Mental Disorder | Hawaii Psychiatric

Steps Towards Mental Health Reform

: Image by Getty Images via @daylife

Mental health practices have come a long way since the terrible tradition of putting “mad” people on ships and casting them off into the ocean. Readers of the Cormac McCarthy American Epic “Blood Meridian” will remember the portrayal of the character “the fool”. In the novel he is displayed for entertainment purposes and treated no better than a circus act animal.

McCarthy’s account is not made for shock value. Using mentally disturbed people as entertainment was a regular act in colonial America. In 1760s Philadelphia it was a regular practice for guests to visit insane asylums on Sundays as if visiting a zoo. Guests would often entertain themselves by taunting the patients, particularly those restrained by chains. The problem became so bad that at one Philadelphia hospital administrators erected a fence to keep tourists out. This failed as the public pushed past the barrier. Rather than attempt to keep the public out, staff began to charge admission.

Perhaps others would have come to similar conclusions, but the terrible practice of using mental patients as spectacle came to an end due to the efforts of Benjamin Rush. Rush was a devote Quaker and a leader in the Philadelphia community. By the turn of the nineteenth century his reforms were giving Pennsylvania Hospital the appearance of a place were actual treatment was taking place rather than just confinement.

Prior to Rush’s arrival it the usual sight was neglected prisoners restricted to cold dingy cells. Of the first changes Rush made was providing patients with a stove to ease the cold and an occasional warm bath. The effects of even these simple pleasures were enough to cause major positive changes in several patients. Rush knew that the body want connected to the brain, and that for patients that struggled to express themselves through conversation providing for basic human needs was one of the portals into a patient’s mind. This simple step was the first of many reforms.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Benjamin Rush, Health, Mental disorder, Mental health, Patient, Pennsylvania Hospital, Philadelphia, United States

Dawn of Eugenics

: Image via Wikipedia

Due to the efforts of visionary doctors the field of treating mental illness grew from an ugly practice filled with quacks to a respectable science by the later part of the 18th century. For all of the advances in the field of mental health made in that era, treatment for the mentally ill would regress around the dawn of the 20th century. Just as a generation of doctors had been influenced by medical studies that stated physically dominating patients was part of the treatment in the 1700s, the doctors of the 1900s would be influenced by the concept of eugenics.

The prevailing attitude that all men were created equal went away in part due to the influence of Sir Francis Galton. Galton, a cousin of Charles Darwin, helped to push the notion that mentally ill people were carries of defective genetic material. Galton portrayed the mentally ill as putting a strain on society, and his writings were used as justification to deny people with a history of mental illness the rights to marry. Some states even went as far as force sterilization.

Galton used some of the concepts made famous by Darwin to form his theories. Since evolution was an ongoing process, he reasoned that the future of mankind could be shaped to produce “prize stock” similar to farmers who breed superior crops or domestic animals.

Galton made a critical assumption in his work “Hereditary Genius”. He conclude it was natural selection rather than a nurturing environment that created the best traits in humans. He based his work on tracking the familial relations among dozens of prominent English leaders. Galton’s ultimate conclusion was that humans were not equal. In 1883, he invented the world eugenics, which translates to the science of improving the genetic composition of a population. The entire world took notice of his findings, with the more dire consequence to occur generations later in Germany.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Charles Darwin, Eugenics, Francis Galton, Germany, Hereditary Genius: An Inquiry Into Its Laws and Consequences, Mental disorder, Mental health, Natural selection

Dark Ages of Psychiatric Care

: Image via Wikipedia

So-called Western “Civilization” might have been making strides during the dawn of the Enlightenment, but despite gains in scientific thought and philosophical reasoning the treatment of lowest members of civilization remained deplorable at best.

The insane were not considered part of society. They were treated as entertaining spectacles at best and as a public nuisance by the majority of society. Rather than worry about how to help these individuals, most governments sought ways to make the problem of housing or controlling mentally disturbed people go away. Despite the pleas of seeking cures from Benjamin Franklin, public officials in the American colony of Pennsylvania were more persuaded to dedicate funds for a hospital due to the fears of violent behavior by “mad” people.

