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Old 08-13-18, 03:11 PM
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I hate the term "mentally ill"

I saw daveddd's thread on the definition of mental illness being invalidating for him, and I was all set to add my own rant about how much I hate the term "mentally ill" but saw that the thrust of his thread was something different, so didn't want to derail it.

So I thought I'd start my own rant here. I'm sure that mental health practitioners would consider ADHD and any diagnosable disorders in the DSM to be "mental illnesses" which, as daveddd rightly pointed out, are defined by impairment or some difficulty in functioning. As a blurb at the Mayo Clinic's website says:

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Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.
But one of the reasons I hate the term "mentally ill" is because it's often used not as a medical term but in a pejorative sense as a way to dismiss or discount what someone has to say. It's another way of saying that someone is "crazy" and doesn't have anything useful or intelligent to say.

I've also noticed in discussions in other Internet forums that people seem to make a distinction between what they call "physical illnesses" like heart disease, or kidney disease or cancer or diabetes and "mental illnesses" as if what happens in someone's mind (i.e. in their brain) is somehow completely distinct and different from what happens in the rest of their body. But this makes no sense to me. The brain is certainly more complex and we know less about how it works than other parts of the body, but it's still just as much a part of the physical body as the heart or the kidneys.

This whole issue really hit me yesterday because of something I was reading in a book called Patient HM: A Story of Memory, Madness, and Family Secrets (NY: Random House, 2016). The book is about a famous patient named Henry Molaison who suffered from epilepsy and had an operation performed on him in 1953 to cure his epilepsy called a bilateral medial temporal lobectomy in which parts of his brain were removed. This did help stop some of the symptoms of Molaison's epilepsy, but it also made him unable to form new long term memories.

This lobectomy was just a more refined form of the lobotomy, a procedure that became popular among neurosurgeons from the 1930s until the 1950s and was mostly used to treat patients who were institutionalized at mental asylums, and especially on female patients. These operations were supposedly done to cure mental illness, but they had the added benefit of helping scientists to learn more about what different parts of the brain do. If they cut out a certain part of someone's brain and they couldn't speak afterwards, then they knew that that part of the brain had something to do with speech. And by removing the hippocampus, amygdala and other parts of Henry Moliason's brain, scientists discovered that these parts of the brain had something to do with long-term memory.

Anyway, the famous neurosurgeon who performed the lobectomy on Henry Molaison, Dr. William Scoville, read a paper at a conference for brain surgeons in 1953 and explained that although he had performed these kinds of procedures on over 200 patients at a Connecticut mental hospital, he hadn't learned very much useful information about how certain parts of the brain work, possibly because the patients he was operating on weren't "normal". So, he asked the question, as the book I'm reading says:

Quote:
What would happen if, rather than performing his limbic lobotomies only on the mentally ill, he began performing them on perfectly sane people who suffered only from epilepsy?
This quote encapsulates the whole issue I have with the term "mentally ill". Those who are "mentally ill" are in the minds of many people not considered to be "sane". But I wouldn't consider someone suffering from ADHD or OCD or anxiety or depression to be "insane" and completely lacking in rationality. And even for a mental disorder that might have some effect on someone's judgement or grip on reality, I don't know why this would be completely distinct in many people's estimation from something like epilepsy where one is thought of as a "mental illness" and the other is thought of as a "physical illness" even though both probably have to do with a physical problem in the brain.

So, what do all of you think about how "mental illnesses" are so often considered to be distinct and different by many people from other kinds of illnesses or problems in our bodies? What do you think about the term "mentally ill"? Does it bother you, for example, for ADHD to be called a "mental illness"? Do you like the term "disorder" better?
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Old 08-13-18, 03:58 PM
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Re: I hate the term "mentally ill"

Firstly thank you for your informative sharing. I read whole post.
But i have to disagree with it at some point. Our OCD,anxiety,ADHD etc. affects our judgements, our actions , even it shapes our personality. I learned much about it when i read Karen Horney’s books about neurosis.
If you have low self esteem, you may fragile relations people , it is the root of social anxiety. And if you dont get professional support, your brain will find neurotic solution types in order to fix problem and it will start shaping your personality.
Of course it is a simple example, ADHD is not a neurosis.
But our impulsivity can have strong effects on our judgements, our behaviour and our actions. I experienced it in my life while playing poker or playing at financial markets.
I also have some kind of perfectionism problem and low self esteem problem.
Can you imagine how bad it can be a mix of neurosis and ADHD

Yes we do not have fairy friends , we don’t kill someone becauas we doubt that person is spy. Those are extreme examples, it doesn’t mean that if it doesnt have extreme impact, it doesnt play significant role in our life.

