Diagnosis, Treatment and Labels - Support & Stigmatisation

[HenryX]

Diagnosis, Treatment and Labels

Support & Stigmatisation

It is interesting to note how often people make observations like,

“At last, I know what the problem is.” or

“Since the doctor/specialist (medical or psychology based) has determined the diagnosis and provided treatment, I am feeling so much better.”

We also hear people make statements like,

“I wish that I knew what the problem was, so that I could deal with it and get the appropriate treatment.”

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While people can certainly be “trapped in their diagnosed disorder”, that can also be the case when a disorder is un-diagnosed. With a diagnosis, we can normally choose who we let know about the diagnosis, unless the diagnosis means that other people are required to be informed for legal reasons – driver's licence, employer (in certain circumstances & occupations), etc.

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Often a diagnosis and proper treatment can lead to a significant improvement in quality of life, personally, socially and occupationally. People who live with a disorder that exists, but is not yet diagnosed and treated, I believe, can often be far more subject to stigma, than those who have a diagnosis that allows for treatment. There is often, as a result of diagnosis and treatment, a consequent reduction in the impact of symptoms, apparent and otherwise, on their personal, family, social and occupational lives. A diagnosis can also allow for appropriate accommodation and, or allowance to be provided, for a person who otherwise meets most criteria, particularly for employment. Even the opportunities for travel can often be enhanced with a diagnosis and suitable medication.

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We are, in life, labelled according to various conventions, over many of which, we have little or no control. Our gender, ethnicity, colour (including hair, eye, skin), and so on.

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We can perceive, and choose whether to view a “label” as stigmatising or defining. If no one else needs to know of the label, then the classification is our own, for our use and that of the people providing us with treatment and or therapy. If other people need to know about a diagnosis or “mental health label”, in some circumstances, even that can be advantageous. For example, if we are able to inform family, social, or work contacts, about how to deal with a problem associated with a mental or physical illness, we may be able to provide ourselves with a more protective environment, outside and around ourselves. In many cases, people would feel honoured and privileged to have been included, to that degree, in our personal care and space.

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There are positive ways that we can view and project a diagnosis, both internally and externally. Unfortunately, I believe, that some of the stigma associated with mental illness can be self imposed. There is still, and unfortunately, always will be stigmatisation, as a result of contrast and comparison, between different groups of people in society. It is a condition of humanity, since we are not perfect beings. However, developments in the medical/psychological treatments, and community information and social awareness programs, has meant that there have also been considerable improvements in attitudes among people in the broader community. These developments have included attitudes about involvement of people from diverse and varied backgrounds, including those dealing with medical and psychological issues, in personal, social and occupational activities. However, we have to see it to believe it. By constantly highlighting the imperfections in a system, we can correspondingly perpetuate those imperfections. We can become hyper-critical and may, subsequently, reverse existing positive trends. I believe that this principle applies to the acceptance of people in circumstances, who have addressed and are addressing mental health issues in their lives. I am certainly not advocating a reduction in attention and review of these issues. However, that attention and review has to be measured, proportional and appropriate.

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I am also endeavouring to raise awareness of the progress that has been made in the last 50 years, (less than the duration of my own lifetime) since the days of institutionalised “treatment”, as recently as the 1970's-80's. There will always be opportunities for improvement, and we should not slacken our search for improved analysis, diagnosis and treatments. Those methods of diagnosis and treatment have come a long way since the first half, and 20-30 years into the second half, of the 20th Century. During that timea.) “straight jackets”, isolation and asylums were common aspects of “treatment”.

Information about the range of treatments, that have previously been used, is readily accessible with a WEB search such as:

"History of Mental Health Treatment" or "History of Treatment of Mental Health Disorders"

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Many of the treatments, for which a diagnosis is required, have enabled people to continue, or enter work positions, that would otherwise have been considered unsuitable. And, that freedom can also include travel, that may not have been possible, for many people, before diagnosis and appropriate treatment.

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With Best Wishes

@HenryX 

a.) https://online.csp.edu/blog/psychology/history-of-mental-illness-treatment/

[StuF]

@HenryX 

I just wanted to say, at this stage, that this looks like an interesting read! But it comes at the wrong time of day for my mind. I look forward to going through it tomorrow 🙂

[HenryX]

Hello @StuF 

Hi Stu, thank you for your comment that also brought a smile to the (sur)face.

Best Wishes

@HenryX 

[AussieRecharger]

@HenryX 

I had a similar conversation tonight with my brother and we were talking about how older people when they retire loose their status as they ae no longer "Managers" or "Electricians" and i replied that this is the whole problem with today's society.  

We no longer see the value in ourselves as people but in the titles we earn. A sparkie is still a person who is valued for his electrical expertise but he is still only as valuable as his lived experience. 

We need to look past the label and start having conversations about who we are.. so when we retire, we know that we value food, we value sharing knowledge, we know we value improving our community, we know we value improving our mental wellbeing etc.. 

We are not just a label, a job title, a person who is only useful when they are earning money.  The Money a person earns is not the usefulness of a person in society. 

[Oaktree]

Hi @HenryX 

I think someof the stigma does come from ourselves (those with mental health issues) because we are so busy trying to be 'normal'. It make us hyper aware of our 'abnormality' (unnormalness is not a word). I think as you point out that mental health and treatment has come a million miles since the bad old asylum and lobotomy days which werent so long ago. Sure improvements could still be made as there are many things wrong with the current system. Such as the critical shortage in beds leading to patients being discharged too early only to boomerang right back again as they were not ready. If hospitals just held patients longer then there would be better outcomes allowing people to be in the community for longer periods which would then take the pressure off the hospitals. Diagnosis is great but is not the be all and end all. People tend to live up to labels. I prefer the idea that the doctors treat the symptoms that are presenting rather than being so caught up in labels.

