Illness and Mental Illness

[Johnny]

@DrMariano 4749 wrote:

Every mental illness is a complex illness involving multiple systems, metabolism, and nutrition.

Where anyone can start is by optimizing nutrition. Nutritional optimization helps correct problems at other levels, making those problems easier to address.

Could you please give me your definition of “mental illness”?

I see you use the term a lot, which probably is not strange considering your background, but I find it a little confusing.

I for one am very confident that I do not suffer from any “mental illnesses” as I know the definition, but being physically ill is depressing in itself since it is hard to stay positive and optimistic when my body is not working properly. Unless chemical imbalances and low dopamine is regarded as a mental illness.

[DrMariano2]

@Johnny 4754 wrote:

Could you please give me your definition of “mental illness”?

I see you use the term a lot, which probably is not strange considering your background, but I find it a little confusing.

I for one am very confident that I do not suffer from any “mental illnesses” as I know the definition, but being physically ill is depressing in itself since it is hard to stay positive and optimistic when my body is not working properly. Unless chemical imbalances and low dopamine is regarded as a mental illness.

Before I define “mental illness”, I have to define the term “illness”.

Surprisingly, it is difficult to find a definition of illness which is not circular.

A very frequent definition for example is similar to the Collins English Dictionary – Complete and Unabridged © HarperCollins Publishers 1991, 1994, 1998, 2000, 2003:

illness [ˈɪlnɪs]
n
1. a disease or indisposition; sickness
2. a state of ill health
3. Obsolete wickedness

Or from The American Heritage® Dictionary of the English Language, Fourth Edition copyright ©2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved:

ill·ness (lns)
n.
1.
a. Poor health resulting from disease of body or mind; sickness.
b. A disease.
2. Obsolete Evil; wickedness.

So far, the best definition of illness I’ve come across is from the Encyclopedia Brittanica. illness. (n.d.). © Encyclopedia Britannica, Inc.. Retrieved September 04, 2012, from Dictionary.com website: http://dictionary.reference.com/browse/illness

illness

a harmful deviation from the normal structural or functional state of an organism. A diseased organism commonly exhibits signs or symptoms indicative of its abnormal state. Thus, the normal condition of an organism must be understood in order to recognize the hallmarks of disease. Nevertheless, a sharp demarcation between disease and health is not always apparent

Thus:

An illness is a deviation from the normal structural or functional state of a person such that the person is harmed. A person with an illness usually exhibits signs and symptoms which indicates this abnormal state. There is not a sharp distinction between illness and health in all cases. Sometimes that line is arbitrarily drawn.

For example, diabetes is acknowledged to clearly be an illness. There is a range of one’s ability to control blood sugar in the body. There is “normal”, there is “hypoglycemic” and there is “hyperglycemic”. Hyperglycemia is usually defined as a blood sugar of 100 and above. The line was arbitrarily drawn such that Diabetes is defined as a fasting blood sugar that is over 125 mg/dL (6.94 mmol/L). Anyone with a fasting blood sugar over 125 mg/dL is said to have the illness of diabetes. Realize that glycemic control is a spectrum. One could argue that “pre-diabetes” – those with blood sugars between 100-125 – is still an illness in that people with that condition are twice as likely to die of a heart attack as those with a blood sugar below 100. But “pre-diabetes” is not defined as an illness yet.

Hypertension is acknowledged to be clearly an illness with all the attendent risks of heart attacks, stroke, kidney failure, blindness, etc. It is arbitrarily defined as a blood pressure above 140/90 mmHg. Powerlifters often reach peaks of blood pressure around 400/200 mmHg. They are not defined as having the illness of hypertension if their resting pulse is the norm.

This arbitrariness of distinction between ill and non-ill is illustrated by the term permanent disability. When determining permanent disability, the Social Security Administration defines permanent disability as having an illness – mental or physical – which prevents a person from working to any extent for at least 1 year. “Permanent” is defined as a period lastilng at least 1 year.

When one has a cold, whether or not one is “ill” depends on how much of an impairment one has. Some people go to work with a cold, some people do not. Some people acknowledge to others they have a cold, some ignore it.

A mental illness then is a deviation in the normal structural or functional state of a person which causes a deviation in mental function (i.e. thought and behavior) such that the person is significantly impaired in at least one area of life functioning. Life functioning includes academic functioning, ability to perform activities of daily living, ability to live independently, ability to maintain interpersonal relationships, ability to work, ability to function socially, etc.

The definition of mental illness already includes the point about how there is not always a sharp distinction between mental illness and normal functioning by including the word “significantly”.

Impairment in function is the harm that a mental illness causes.

Once the mind is defined, then the definition of a mental illness becomes:

A mental illness is deviation in the normal structure or functional state of the mind which causes a deviation in mental function (i.e. thought and behavior) such that the person is significantly impaired in at least one area of life functioning. Life functioning includes academic functioning, ability to perform activities of daily living, ability to live independently, ability to maintain interpersonal relationships, ability to work, ability to function socially, etc.

[Johnny]

Thank you, but I`m not sure if I follow you 100%, possibly since english is not my native language.

Do you not make a distinction between mental and physical illness?

Diabetes and hypertension are physical illness, yes? Which may affect mental function and daily life function?

Are all illnesses mental illness then?

[DrMariano2]

@Johnny 4869 wrote:

Thank you, but I`m not sure if I follow you 100%, possibly since english is not my native language.

Do you not make a distinction between mental and physical illness?

Diabetes and hypertension are physical illness, yes? Which may affect mental function and daily life function?

Are all illnesses mental illness then?

There is very little difference between a mental and physical illness. The primary difference is that in mental illnesses, mental function is impaired.

Every mental illness involves physiologic problems or physical illness that contribute to impaired mental function. There is no purely psychological mental illness.

Not every illness affects mental function significantly. Thus not every illness may contribute to the development of a mental illness. The common cold, for example may not significantly contribute to major depressive disorder in most people. however, some people with major depressive disorder can worsen in mental function and even become suicidal when they have a cold.

A problem in discussing mental illness is that the method used to diagnose a mental illness – DSM-IV – is incomplete. A DSM diagnoses is an incomplete diagnosis. It does not generally include the physiologic basis for the illness. It is purely descriptive of the external manifestations of the illness. Many mental illnesses have the same underlying physiologic causes yet different expressions that arise from these and the environmental-psychological factors involved. From my point of view, if two different DSM diagnoses have the same physiologic basis, then they are the same illness though are given two different names. Physical illnesses on the other hand generally are defined by their physiologic basis. This disparity makes it more difficult for people to understand why a mental illness is also a physical illness.

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