It was determined that society had to be protected from the insane, so Pennsylvania opened a hospital that operated mostly as a prison in 1756. Society’s worst were shipped to the dank and gloomy cells and ruled over by keepers that were not afraid to use violence to keep the patients from acting up. Overseers used whips often, and when not beating patients, the staff would often chain them to floors with handcuff and iron-ankle bracelets. Part of this treatment was pure human cruelty. More powerful people have taken their anger and aggression out on the less fortunate throughout history. But regular beatings were also part of the science of the day. English physician Dr. Thomas Willis wrote the book “The Practice of Physick: Two Discourse Concerning the Soul of Brutes”. The influential book held that to cure the insane, patients had to view their doctors as tormentors. Beatings were as important as any medical treatment. A tradition was born from these observations and a generation of misunderstood people had to suffer the consequences of physical and mental torment as part of their “treatment”. In the 18th century Even as scientists advanced human thought, medicine remained in the Dark Ages.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Benjamin Franklin, Dark Ages, Health, Medicine, Mental disorder, Pennsylvania, Thomas Willis, United States

Eugenics in America

: Image by Getty Images via @daylife

Despite the United States’ reputation as a land of liberty and equality, it is difficult to find a time in American history when justice for all included the mentally ill. During eras of xenophobia it was a common practice to put the stamp of mental illness on certain segments of society in order to justify terrible practices by the ruling elite.

At the begging of the 20th century the ruling class in America consisted of white Anglo-Saxon Protestants. As eastern European immigrants flooded into Ellis Island the make-up of the country began to change, which caused the elite to backlash against the changing demographics.

Scientist offered a solution to this problem through the concept of Social Darwinism. In nature the weak died, but the compassionate heart of the American public supported the less fortunate through poor house and mental hospitals. Rather than letting the “bad seeds” die the American public supported individuals who caused a drain on American society.

Rather than accept that some people would not meet their standards several wealthy proponents of eugenics commissioned studies to support policies that would prohibit people with a history of mental illness from having children. Perhaps the most famous of these studies was carried out by Harvard-educated biologist Charles Davenport. Davenport used studies that Austrian scientist Gregor Mendal had employed to learn about the inheritance traits of pea plants. This cold approach led Davenport to believe that social misfits were genetically impure.

Davenport suggested that immigrants from eastern Europe were prone to have inferior genes that made them more prone to commit violent crimes. He suggested the forced sterilization of millions of Americans to reduce the percentage of deflective to an acceptable level. The study of mental health had become hijacked by social theory, and as a result, scientific “studies” were written to justify terrible crimes. Countless patients suffered at the hand of the medical professionals trusted with their care.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Charles Davenport, Eugenics, Harvard University, Health, Mental disorder, Mental health, Social Darwinism, United States

Munchausen Syndrome: Dangerous Mimicry

: Image via Wikipedia

unchausen Syndrome has been a standby plot device in almost every medical and crime television show in the last ten years. This disorder compels a person to pretend to have increasingly complex medical disorders in order to seek attention. A person suffering from Munchausen Syndrome is often such a good mimic that they can convince doctors to give them unnecessary surgeries. In a more dangerous twist, people with Munchausen Syndrome By Proxy force harm upon a person in their care, usually a child, to gain attention as an afflicted caregiver.

Physicians and mental health professionals alike have a very difficult time recommending care for people with Munchausen Syndrome because diagnosis comes with a high risk. If a person is indeed faking illness, they are inflicting harm upon themselves without solving their underlying psychological issues; but what if a person really is repeatedly afflicted with illness? He may appear to have Munchausen Syndrome, but treating him for it would ignore his true illness.

The stakes are even higher for the helpless victims of Munchausen Syndrome By Proxy. If indeed someone is inflicting harm upon them, a doctor should intervene and stop the abuse. However, accusing a caregiver of Munchausen Syndrome will prevent or delay treatment if the patient genuinely needs it. For this reason, a thorough physical should always accompany any suspicion of Munchausen Syndrome.

