone else here has ever met anyone who's floridly psychotic- a schizophrenic suffering an acute relapse, for example- but in some cases there's absolutely no way it would be possible or ethical to allow them to go untreated. Whether they are running around the street stripping off and masturbating, catatonic (a severe type of schizophrenia with bizarre disorders of movement) or attempting to kill themselves by setting their hostel on fire- all of which are real patients I've met and clerked. And what people don't realise is that anti-psychotic drugs actually work. Really well. By not taking antipsychotics after a first episode of acute psychosis in a diagnosis of schizophrenia, you increase your chance of relapse by something like 60% in the next two years. If you've got bipolar affective disorder and don't take mood stabilisers then that risk is even higher. And clearly psychiatry isn't just about the drugs. Psychiatrists here in the UK coordinate the care package of the patient after discharge from the hospital and also administer psychotherapy (forms of which are recommended by NICE- the body that issues clinical guidelines over here- even in schizophrenia so once the patient has some insight into their condition).

I also spent some time on an inpatient eating disorders unit, which was interesting too. If I had to pick between being a psychiatrist on an acute ward or in an eating disorders unit, I'd go for the former. Far less stressful.

As for judgement- why would I judge someone for having a mental illness any more than I'd judge them for having, say, heart disease? I have a close family member with bipolar disorder who was admitted to a psychiatric hospital in his youth (and given electroconvulsive shock therapy) so it would be a bit short-sighted of me! Not to mention it wouldn't be particularly compatible with my future career...

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Ylanne on Mon Apr 02, 2012 11:59 pm

My boyfriend has a mental illness; he has Bipolar disorder. I happen to be Autistic (not a mental illness), and very active in the Autistic community, and I know a number of Autistics who happen to have co-occurring mental illnesses. I also know many other people who have mental illnesses.

I think that there is generally less stigma associated with mental health treatment today than there was even a few decades ago, as a higher percentage of people seek mental health treatment of various kinds; however, there seems to remain a significant amount of stigma associated with having mental illness of any kind. The vast majority of people who genuinely have anti-social personality disorder, the traits of which are commonly conflated with psychopathy or sociopathy (neither of which are currently diagnostic labels in the DSM-IV-TR), are not violent, sadistic, or malicious people, nor are the vast majority of people with schizophrenia or bipolar disorder.

My boyfriend has long taken medication for his Bipolar disorder, and he does so of his own volition. I believe strongly in the right of all people, whether they have mental illness or not, to self-determination. Most people with mental illnesses whom I know whose conditions are typically treated or supported with specific drugs designed to improve quality of life for people with those specific conditions have chosen voluntarily to continue their medication regimen. I have no problems with that. I only believe that medication should be forcibly administered to an individual if there is reasonable, evidence-based cause to believe that without that medication that person poses an imminent and immediate risk of danger to self or others. Otherwise, the choice to take medication should remain with the individual.
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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby dealing with it on Thu Apr 05, 2012 6:14 pm

NorthernSoul wrote:I don't know if anyone else here has ever met anyone who's floridly psychotic- a schizophrenic suffering an acute relapse, for example-
Sometimes I wonder if I know any.
And clearly psychiatry isn't just about the drugs.
I kind of wonder where the drugs came from. When did doctors first start being the ones in command? Who ran hospitals before them? Who's next in line for the task of handling the ... clients? ?
If I had to pick between being a psychiatrist on an acute ward or in an eating disorders unit, I'd go for the former. Far less stressful.
Missing joie de vivre?

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby NorthernSoul on Mon Apr 09, 2012 3:28 am

I kind of wonder where the drugs came from. When did doctors first start being the ones in command? Who ran hospitals before them? Who's next in line for the task of handling the ... clients? ?

Do you mean what was before hospitals? Asylums, or before that- prison. I know where I'd rather be for a few months. Why wouldn't doctors be the responsible clinicians? They are in every other medical speciality. And I'm not sure if you meant your last sentence to come across so disparaging to people with mental illness I found it to be a little... The only reason that the word 'client' has found its way into psychiatry is because of the immense stigma attached to the word 'patient' in that context. Which is a shame.

Missing joie de vivre?

Well, it's certainly less depressing...

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Grahf on Mon Apr 09, 2012 3:42 am

I suffer from quite a few psychological issues myself, and have spent some time in a hospital due to that fact. From my time there alone as judge I found it to be terrifying at first, boring later and a big help in the end. It's just getting used to it all that's so damn scary. You go in, and lose all power. Someone tells you when you can sleep, when you can eat...tells you what pills you HAVE to take. It's alot to get used too.