The real problem here is feeling offended our current generation’s new trend . I feel ok to be called mentally ill. I do not reject that other people use this term as a insult but when i get angry on a person , sometimes i call that person mentally ill too.
So it is used as a scientific term and as a insult, it is a cultural problem. But for me it isn’t important thing to feel offended or get my feelings hurted.
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Old 08-13-18, 04:08 PM
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Re: I hate the term "mentally ill"

By the way,i forgot to add something , why do we feel bad when someone call us”mentally ill” because our brain thinks that illness is equal to some kind of weakness, and oyr ideal image is being strong. At the deepest side of our mind if we have adhd , it creates a feeling of valueless because somebody remind that we are weak.
It depends our own acceptments , not the words that we hear. Otherwise we would laugh when somebody calls us mentally ill
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Old 08-13-18, 04:33 PM
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Re: I hate the term "mentally ill"

Thanks for a really interesting post. I've heard lots about HM of course but never heard the angle that neurosurgeons might have performed lobotomies for the sake of science rather than for what was in the best interests of their patients. I know that's not the main point of your post but it made for some chilling reading.

The term mentally ill never bothered me but I do think you have a point. Mental seems to imply that it's something purely in someone's thoughts, and therefore possibly under their control. Maybe this is why mental illness is perceived as a weakness or a character flaw or even as fake, not a real illness.

I think that our thoughts just like everything else are the outcome of physical processes in the brain so I don't really draw a clear distinction between physical and mental and I believe that we have a lot less control over our thoughts than a lot of people would like to think.

I'm not sure what would be a better word to describe mental illness but maybe we don't need one. Maybe physical illness and mental illness are not two near categories and maybe it would be better to do away with these terms so that mental illnesses stop getting other trivialised and maligned.
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Old 08-13-18, 04:37 PM
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Re: I hate the term "mentally ill"

Thanks for your reply, Emre22.

I'm in a hurry and don't have time right now for a more detailed response, but one thing that bothers me the most is that people often make a distinction between disorders in your brain and disorders in the rest of your body. And, of course, if you have a disorder in your heart or your kidneys, that might not be your fault.

But if there's a disorder in your brain, people often seem more judgmental. This is probably partly due to the fact that doctors have a much better idea of what causes a heart disorder like heart disease and they can do MRIs or blood tests to check for it. So, if someone needs to take it easy because they have a heart problem, a lot of people are more understanding.

But if someone has a disorder in their brain, especially one that can't be detected with a blood test or a scan, many people probably suspect that it might not even be real. For a long time, mental problems were seen as a moral failing of some sort, not a physical one in someone's body. That way of looking at things is changing, but it hasn't changed completely.

Also, until more recently, mental health care got much less funding than other kinds of health care, which shows how it was perceived differently.
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Old 08-13-18, 10:57 PM
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Re: I hate the term "mentally ill"

Quote:
Originally Posted by PoppnNSailinMan View Post
Thanks for your reply, Emre22.

I'm in a hurry and don't have time right now for a more detailed response, but one thing that bothers me the most is that people often make a distinction between disorders in your brain and disorders in the rest of your body. And, of course, if you have a disorder in your heart or your kidneys, that might not be your fault.

But if there's a disorder in your brain, people often seem more judgmental. This is probably partly due to the fact that doctors have a much better idea of what causes a heart disorder like heart disease and they can do MRIs or blood tests to check for it. So, if someone needs to take it easy because they have a heart problem, a lot of people are more understanding.

But if someone has a disorder in their brain, especially one that can't be detected with a blood test or a scan, many people probably suspect that it might not even be real. For a long time, mental problems were seen as a moral failing of some sort, not a physical one in someone's body. That way of looking at things is changing, but it hasn't changed completely.

