The Mental Illness Dilemna

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Registered: 07-11-2006
The Mental Illness Dilemna
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Wed, 08-01-2012 - 10:51am

Advocates for the mentally ill are faced with a deep dilemma each time extreme and deadly crimes are perpetrated by those with a mental illness. Obviously, such acts are not sane or normal; it beggars common sense to suggest that a person who is thinking straight would choose to kill or wound dozens of strangers. And yet most mentally ill people — even those with conditions that have been linked to violence, such as addictions and schizophrenia — are no threat to anyone other than themselves.

[continued]

For the mentally ill, who might be seen as canaries in this coal mine, stigma serves to wall them off from the social support and medical care that are necessary to spur recovery and prevent illness from leading to tragedy. As a society, we need to understand that risk does not equal destiny — and that believing it does is a self-fulfilling prophecy. It’s not wrong to see schizophrenia as a disease or even to appreciate its association with violence, but to view people with schizophrenia as hopeless can in some cases worsen their course unnecessarily.

Read more: http://healthland.time.com/2012/07/31/mass-murder-and-mental-illness-the-interplay-of-stigma-culture-and-disease/?iid=hl-article-mostpop1#ixzz22J3U2hHn

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iVillage Member
Registered: 07-11-2006
Wed, 08-08-2012 - 11:15am

I think the challenge of this conversation is with the use of the word resilience.

Would ya look at that. Wiki beat us to it:

http://en.wikipedia.org/wiki/Psychological_resilience

Resilience in psychology refers to the idea of an individual's tendency to cope with stress and adversity.

iVillage Member
Registered: 07-11-2006
Wed, 08-08-2012 - 11:18am

When someone dies there is a grief process. Again, some will become depressed temporarily.

By and large I believe that depression is a disorder, not a natural part of life. Sadness, grief, difficulty,being in a funk, etc are all normal aspects to grief, but they are not depression.

I totally recommend that book "Against Depression"

iVillage Member
Registered: 07-11-2006
Wed, 08-08-2012 - 11:36am

In some ways I think the conversation about resilience can easily turn negative

I agree. "Keeping a stiff upper lip" is NOT resilient. It is stuffing feelings or denying them.

OTOH being aware of and experiencing emotions IS resilient, IMO.

http://www.today.ucla.edu/portal/ut/using-mindfulness-to-reduce-stress-96966.aspx

Participants in a study who practiced mindfulness techniques for five minutes a day over a period of three weeks reported significant reductions in stress along with increases in life satisfaction, positive relations with others and mastery of one's environment. These are "all key players in creating a life worth living," Golstein added.

Another way I think that the resilience idea can turn negative is by making "lack of resilience" synonymous with "mental illness".  It is almost the opposite of viewing depression as a disorder. - Um, I'm going to leave that comment there for now even though I do not think it will make sense as written.

I think that resilience is fits better in the Recovery Model of mental illness than the Medical Model of mental illness.

iVillage Member
Registered: 07-11-2006
Wed, 08-08-2012 - 9:34pm

Maybe you can explain how you would teach resiliency to a classroom of children?

Sure.

I think groups or classrooms could be taught the notion that our beliefs about events influence  our emotions and behavior. Kids could learn to recognize negative thinking and learn to challenge negative beliefs by considering alternative interpretations. Other strategies such as mindfulness, relaxation, problem solving, and assertiveness techniques could be taught.

 

iVillage Member
Registered: 07-11-2006
Wed, 08-08-2012 - 9:55pm
Here is an abstract that attempts to show how resilience training could be used treat heart disease  
Background

Depression and poor social support are significant risk factors for coronary heart disease (CHD), and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY) to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion.

Methods/Design

In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY) over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action) and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of stress, anxiety and physical activity, and objective indicators of CHD risk (blood glucose, cholesterol [mmol·L-1], triglycerides, blood pressure). Process measures of attendance, engagement and fidelity will also be conducted. Linear analyses will be used to examine group differences in the outcome measures, and the product of coefficients method will be used to examine mediated effects.