Luckily I had been used to some of it already, having done time in the Military. It was still unsettling.

Once I got used to it all..it became rather dull. Not much to do all day; wake up, eat, morning therapy. Lunch, watch tv, group therapy. Dinner, evening tv..bed time. The days bled into eachother.

In the end though, when I was done..I felt good. Less angry, less contained. I could talk again. I had my own strength of mind back. It was a good thing after all. I still talk to my Dr, every once in a while. It helps me adapt and cope with things.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby dealing with it on Mon Apr 09, 2012 8:49 pm

Noxize, if you don't mind talking about it, do you ever experience any form of ableism/mentalism?

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Grahf on Tue Apr 10, 2012 12:04 am

For the most part, no. If people learn the true depth of my problems, and the sources I have noticed 'kid gloves' being used, as if I was delicate. Other times, due to actions I took in my 'dark days' I have been treated poorly, by those that do not know or care about the full details. All they see is my actions, not the cause.

I am lucky, in that for the most part it is hard to see that I am damaged. I do not rave, twitch or show any outside sign of my deep mental problems. So most of you would pass me on the street knowing nothing. Those that do know though are both warry, overly kind or down right rude.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Ylanne on Thu Apr 26, 2012 9:04 pm

The blogs Just Stimming and Autistic Hoya discuss ableism quite extensively, though mostly in regards to autism.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby JewelGlutton on Tue May 01, 2012 6:59 pm

I, being someone with Aspergers, Severe Generalized Anxiety Disorder, and ADD, have noticed that while my medicine does help, I would honestly hate to be forced to take medication.

But, that's just me. Sometimes I don't know what's best for me, others do. Same may go for Mental Institutions.

And yes, I have been discriminated because of these 'problems'.

Someone I know with Aspergers, has been called 'weird', 'stupid', 'creepy', etc. So have I.

But back on the subject of medication, sometimes it's kinda' needed. A person suffering from delusions wouldn't know if they should accept it, or something else.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby kathrin on Wed May 02, 2012 11:51 am

Well, when you hear the word:psychiatry, you instantly think ”Wow, that person is insane, let.s do not talk to him!” No, it is not good.You have to think that she or he are like you, a normal people just with some mental problem.Sometimes I wonder if I am sane enough to judge them.I do not have the right to judge them, because I do not know what they feel...If I knew their emotions, their deepest feelings, I could understand more about them.The thing is that hospitals for mental people are not right builted.Because if you want to help a mental people, you do not have to input him or her the ideea that he or he is insane..If you understand me.Psychiatry is a quite good way to calm those people, to make them feel more comfortable in their bodies.
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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Fadded on Thu May 24, 2012 1:25 am

I am currently a psychology student going for clinical psychology which is like psychiatry except in most states, the clinical psychologist aren't allowed to prescribe medication. There are a lot of things that can be calmed down simply by going to a counselor or some type of psychiatrist and talk about the problems with someone outside of the situation that can help you build ways around stress and work out plans of how to deal with problems. Taking pills isn't the sole answer.

However some disorders such as schizophrenia as mentioned above needs to be treated with medication. I do believe in the right for people to deny or accept help and medication but honestly, if someone is currently in a psychotic episode, they don't know exactly what is reality, what they should take, and what is good for them so in these cases, I do understand begin forced to take medication until they have calmed down enough to say they do want to continue or they shouldn't. This seems to be a common thread through the posts so far.

I also have OCD which is obsessive compulsive disorder. This can be treated with medication but it can also be treated with therapy. I went to a psychiatrist to talk about it and such and my psychiatrist asked if I wanted to take it and she advised me to try it to help my anxiety go down. I decided to go ahead with therapy without the medication so currently psychiatry is freer than it has been over the years and slowly people are opening their minds to the fact that people with mental illnesses are just people and don't have to be afraid of them which is a good thing. Yes there are still prejudices but it is nice to see that it is improving.

For the most part, psychiatry is still improving and getting better at treatment and I do believe that it is an effective way to treat someone. Do I judge people? No. Why would I judge them for it? We all have problems and challenges we must overcome and quiet frankly, that would be quite hypocritical of me to judge them since I have OCD and am going to be a psychologist lol. I sympathize with their problems.

Did I answer the questions? I feel like I rambled a bit lol.
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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby dealing with it on Thu May 24, 2012 2:26 am

A little something I came across in my travels:

To Be a Mental Patient

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Fadded on Thu May 24, 2012 1:58 pm

I would like to point out that "To Be a Mental Patient" by Rae Unzicker is sad but you have to take note that in recent years, treatment of mental patience has changed drastically from where it was in the beginning and acceptance is growing.