Also, until more recently, mental health care got much less funding than other kinds of health care, which shows how it was perceived differently.
I think there is more of a stigma for mental illness. Like people would whisper and talk behind backs about. "Mary's husband is mentally ill" then the hush falls over the crowd. I think it's defined how it is because it is recognized under the ADA. I have heard much talk about changing the ADHD moniker to something else. I do think of mine as an impairment to some degree. I always wonder how i would act and think without it. Wonder if i would have made it further in life without ADHD being in the way. My doctor always dances around the issue. Trying to be sensitive i guess. I'm really direct, off putting to most in fact.
I agree it totally sucks that if people can't see something they don't believe it. I have already gotten the weird looks when i mention ADHD to people. Like it's an adult made up thing. Like the dog ate my homework excuse or something. Even when i get my meds the pharmacist always gives a smirk. Like "oh look this adult can't handle it".
To me ADHD is still in it's infancy. There is so much to learn and figure out. And so many adults like myself fell through the cracks as kids and never got diagnosed. Now schools screen more closely and watch for signs of a kid struggling. I think the adult side of our condition needs much more research and much more development. I have been going to my local ADHD meetings but nobody shows up. It's literally been just two or three people every time. I was hoping to meet others and chat. Maybe make some great friends. You always seek out others like yourself or with similar interests or whatever.
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Old 08-14-18, 02:59 AM
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Re: I hate the term "mentally ill"

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Originally Posted by Fuzzy12 View Post
Thanks for a really interesting post. I've heard lots about HM of course but never heard the angle that neurosurgeons might have performed lobotomies for the sake of science rather than for what was in the best interests of their patients. I know that's not the main point of your post but it made for some chilling reading.
If you want to read a fascinating books, I highly recommend the book I mentioned above by Luke Dittrich, Patient HM: A Story of Memory, Madness, and Family Secrets (NY: Random House, 2016). It's really well written and Dittrich also happens to be a grandson of Dr. William Beecher Scoville, the neurosurgeon who performed the lobectomy in 1953 on "Patient HM" (which is what Henry Molaison was known as until his identity was finally revealed after his death in 2008). Scoville was one of the most prolific lobotomists in the US at the time.

But the book also gives me the willies sometimes because Dittrich goes into a lot of detail in describing how the lobotomies were performed. Just to give an example from the operation performed on Patient HM (pp. 210-211):

Quote:
Just as he had done so many times before in the asylums, my grandfather injected a local anesthetic into his patient's scalp, sliced an arc across the top of his head, and rolled the skin of his forehead down like a carpet. He then used his trephine drill to remove two silver-dollar-size plugs of bone, a scalpel to cut through the meninges that protected the cerebrum, and a flat brain spatula to lever up the frontal lobes, exposing the deeper structures beyond.
Dittrich then explains how his grandfather applied tiny electrodes to different parts of the exposed brain to get EEG readings to see if he could find the location in the brain that was responsible for the epileptic seizures that Molaison had been experiencing. But he couldn't find any focus of the seizures. Dittrich says that many surgeons would not have proceeded any further without having pinpointed the region of his patient's brain that was causing the problem. But Dr. Scoville decided to operate anyway and just hope that the parts of Henry's brain he was going to cut out would improve his symptoms (p. 213):

Quote:
My grandfather...picked up his suction catheter, inserted it carefully into one of the trephine holes, and proceeded to suction out that hemisphere of Henry's medial temporal lobes. His amygdala, his uncus, his entorhinal cortex. His hippocampus. A good portion of all of those mysterious structures disappeared into the vacuum. Then he pulled the tool out of the first hole, cleaned it off, and inserted it into the second. Lacking a specific target in a specific hemisphere of Henry's medial temporal lobes, my grandfather had decided to destroy both.
I have this image of something like a tiny vacuum cleaner hose being stuck into the two holes in Henry's head. At least Henry Molaison had consented to being operated on. But the vast majority of patients with various kinds of mental disorders who had lobotomies performed on them were in mental hospitals and no consent was gained from them beforehand. Moreover, as Dittrich points out (p. 196):

Quote:
My grandfather, like most lobotomists, performed a disproportionate number of psychosurgeries on women. This discrepancy never received a satisfactory explanation, but it seems worth pointing out that the known clinical effects of lobotomy - including tractability, passivity, and docility - overlapped nicely with what many men of the time considered to be ideal feminine traits.
Wikipedia has the following about one famous lobotomist named Walter Freeman:

