20 April 2017

Mental Health

An important issue but over-reacting will not be helpful.

by Lynda Goetz

Until the front pages were hijacked by Theresa May’s decision to hold a snap election on 8th June, the Princes and mental health were very much amongst the top stories of the last few days.  The Mail highlighted the fact that Prince William had been in touch with Lady Gaga over the issue.  The Guardian ran a story about Princes William and Harry breaking the mental health taboos for a new generation;  The Express speculates that it may be his relationship with Meghan Markle which has helped Prince Harry speak out and The Telegraph’s Bryony Gordon was expressing amazement and delight in Tuesday’s issue that her podcast interview with Prince Harry in ‘Mad World’ should have provoked so much interest and discussion.

It is fantastic that not only the Royals, but many other high-profile characters are speaking out on a subject which for a long time was not considered appropriate for discussion.  It is brilliant that we are a very long way from the world described in Ken Kesey’s 1962 novel, One Flew Over the Cuckoo’s Nest; a world where mental health conditions were treated with the highly damaging electro-convulsive therapy (ECT) or even by cutting away part of the brain (lobotomy).  I can still remember vividly the beginning of that winter term at university in the early 70s, when we were told by our head of department that one of the lecturers would not be coming back.  He had committed suicide on Christmas Eve, following years of ECT treatment, which he was convinced was gradually reducing his intellectual abilities.  This barbaric treatment was supposedly given to ‘cure’ his depression.  Thank goodness that attitudes and treatments have changed.  It is right that they should have done so and that medical professionals and the public now view such things very differently.

Prince Harry’s involvement with veterans has been particularly important.  As one able to identify with what members of the armed forces have to go through and the mental as well as physical effects this can have on them, particularly those who have been involved in combat, he has done a great deal to raise the profile of the myriad issues frequently lumped together under the label of PTSD (post-traumatic stress disorder). Many in the past have endured these conditions without being able to discuss them, in a world where discussion of war and its impacts on individuals was taboo.  Prince Harry’s concern for those affected by war in all its aspects has gained him a respect and affection which spreads far beyond those closely or immediately concerned.  By now speaking out about the impact of an unexpected bereavement he has reached out to more people, many of whom want to say ‘Yes!  That is how I felt too.’

However, in all this ecstasy of release and relief at the liberation of minds and speech, we must tread a little carefully.  How the mind works remains an area in which we and the health professionals are still stumbling toddlers.  Different conditions have been given different labels . The labels change.  What used to be called ‘manic depression’ is now known as ‘bipolar’.  It is not the same as depression.  Then there are the many and varied anxiety disorders from agoraphobia to OCD (obsessive compulsive disorder); Borderline Personality Disorder (BPD), also called Emotionally Unstable Personality Disorder (EUPD), psychosis and schizophrenia.  Many of these co-exist; some are treatable with medication; others such as BPD, are not and can only be treated by various therapies, many of which are not available on the NHS.  The seriousness and extent of disability which arises from any of these conditions varies massively and it is often extremely difficult for the layman to understand or to know how to be of any help to family members or friends who are suffering.

What we must not allow to happen is for the pendulum to swing too far the other way and to see mental illness where there are only variations of normal human behaviours and reactions to unavoidable events.  Of course we will be distressed when a family member dies or goes missing or is seriously ill.  Clearly events such as the breakdown of a relationship or a divorce are traumatic.  Being made redundant or being sacked will affect our feelings of self-worth and sense of self-esteem.  A teenager who has failed to find friends at school will understandably not be happy.   Feeling sad however is not depression.  Our responses to experiences of this sort will vary depending on our own personalities and situations.  They are all normal.   Normal varies.  What we must avoid is labelling too many as mentally ill without perhaps recognising that much of modern ‘depression’ or personality disorders can perhaps be attributed to the less healthy aspects of modern Western society itself.

In an interesting article in The New Internationalist Magazine in April last year, (https://newint.org/columns/essays/2016/04/01/psycho-spiritual-crisis/) , John F. Schumaker points out that three decades ago the average age for the first onset of depression was 30.  It is now apparently 14.  The rate of depression in Western societies is doubling with each generation (Stephen Izard Duke University, North Carolina).  The logical extrapolation would be that before long almost everyone will suffer.  Conversely, in traditional societies there is frequently no depression and not even a word to describe it.  Mr Schumaker takes the view that part of the problem is that although depression clearly exists in modern society, it is also often confused with what he calls ‘demoralization’, something he attributes to the modern lifestyle and obsession with empty consumerism and pointless consumption.  This, he feels, leaves many people feeling dehumanised, demoralised and disappointed with their lives.  So, the question is perhaps not how to treat sick individuals, but how to treat a sick society?  That of course would require a massive culture shift.  In the meantime we must be grateful that our young Royals have taken a lead in speaking out in a way that would not have been acceptable or possible even a few decades ago.


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