The second article about if Mental illness is real.... it says that there are no biological markers, but there have been. For an example, go read the book by the neurologist/psychologist Oliver Sacks about the Man who Mistook His Wife for a Hat and other case studies. He has found a lot of different brain function that are different from a 'normal brain' and one that has agnosia for example.

Yes there are cultural differences that define what is morally acceptable and over the years there have been changes to the DSM but that change is also due to the advancement of the field. New studies are being conducted to try and figure things cross-culturally. If we ignore mental illness and say it is a myth, what happens to the people who do need help? People who do have schizophrenia? Multiple personality disorder? Psychopaths? Without any treatment and therapy, they could spiral down. It is not just a case about learning and teaching people how to act. Psychology is also used to understand the brain, not just treat mental disorders.

Psychology is still a growing science with studies constantly finding out new things and evolving.The article you produced talked about things that happened in the past. Things have changed since then as well.

Secondly, you got this off an anti-psychiatry website which can be biased for their cause.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby NorthernSoul on Thu May 24, 2012 2:44 pm

Fadded wrote:The second article about if Mental illness is real.... it says that there are no biological markers, but there have been. For an example, go read the book by the neurologist/psychologist Oliver Sacks about the Man who Mistook His Wife for a Hat and other case studies. He has found a lot of different brain function that are different from a 'normal brain' and one that has agnosia for example.


Agnosia isn't a psychiatric illness, it's a neurological one. And the results of functional imaging between that of a 'normal' brain and that of someone affected by a psychiatric illness have been subject to a great deal of debate. Not to say that there aren't differences but it's difficult to attribute them to the psychiatric disorder itself and not the long-term consequences of the associated environment that tends to come with severe mental illness e.g. social withdrawal and deprivation, for example.

But for the most part, I agree with you. There are plenty of diseases in medicine that are diagnosed purely on a clinical basis simply because there are no reliable biological markers or tests for that particular disease. It doesn't mean it doesn't exist. Idiopathic Parkinson's disease, for example, is diagnosed purely on history and examination. You don't hear many people going around denying the existence of that...

People who do have schizophrenia? Multiple personality disorder? Psychopaths?


This is by no means a criticism of yourself but I find it interesting how two of your examples (dissociative identity disorder and psychopathy) are both a) incredibly rare and b) are a subject of intense debate amongst the psychiatric scientific community as to their aetiology and even their existence as proper diagnostic categories. It just goes to show the effect the media and popular culture can have on the general public's perception of psychiatric illness, I suppose. Depression, for example, causes far more mortality and morbidity across the world than all three of those conditions combined.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Ylanne on Thu May 24, 2012 3:15 pm

"Illness" isn't generally the most appropriate word to use. Those with "mental illnesses" have increasingly preferred the terminology "mental disability" in line with the rest of the disability rights movement. (I glanced above, and see that my April 2 post in this thread used the terminology "mental illness." Between then and now, I've learned of the fact that many people with mental disabilities prefer not to be referred to as having mental illnesses, and I've made an effort to change the language that I use to describe those conditions.) As a person with spatial agnosia and severe prosopagnosia, I describe myself as a person with neurological disabilities, as it is neurological difference that causes both of those conditions. I am Autistic, and that's a developmental disability -- neither an illness or a disease nor a disorder. I know several people with intellectual disabilities and learning disabilities, as well as mental disabilities.

I'd like to note that dissociation, such as with dissociative identity disorder, can be a result of trauma as in post-traumatic stress disorder. I know several people who have PTSD, and at least two of them regularly dissociate; that is a characteristic of the PTSD diagnosis. It is a coping mechanism for the experience of having PTSD badly triggered. Likewise, psychopathy is not a diagnostic term. The closest that the DSM-IV comes to describing "psychopathy" is with the diagnostic label for "anti-social personality disorder," but in terms of traits considered sociopathic or psychopathic, there's some fairly large number of people in the general population who have a good number of those traits -- such as narcissism, lack of empathy, and such.

Fadded, it's said that the rights of one person end when they infringe upon the rights of another. Thus, if a person were behaving violently and posed an imminent and immediate threat of harm to self or others, and medication were the absolute only way to stop that violent behavior from harming someone else -- then yes, I would support forcing medication solely for the purpose of preventing that person from harming self or others. Nevertheless, in general, the right of the individual to be presumed competent and able to make his or her or xir own decisions regarding medication is paramount; whether the individual chooses to accept or decline medication, I would not argue against an informed decision.