Meggle

[HenryX]

Hello @AussieRecharger  and  @Oaktree  &  @StuF 

Thank you all, for your replies and comments. Very much appreciated.

Like Stu, it is nearly time for sleep, otherwise I'll end up going to sleep sitting on a backless chair, which would do me no good. I'll certainly be able to offer responses tomorrow.

With Best Wishes

@HenryX 

[StuF]

@HenryX 

Good post!

I've found, in my life, that diagnosis can certainly be double-edged. The diagnosis of a physical illness answered some questions and facilitated treatment (successful). But it also has left a life long impression and underlying fear/expectation of a return, no matter how long ago it was.

As for mental illness, my diagnosis evolved over a couple of decades. At least partly due to my ongoing addiction issues. However, once I got that sorted (in 2005), my illness became more stable and chronic, rather than acute. Since then, I have been seemingly paired with the right medication and established strong supports. I'm lucky.

Still, the stigma remains. And yes, a lot of which is self-imposed, really. Obviously, it comes to mind the most when meeting new people, trying new work and so on.

Society as a whole still has a long way to go regarding attitudes to mental illness. It has featured prominently of late with a few athletes/sports people having openly announced their own battles with MI. The reaction varies, between sympathy and empathy; and derision.

Anyway, I fear I am waffling. I'll finish in agreement that attitudes and treatments of MI have come an awfully long way in a matter of decades. That gives us hope

[Lost9]

@StuF @HenryX @Oaktree 

Hi everyone,

Diagnosis and stigma pose a difficult choice. I showed symptoms of schizophrenia and depression in the 1980's. My doctor refused to put me on disability benefits as he said I would never be employed. I believe he was reticent to diagnose me as schizophrenic as he believed it would not be in my best interest but that lead to several years without the appropriate treatment. Yes, I only had the stigma of deptression but for years I had to grapple with feeling isolated from society because I was paranoid. That didn't help scholastically nor for employment. Today, a relatively fast diagnosis can lead to the least disruption of academic achievement and being on disability benefits does not prevent you from being employed. Yes one still lives with a stigma but it will lesson in time with the education of society. I was always open with my diagnoses because I wanted to educate people that I am still a person who has a sense of humour, who feels emotions and has interests a lot like other people. It is by sharing what we have in common, not our differences, that people will eventually learn to accept us without stigma. We have come a long way but we still have a way to go.

lost9.

[HenryX]

Hello  @StuF and

@Emelia8  , @AussieRecharger , @Oaktree  , @Lost9  , @cloudcore , @RICH1 

Thank you for your comments, observations and self disclosure regarding the post and about your own experiences with both physical and mental health issues.

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I hope that knowledge of the leg issue means that monitoring is likely to address any re-occurrence before it causes more severe problems.

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It is often the case that MI issues can be made more difficult to define and diagnose when experienced in conjunction with other issues, such as can occur with medications for other illnesses, and also addictions, that can compound and sometimes obscure other problems.

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Your reference to treatment being relatively successful, with right medication and strong supports, is reassuring. I hope that the stability, to which you refer, was more “good management than good luck”, to reverse the oft quoted expression. That would hopefully, be a form of reassurance to others.

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It is certainly 'beneficial to the cause', when people, who are accomplished in any particular sphere, such as the athletic and sporting arena, politics, business or academia, demonstrate that they also, are subject to the impact of mental health issues in their lives. Sometimes their particular field of endeavour has exacerbated an already existing problem, or they have achieved their goals in spite of the difficulties that they faced. In some ways there are cautionary lessons, in others, reassurance that goals can be achieved in spite of such obstacles.

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There is a book that I recently became aware of, and intend reading. The topic that it addresses is in its title:

“The Righteous Mind: Why Good People are Divided by Politics and Religion”

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I am not promoting the book or “Politics and Religion”, but the ideas encapsulated, as described in the following extract from the Z-Library description:

{“In The Righteous Mind, psychologist Jonathan Haidt answers some of the most compelling questions about human relationships:
Why can it sometimes feel as though half the population is living in a different moral universe? Why do ideas such as 'fairness' and 'freedom' mean such different things to different people? Why is it so hard to see things from another viewpoint? Why do we come to blows over politics and religion?”

…..and so many other topics of discussion and debate (a).}

This question could be asked, with reference to a great number of topics, including abilities and inabilities due to physical and mental health challenges.

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We can spend a lot of time debating a subject, such as preferences and discrimination, for and against the interests of various groups of people, when we haven't yet addressed the topic that this book explores. The question is easily posed, but not easily answered. I wonder if the reactions to which you refer, Stu, of sympathy, empathy, support and derision, might be addressed in the content of a book such as this.

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I do believe that frank and open discussion on the topic of MI is really important, and where better than on a forum such as this? So, I do not think that you are waffling. I agree with you, when you write,

“that attitudes and treatments of(, for and about (a)) MI have come an awfully long way in a matter of decades.”

That is a reason to be aware of the past and present, and to look purposefully and hopefully to the future.

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With My Best Wishes

@HenryX 

((a)) Text added by HenryX

[StuF]

@HenryX 

Just wanted to add- that book sounds interesting. Please give us your thoughts when you've had a chance to read it 🙂