The root psychological cause of Munchausen Syndrome is usually another mood disorder, often stemming from childhood experience. For example, a child that was neglected, especially in favor of a person with a true illness, learns to associate illness with the reward of attention. As a depressed adult, she may seek out the same reward. Munchausen Syndrome patients generally do well in cognitive behavioral therapy if the association of reward and illness is broken. It is equally important that the underlying emotional issue is treated, or the patient may return to the established cycle of Munchausen Syndrome behavior.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Child abuse, Disorders, Factitious, Health, Medicine, Mental disorder, Mental health, Münchausen syndrome by proxy

The ADHD Controversy

: Image via Wikipedia

Attention-Deficit Hyperactivity Disorder, or ADHD, has become almost a clichÃ© of public mental health debate in the last decade. To summarize public commentary, this developmental disorder is either tearing up our schools or does not exist. It is either undiagnosed due to lack of teacher and clinician awareness, or it is overdiagnosed to give schools an excuse to drug unruly students. We either need to know more about it, or stop hearing about it altogether.

Though the controversy over ADHD continues, there is certainly a good body of evidence that shows that the disorder itself is no myth. Brain scans conclusively show less dopamine transporter activity in the brains of ADHD patients than the brains of the unaffected. Currently, this neurological discrepancy can be smoothed over with a combination of mental health counseling, corrective drugs, and vigilance.

Because psychological medicine is capable of helping properly diagnosed ADHD patients, it seems that the most important kernel of the controversy is whether we are overdiagnosing or underdiagnosing. Even though there are neurological markers, most doctors diagnose without an expensive and uncomfortable PET scan of the brain, so they must go on behavioral markers alone.

In many cases, it’s straightforward; a child who exhibits an impaired ability to focus and to control impulses is considered a candidate. If these symptoms are affecting multiple areas of her life, such as her classwork, her social life, her behavior on the playground, or her behavior at home, usually a doctor recommends treatment for ADHD.

However, these symptoms can potentially be caused by other situations: reaction to a family crisis, an underlying medical problem, childhood depression or anxiety, or even hearing and vision impairment.

If your child is experiencing symptoms of ADHD, don’t avoid a mental health consultation just to avoid burdening the child with the label. Your child can get care that will help her succeed, or your mental health provider may uncover another issue that has been causing her disruptive behavior.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: ADD and ADHD, Attention-deficit hyperactivity disorder, Child and Adolescent, Disorders, Health, Medicine, Mental disorder, Mental health

The Trail of Substance Abuse

: Image by ArunaR via Flickr

The trail of substance abuse can always be traced back to the beginning. Nobody goes down that road “just because.” You may not want to confront those inner demons but they are there and they’re always hungry for more. The destructive cycles of substance abuse can be broken but not without some deep, introspective work. We’ve all heard stories of people hitting rock bottom then going cold turkey and turning their lives around. That might be an appropriate path for some people but for many others the journey out of substance abuse can’t be taken alone.

Being diagnosed with a substance abuse problem is to be diagnosed with a mental disorder. Although heredity factors can come into play, these really are diseases that need to be treated by professionals. Once you’ve gotten clean the real work can begin with the help of a trained psychiatrist. Through intense therapy you can seek out the reasons you began the trail of abuse in the first place. You can still work the traditional and supportive 12 step programs but direct counseling should be part of the overall recovery plan. You may think you’ve lost control of your life but with work you can get it back.