On that note, I'd like to remind you that the social model of disability has done much to advance understanding of the complex ways in which societal structures and disability interact and develop one another. Much of psychiatry and psychology are built upon an essentialist model, which claims that disability is primarily or solely innate to an individual, and thus is a problem with the individual. The social model of disability posits a constructivist model of disability, which argues that rather than being innate to an individual, disability is largely created and shaped by society -- that is, that societal attitudes, perceptions, and practices create a certain "norm," and that if an individual's abilities -- physical, neurological, or otherwise -- diverge enough from that "norm" to become markedly different, that individual is labeled disabled and therefore defective and in need of fixing or curing. The constructivist model of disability posits that the problems that people with disabilities face are primarily a result of their existence in a society that has not been built as inclusive and accessible for those with marked deviations from the "norm."

In regards to autism in particular, cultural anthropologist Roy Richard Grinker (George Washington University) wrote an excellent book a few years ago (Unstrange Minds: Remapping the World of Autism) in which he explored cultural perceptions of autism and Autistic people around the globe during his research for the book. He noted that regarding autism as primary a set of deficits -- disease, illness, disorder -- is not necessarily the norm, and that outcomes and integration for Autistic people, whether mildly or severely disabled, often vary depending on the culture and society in which the individual lives.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Fadded on Thu May 24, 2012 3:35 pm

NorthernSoul wrote:
Agnosia isn't a psychiatric illness, it's a neurological one. And the results of functional imaging between that of a 'normal' brain and that of someone affected by a psychiatric illness have been subject to a great deal of debate. Not to say that there aren't differences but it's difficult to attribute them to the psychiatric disorder itself and not the long-term consequences of the associated environment that tends to come with severe mental illness e.g. social withdrawal and deprivation, for example.

People who do have schizophrenia? Multiple personality disorder? Psychopaths?


This is by no means a criticism of yourself but I find it interesting how two of your examples (dissociative identity disorder and psychopathy) are both a) incredibly rare and b) are a subject of intense debate amongst the psychiatric scientific community as to their aetiology and even their existence as proper diagnostic categories. It just goes to show the effect the media and popular culture can have on the general public's perception of psychiatric illness, I suppose. Depression, for example, causes far more mortality and morbidity across the world than all three of those conditions combined.


My mistake about Agnosia. I think I got a little carried away. However for psychopaths, I am currently reading a book about them so they were at the fore of my mind lol. The book is called Without Conscience by Robert D. Hare, PhD. Psychopaths are more common than we think. I have no comment about dissociative identity disorder for I have only studied it briefly and do not know enough yet about this the disorder.

Ylanne, you are right, I forgot they changed the terms recently. I also agree with you about how social norms shaped psychiatry and that different is a cue for people to start labeling. I just meant that there has been a more acceptance since the earlier days. Personally I find different cultural views about things rather interesting. I personally know a student in psychology who hopes to finish her Ph.D and go back to her home in Africa and teach them about mental disorders because they still believe that if you have something wrong mentally, you are possessed and such where she is from.

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby NorthernSoul on Thu May 24, 2012 4:01 pm

Lol, Hare receives royalties for use of a set of criteria he devised for the diagnosis of psychopathy (http://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist) so it definitely suits his interests to play up the incidence of the condition as much as possible. Apparently people with psychopathic traits make up around 0.6% of the population. Whether this translates into 'full-blown' psychopathy, I don't know...

Regardless of the epidemiology, like many of the more severe personality disorders, it's considered basically untreatable. Very interesting stuff though!

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Fadded on Thu May 24, 2012 4:10 pm

Lol I'll keep it in mind. I plan on reading a variety of different people on the subject. I've always had an interest in psychopaths XD. They are an interesting case. Thanks for the checklist! I didn't even think about it. ^^ If you have any more interesting tid-bits or doctors to check out, send them my way. ^.~ lol. Thanks!

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Re: The Stigma of Psychiatry

Tips: 0.00 INK Postby Ylanne on Thu May 24, 2012 4:37 pm

Fadded, your language is still shaped by societal ableism. Many people in the disability rights community, which has increasingly included those with mental, learning, developmental, and intellectual disabilities, do not believe that there is anything "wrong" with them regardless of diagnostic label or level of disability. In fact, I cringe to hear people discuss disability as meaning "something is wrong" with a person, especially any type of neurological disability -- mental, learning, developmental, or intellectual. Different, yes, and in many cases, to varying degrees of disability -- which is very, very contextual -- but not wrong. Not less than, not defective, not diseased, not broken.

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