Why do we call it “mental” illness?
A person who has had a stroke may experience dramatic (sometimes very negative) changes in his or her personality, but we don’t call those changes “mental” illness. Why, then, are depression, bipolar disorder, schizophrenia, et al called “mental” illnesses?
The very decision to linguistically categorize these conditions as “mental” infers that they are “in or of the mind” — perhaps even “imaginary.” This usage can suggest that behaviors which develop from (or are exaggerated by) these disorders are caused by controllable errors in an individual’s thinking. That has led to a widespread sociocultural belief that “mental” illness is just symptomatic of a character defect or lack of restraint, and this has stigmatized terribly the individuals who suffer from any form of psychiatric illness.
(This was especially true in earlier generations. For example, my older daughter struggled most of her life with severe and frequently acute bipolar disorder, but my late father — an otherwise well-educated and cultured man who was the chief executive of a multi-national company — felt strongly that her problems were caused by insufficient discipline in my household. Unfortunately, that utterly wrong-headed notion is still seen today even among some younger people.)
I think I have a better idea . . .
Science is only now beginning to recognize fully that so-called “mental” illness is physiologically based. Since “we are what we speak,” I think it’s time to linguistically locate these illnesses more correctly — in the brain, not the mind — and to stop adding “mental” to diagnoses of psychiatric illnesses. I’d like to see depression, bipolar disorder, and all the other conditions which are presently lumped together as “mental” illnesses re-categorized as neurological diseases and disorders.
Psychologists, psychiatrists, and other “mental” health professionals wouldn’t lose any business over such a change, as patients with any of these disorders could still be treated by the same individuals who are trained in those specialties. Yes, medical societies and such might have to revise their hierarchies, with psychiatric physicians now paying dues as a sub-specialty of neurology groups instead of — or in addition to — having their own overarching umbrella group for “mental” disorders, separate from the hierarchy of groups that deal with strictly “physical” health.
But isn’t specialization what medical care is all about nowadays anyway? The broad category of “Neurology” already includes many sub-specialties: physicians, therapists, and researchers who specialize in neuromuscular disorders, others who address primarily the physiological activity of the central nervous system (CNS), still others whose expertise lies in tumors of the brain or CNS, and so on. Why not consider “psychiatry” and “psychology” as additional sub-specialties of Neurology?
(Shoot — physicians might even be pleasantly surprised, finding a new kind of cross-fertilization occurring with their colleagues if those studying and/or treating psychiatric disorders are no longer separated from others by a Chinese wall which dictates that “this is physiological; that is mental.”)
At any rate, who’s paying dues where, and what conventions they attend, is not important to me: What I care about is society’s treatment of people with diagnoses of psychiatric illnesses. Why not use the term neurological instead of “mental” to describe their health or afflictions? Over time, if disorders and diseases of the brain are no longer called “mental” illnesses but rather the neurological conditions they really are, society might come to be more accepting of patients with those diagnoses.
And I think that would go a long way toward creating a more civil society. What do you think?