Substance abuse can come in many forms. Whether it is alcohol, illegal drugs or prescription narcotics, anyone who seeks to mask their pain with mood altering substances is really just heading towards a downward spiral with no happy ending. Of course you’re not thinking about that the first time you get high or drunk. You just know it feels pretty good. Yet, when you keep returning to those substances for escape instead of dealing with the real issues, you’re setting yourself up for a fall. And this fall can bring down everyone around you. When you clear your mind of the fog of substance abuse, you can see the kind of emotional and physical pain you’re capable of inflicting on your loved ones. Is that really how you want to live?
The trail of substance abuse can always be traced back to the beginning. Nobody goes down that road “just because.” You may not want to confront those inner demons but they are there and they’re always hungry for more. The destructive cycles of substance abuse can be broken but not without some deep, introspective work. We’ve all heard stories of people hitting rock bottom then going cold turkey and turning their lives around. That might be an appropriate path for some people but for many others the journey out of substance abuse can’t be taken alone.
Being diagnosed with a substance abuse problem is to be diagnosed with a mental disorder. Although heredity factors can come into play, these really are diseases that need to be treated by professionals. Once you’ve gotten clean the real work can begin with the help of a trained psychiatrist. Through intense therapy you can seek out the reasons you began the trail of abuse in the first place. You can still work the traditional and supportive 12 step programs but direct counseling should be part of the overall recovery plan. You may think you’ve lost control of your life but with work you can get it back.

Filed Under: Alcoholism Treatment, Health, Substance abuse, Treatment Tagged With: Addiction, Disease, Mental disorder, Substance abuse

Understanding Psychotic Disorders

: Image via Wikipedia

There are many complications associated with a schizophrenic patient. Their cognitive reasoning abilities can become impaired which leaves them unable to cope with much of society. Being cutting off from people and relationships further isolates the patient and compounds the symptoms. Unfortunately, there is no lab test that can be given to a person to determine if they have schizophrenia. It all comes down to their erratic behavior.

The course of treatment depends on how advanced the complications have become. Schizophrenia typically begins to show up in early adulthood. If properly diagnosed by a psychiatrist, a patient can be prescribed a course of drug therapy that can greatly improve their quality of life. Like a diabetic, a schizophrenic patient will most likely have to stay on those drugs for the remainder of their lives. There are side effects of these medications that should be reviewed with the doctor prescribing them. The harsh reality is that a patient with severe indications of schizophrenia might not be able to completely assimilate into a job or relationship. They’ll need constant supervision. Fortunately, there are many government programs in place to assist patients and their family in treating this disorder.

Chances are if you’re the one reading this article you don’t have a psychotic disorder. Instead, it’s probably a love one, a friend or a neighbor who is suffering from the breakdown because if they are in the throes of this issue, they might not be surfing the net for a cure. The severest form of psychotic disorder is schizophrenia which can be described as fracturing of the though process. You’ll know schizophrenia when you see it. Persons afflicted with this disorder exhibit great mood swings, they become delusional and begin suffering from hallucinations. Schizophrenia is not something a person can be talked out of. It’s a deep rooted mental disorder that needs to be treated with intense drug therapy and perhaps a stay in a psychiatric care facility.
There are many complications associated with a schizophrenic patient. Their cognitive reasoning abilities can become impaired which leaves them unable to cope with much of society. Being cutting off from people and relationships further isolates the patient and compounds the symptoms. Unfortunately, there is no lab test that can be given to a person to determine if they have schizophrenia. It all comes down to their erratic behavior.
The course of treatment depends on how advanced the complications have become. Schizophrenia typically begins to show up in early adulthood. If properly diagnosed by a psychiatrist, a patient can be prescribed a course of drug therapy that can greatly improve their quality of life. Like a diabetic, a schizophrenic patient will most likely have to stay on those drugs for the remainder of their lives. There are side effects of these medications that should be reviewed with the doctor prescribing them. The harsh reality is that a patient with severe indications of schizophrenia might not be able to completely assimilate into a job or relationship. They’ll need constant supervision. Fortunately, there are many government programs in place to assist patients and their family in treating this disorder.