Quote:
He described one 29-year-old woman as being, following lobotomy, a "smiling, lazy and satisfactory patient with the personality of an oyster" who couldn't remember Freeman's name and endlessly poured coffee from an empty pot. When her parents had difficulty dealing with her behaviour, Freeman advised a system of rewards (ice-cream) and punishment (smacks).
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Old 08-14-18, 04:00 AM
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Re: I hate the term "mentally ill"

This is really interesting Poppin'. I was always under the impression that ADHD was treated by psychiatrists because it was similar to treating someone with say bipolar. But I also though it was considered neurological or neuro-developmental? At least I thought it was distinct from other mental health stuff like depression or bipolar. I am bipolar II as well as ADHD, and I see them as very different in the way they impair me. I know when I was not medicated properly for bipolar the impairments I had were glaringly obvious and I would say I was a danger to myself. ADHD can be similar when it comes to inattention but I still think it needs its own category or treatment professionals. So I guess I kinda sorta agree that mental illness is too much of a blanket term used for too many things. In fact I am ok with bipolar being considered a mental illness based on my own experiences with it but it is very different than my experiences with ADHD. Am I making any sense?
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Old 08-14-18, 09:38 AM
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Re: I hate the term "mentally ill"

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Originally Posted by sarahsweets View Post
This is really interesting Poppin'. I was always under the impression that ADHD was treated by psychiatrists because it was similar to treating someone with say bipolar. But I also though it was considered neurological or neuro-developmental? At least I thought it was distinct from other mental health stuff like depression or bipolar. I am bipolar II as well as ADHD, and I see them as very different in the way they impair me. I know when I was not medicated properly for bipolar the impairments I had were glaringly obvious and I would say I was a danger to myself. ADHD can be similar when it comes to inattention but I still think it needs its own category or treatment professionals. So I guess I kinda sorta agree that mental illness is too much of a blanket term used for too many things. In fact I am ok with bipolar being considered a mental illness based on my own experiences with it but it is very different than my experiences with ADHD. Am I making any sense?
Adhd is considered mental illness like depression and anxiety

Considered by most pros nowvas emotional dysregulatio
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Old 08-14-18, 08:01 PM
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Re: I hate the term "mentally ill"

I think it would be better if they could find exact causation for ADHD in all its various and sundry forms. Instead it appears (to some) to be a lot of vague symptoms, and the causation is at best pretty much unknown or not proven or maybe I should say all theories with no real proof. Some in the world outside of the ADHD bubble perceive it as either hocus pocus or maybe disdiagnosis...or, just laziness, not paying attention, not trying (sound familiar to something you've heard?). I mean, if you hadn't experienced it yourself, would you believe it is a real condition? And other than it having to do mainly with the mind and how it works (or doesn't), isn't it possible, even probably there is a physical cause? It's not like we all saw something traumatic and the mind just reacted by making us this way, is it? To me, that's more mental, the mind reacting against something unbearable. I don't believe it's the mind reacting to some terrible event I experienced. But more likely, maybe the mind trying to deal with some something medically different in our brains. At least, that's what makes more sense to me.
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Old 08-15-18, 01:05 PM
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Re: I hate the term "mentally ill"

I share the concern about people who dismiss mental health conditions with the label "mental illness."

But to be honest, I think was a much bigger problem 30 years ago ... Our society has made tremendous progress in taking brain issues or "mental health issues" or "mental illness" quite seriously and without stigma.

We are in a period of transition from discussion of "the mind" to a lot of references to "the brain." Medical and scientific research has made clear that a lot of "mental disorders" are brain-based, as in have their origin in basic biology and bio-chemistry. And the transition, in my view, is rapidly accelerating in the right direction--away from stigma. The ultimate logic of this transition, of course, is that there is no real distinctinction between schizophrenia and multiple sclerosis ... or depression and kidney problems ... ADHD and vision problems.

Right now, "mental illness" is used more narrowly to refer to conditions like schizophrenia, which affects several close relatives of mine. People use the term to describe people whose brains lead them to wildly and cruelly misinterpret the world.