Discussion

If successful, this program will provide an innovative means by which to promote psychosocial well-being for heart health in the general population. The program could also be adapted to promote well-being in other at risk population subgroups.

 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2784777/
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Registered: 07-11-2006
Wed, 08-08-2012 - 10:13pm

A snip-it from a critique of Against Depression

http://serendip.brynmawr.edu/exchange/node/445

But despite what we think of depression, an overwhelming amount of research has recently demonstrated that depression is a disease just like any other. Just the fact that Prozac and other anti-depressants work shows that our brain chemistry plays a role in the course of depression. Moreover, Robert Sapolsky has experimented on rats in order to better understand the effects of aging and chronic exposure to stress hormones on hippocampal atrophy. Sapolsky’s research suggests that excess stress hormones, while not directly destroying cells, bring neurons to the “brink of death” (Kramer 117). This over-expression of stress hormones and the subsequent destruction of the hippocampus may be a central factor in the development and course of depression. Too much stress can trigger an episode of depression, and depression itself leads to chronic stress. Therefore, Kramer contends, stress hormones may play a causal role in the development of depression, or at least a significant role in the course of the disorder.

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Registered: 07-11-2006
Thu, 08-09-2012 - 7:26am

We've discussed here the fact that "what resilience is" is part of our conversation.

I can agree that one could be short on patience and tolerance and somehow manage a full life.

But unless one is lucky enough to never have more than they can manage, how can a person have a lack of resilience and still have a full life? Most lives are filled with challenges and hardships which require resiilence.

OTOH, if the opposite of patience is "impulsiveness", then I could see how it can be addressed as a "symptom".

 

iVillage Member
Registered: 12-17-2003
Thu, 08-09-2012 - 8:55am

.I don't know, But if resilience is the ability TO DEAL with challenges and obstacles there are people that DON'T DEAL too. 

 To me, they are people that avoid certain situations and risks, People that don't want to rock the boat or are stuck in status quo, How many people do you know that avoid conflicts?

Oh, see, I totally agree with this. Many people, IME, avoid conflicts and confrontations in order to manage, say anxiety.

iVillage Member
Registered: 12-17-2003
Thu, 08-09-2012 - 9:00am

But unless one is lucky enough to never have more than they can manage, how can a person have a lack of resilience and still have a full life? Most lives are filled with challenges and hardships which require resiilence.

I think what was being questioned was whether or not resiliency can be an innate quality or if it's strictly learned. For a majority of people, it's never an issue. And yes, some people just flat out handle stress better then others.

So, this position that our traits have nothing to do with resilience, I do not find that to be an accurate view.

I don't think anyone is questioning whether or not resiliency is an important ability.

iVillage Member
Registered: 12-17-2003
Thu, 08-09-2012 - 9:10am

I think groups or classrooms could be taught the notion that our beliefs about events influence  our emotions and behavior. Kids could learn to recognize negative thinking and learn to challenge negative beliefs by considering alternative interpretations. Other strategies such as mindfulness, relaxation, problem solving, and assertiveness techniques could be taught.

Oh, I think most schools already to do this.

Can I ask if you have children or any experience dealing with children? I think your responses are very educated and text book, but you cannot isolate one factor of mental health and think it will cure the masses.

So again, I am right back to saying, and we'll use your words, a child has to experience negative thinking before it be challenged.  And usually this is pretty specific and varies between children. This may fly with older students, but can you imagine sending a 6 year old to school and having a teacher or psychologist ask the child to think up something like ... "how would you feel if your parents were to divorce?" Or, "Gee class, let's sit down an think of something really negative that might happen to us and we'll go over ways to get over it"  ..... It's not going to happen. However, when bad things do happen, most schools have staff available to hone in and work with the child on a specific event.

You can teach the skills, which they do, but putting them into action isn't going to happen until it's necessary. You cannot predict what you will find to be stressful life.

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