Filed Under: Health, Mental Health, Psychiatric Consultant Tagged With: Mental disorder, Mental health, Psychiatry, Psychosis

Don’t Be Scared of Healing

: Image by Constantin B. via Flickr

The words “psychiatric care” can be extremely intimidating for some people. We’ve all grown up on a steady diet of Hollywood images of mental health facilities. Most recently the film “Shutter Island” presented yet another in a long line of creepy and scary places where the mentally ill are housed. It’s no wonder folks would be afraid of getting help! The truth of the matter is that most mental health care facilities are bright, clean and friendly places that provide a warm atmosphere for healing. You’ll know simply by walking through the door that there’s nothing scary about these places.

The healing journey for people suffering from mental health issues can be a difficult one. On some level, the patient has been dealing with these issues their entire lives. Because of that, it’s going to take some time to find the proper course of treatment. This treatment could become a combination of drug therapies along with intense counseling. Even that counseling can have many levels from one-on-one visits to group therapy to other forms of constructive rehabilitation activities. The bottom line is that a lifetime of pain and confusion can’t be erased in a weekend. The patient will be setting a new course for their lives and that won’t happen overnight.

Support is the key element to any recovery process. The obvious first level of support comes from the experienced mental health professionals charged with the patient’s care. They will be very familiar with all the struggles and know just how to manage them. Everyone’s pain is personal but that doesn’t mean a sufferer won’t find empathy.

The other, and most important, level of support comes from the patient’s family and circle of friends. The goal is to rejoin those groups and continue to heal. A patient needs to see that their family and friends are standing behind them. Their journey towards wellness should be celebrated and not at all feared.

Filed Under: Health, Psychiatric Consultant, Treatment Tagged With: Healing, Health care, Mental disorder

How To Support a Person’s Mental Wellness Recovery

: Image via Wikipedia

If a patient enters treatment facility, there might be some initial restrictions on visitation.. Once their condition has been diagnosed and a treatment plan has been implemented, you’ll be able to resume contact with them. In fact it will be encouraged. Before visiting with a patient at a facility, there is nothing wrong with calling up their doctor and asking questions about what to expect. The last thing a patient needs is for their first visitor to be over anxious at the surroundings. Of course this doesn’t mean being in denial about what’s going on but finding that balance.

For friends or loved one who are going through therapy without a stay in a care facility, you still have a role to play in their recovery efforts. The most important thing is to support their decisions to seek help and encourage them to stick with whatever program they are working through. This transition is going to be challenging for them and they’ll need to know a normal life is waiting for them on the other side. Even small gestures like going out to lunch or a movie can go a long way to helping them resume their lives. There is no stigma with seeking help for a mental illness. If you loved the person before, you’ll love them during and after!

It’s a simple fact that mental disorders can touch all of our lives. We might know someone who is going through marriage counseling or personal therapy. There could be members of our family who are dealing with issues of substance abuse. Or perhaps a co-worker becomes burdened by stress to the point of a meltdown. At the moment of experiencing a mental disorder, these people can feel confused and anxious. Once they seek out help, they are going to depend on a tight circle of trusted allies to help them through their recovery. They won’t just be getting help from the therapists and medical practitioners but by the very people who matter to them.
If a patient enters treatment facility, there might be some initial restrictions on visitation.. Once their condition has been diagnosed and a treatment plan has been implemented, you’ll be able to resume contact with them. In fact it will be encouraged. Before visiting with a patient at a facility, there is nothing wrong with calling up their doctor and asking questions about what to expect. The last thing a patient needs is for their first visitor to be over anxious at the surroundings. Of course this doesn’t mean being in denial about what’s going on but finding that balance.
For friends or loved one who are going through therapy without a stay in a care facility, you still have a role to play in their recovery efforts. The most important thing is to support their decisions to seek help and encourage them to stick with whatever program they are working through. This transition is going to be challenging for them and they’ll need to know a normal life is waiting for them on the other side. Even small gestures like going out to lunch or a movie can go a long way to helping them resume their lives. There is no stigma with seeking help for a mental illness. If you loved the person before, you’ll love them during and after!

Filed Under: Health, Mental Health Tagged With: Mental disorder, Mental health, Psychotherapy, Substance abuse