Now, the depth of the stigma against "mental illness" varies by community and by family. If you have family members that dismiss "mental illness"--and use that term to indicate someone is defective-- then you will likely feel a stigma. I was fortunate in that my mother was a counselor and always endorsed the project of attending to my mental and emotional health.

Young people are definitely rejecting the stigma more than ever. They understand the biological and brain nature of what we used to call "mental illness" far more than any previous generation.

The one pet peeve I do have on this issue has to do with the phrase "mental institution" or "mental hospital. I hate those phrases, because people openly use them in a derogatory way. He had to go to a mental institution. I have a family who has been in long-term residential treatment center for people with severe brain conditions. I use the phrase "psychiatric hospital" to describe where he lives and where he receives treatment.

All in all, though, I think the news is good on the stigma front. But I may be speaking only from my personal journey. At some point along the way--I suffered my first major depression when I was 21 & 22--I realize, if I wanted to get healthy, I had to say F-u to all stigma. Getting diagnosed with ADHD at age 46 only deepened that conviction.
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Old 08-15-18, 03:10 PM
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Re: I hate the term "mentally ill"

as you probably already know, poppin, i have more than adhd going on. i feel incredibly stimatized by my primary diagnosis and i hate a number of terms associated (clinically) with it that have found their way into the vernacular and usually mean b**** or unhinged somehow (specifically, i hate when people who've not endured psychosis talk about someone being psychotic and i also hate when people who've not experienced delusions calling other delusional).

i feel like there's an enormous stigma in our culture about having a psychotic disorder. there's also a lot of uneducated people, but i feel like it's not my responsibility in life to educate them either. i have enough going on without being tasked with that.

as for "mental illness"...i don't know if time has worn me down or what, but i can admit i'm mentally ill. i kinda prefer that to "disorder" because ill indicates firmly that i'm sick sometimes.

as to the post above, with mental hospital, i'm probably guilty of saying "i was in the mental hospital again" or similar. in fact, i've probably typed that exact phrase somewhere on this forum over the years i've been here and been in and out of the hospital. i don't say "mental institution" because institutionalisation is a different beast than what happens nowadays. but i do say i was in the psych ward and i've definitely said psychiatric hospital.

frankly, i view a lot of these terms as perhaps poor choices by those who also have mental health concerns, ignorance by those who don't know any better, and malice by those who would discriminate against me on the basis of my particular mental illnesses. i also think there are advantages/disadvantages to "person first" language, but i don't refer to myself as a person with xyz. i don't use person first language to talk about myself and i feel like that's my right as someone actually with the mental illnesses.

where adhd falls...for me i was diagnosed as a kid and told i had a neurological difference. so i wouldn't say that i've always associated adhd with equating to having mental illness. but i can see the argument for and against it... with my other two diagnoses, they're clearly in the mental illness camp, i think.

interesting topic. x
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Old 08-15-18, 04:42 PM
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Re: I hate the term "mentally ill"

I think I prefer the term 'disorder' but ultimately they have similar connotations... I don't like terms like 'difference' that are just there to make you feel better. Feels kind of patronising.
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Old 08-15-18, 07:52 PM
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Re: I hate the term "mentally ill"

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Originally Posted by daveddd View Post
Adhd is considered mental illness like depression and anxiety

Considered by most pros nowvas emotional dysregulatio
Yes but its that the only way its classified? As a mental illness?
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Old 08-16-18, 03:03 PM
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Re: I hate the term "mentally ill"

Well, I looked up definitions of ADHD from a couple of US government sites. Now, the term ADHD has the word "disorder" in it. CDC uses the words "neurodevelopmental disorder" in its definition. NIH uses the words "brain disorder" in its definition. Genetic factors are always mentioned in connection to causation, but without an agreed upon exact causation other than that, IMHO it's all speculative other than that. I like the term "neurodevelopmental disorder" myself. I do believe that treatment should fall within the psychiatric field because, other than maybe the neurology field, how else could a disorder of the brain be treated? I also think that having this disorder linked to other things like depression, anxiety, insomnia, etc. means it falls into other areas of mental illness. The brain itself affects so many things that you wouldn't normally associate with it. I took an anatomy and physiology course once and it's really mind-blowing how interconnected every system in the body is with everything else.
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