Psychology Today has a post titled “60 Million People in the U.S. Negatively Affected By Someone Else’s Pathology.” Here is an excerpt:

A psychiatrist once remarked, “I consider pathology to be the country’s number one public health issue.” And with good reason–these 60 million people are negatively (and sometimes criminally) impacted by someone else’s extreme pathology (Otto Kernberg called this pathology ‘Severe Personality Disorder’).

Exposure to a pathological causes emotional aftermath (sometimes with or without PTSD). This aftermath causes treatable mental health symptoms like cognitive dissonance, intrusive thoughts, sleep disruptions, increase use of alcohol, concentration problems, flashbacks, depression, anxiety and paranoia. The emotional impact–referred to as ‘the aftermath symptoms’–leaves 50% of the affected people with PTSD. That’s almost equal to the percentage of war vets who return home with PTSD.

The emotional aftermath affects the work environment. Almost 50% of the people negatively affected by the pathological find their work performance negatively affected. As they struggle to manage the aftermath symptoms, some drop from full time to part time, demote and make less money, or go on short term disability. This results in MILLIONS of dollars in lost wages. I have seen doctors move to ‘impaired practitioner’ status, attorneys step down to paralegals, social workers become mental health techs. Others take paid time off, use their vacation time, or go on disability and begin using state services such as food stamps and subsidized housing.

(Find the image above here.)

A photograph taken after a protest in Grand Rapids, Mich. (Flickr user StevendePolo)

The Washington Independent has an article worth noting titled “Death and Joblessness: Suicide Dogs the Long-Term Unemployed. What Can Be Done to Help Them?” Here is an excerpt:

The unemployed commit suicide at a rate two or three times the national average, researchers estimate. And in many cases, the longer the spell of unemployment, the higher the likelihood of suicide.

On online fora such as Unemployed-Friends, the topic comes up often, users finding news reports or hearing tell of deaths in their community, and mourning them. There was the Staten Island suicide, where an emergency medical services employee who thought himself about to be fired posted his final words on Facebook: “I can’t go on anymore. I just hung myself.” In Anaheim, Calif., there was the man underwater on his mortgage and awash in credit card debt who shot his wife and and one of his children before himself. His two children survived. His wife did not. In Indiana, there was the middle-aged mother who sent her daughter out to buy soda and killed herself before her daughter came back. That happened the day after the repossession of her Chevy Malibu.

3 Quarks Daily has another post from Norman Costa, this one titled “Blame the Victims and Make Them Feel Guilty – Part 2.”

The Pope’s understanding improved a little 2008 to 2010, and it appears he has begun to appreciate the gravity and nature of the problem. Judging from his words, alone, one has to ask if the Pope was mindful of what really happened to the victim members of his flock. In keeping with his own words of admonishment, he could have acknowledged their feelings of guilt, shame, and responsibility, successions of failed relationships, problems with authority and in the work place, substance abuse, enormous rage and anger, self-destructive behaviors and suicide, higher risk of serious illness, mental disorders including depression, bipolar, anxieties, phobias, dissociation, insecurities, loss of self-esteem, deterioration of self-confidence. To this list can be added the entire list of problems associated with Post-traumatic Stress Disorder (PTSD), not already covered here.

Was the pope mindful of what is required for the healing, recovery, and integration of victims of clergy abuse? Judging from his words alone, he does not understand, fully, what is involved in the victims’ journeys toward healing and mental health. It requires a safe place, telling their story to others who have experienced similar abuse, listening to the stories of others, and integration of their personalities and social experiences on all levels.

Addiction Inbox has another great post, this one titled “A High Old Time in Rhode Island” about the government’s annual state-by-state survey of drug use in America put out by the Substance Abuse and Mental Health Services Administration (SAMHSA). Here is an excerpt:

The most meaningful change compared to the 2002-2003 period was a 2.5 per cent decrease in the use of cocaine among people 12 or older. Nationwide, the percentage of alcohol use remained almost identical (51.4 per cent).

SUFFERERS ALL Clockwise from top left, William James, Isaac Newton, F. Scott Fitzgerald and Gene Tierney are among the well-known people said to have had a nervous breakdown, or something like it, during their lives.

We often comment on and I center my career around tracking the questions of how sick and/or disturbed are we and when do we in fact cross a diagnostic threshold into having a true psychiatric disorder? There are degrees of mental disturbance from mild forms of depression and anxiety due to life circumstances to more severe neurological conditions that defy explanations and treatment. As a culture, we tend to lump so many of us into these severe categories rather then making better distinctions about who is this disturbed.

The point for us, if we more effectively define and treat people who in reality have a mental illness while also guiding others who exhibit milder forms of depression and anxiety through how to manage their symptoms and lives, our precious time, resources, and energy can be saved and focused on where the greater needs lie. On this note the NYT has an article worth checking out titled “On the Verge of ‘Vital Exhaustion’?” by Benedict Carey. Here is an excerpt:

Through the ages, every generation has attributed its own catchall diagnosis to larger cultural changes. Industrialization. Modernization. The digital age. The 19th-century philosopher William James reportedly called neurasthenia, from which he claimed to suffer himself, “Americanitis,” in part the result of the accelerating pace of American life. So it was with breakdowns. The causes were largely external — and recovery a matter of better managing life’s demands.

“People accepted the notion of nervous breakdown often because it was construed as a category that could handled without professional help,” concluded a 2000 analysis by Dr. Stearns, Megan Barke and Rebecca Fribush. The popularity of the phrase, they wrote, revealed “a longstanding need to keep some distance from purely professional diagnoses and treatments.”

The Guardian has an article by Lewis Wolpert titled “Manufacturing Depression: The Secret History of a Modern Disease by Gary Greenberg.” His critique of the book by Greenberg illuminates the ongoing debate on depression, how it is treated, and the pharmaceutical industry’s role in marketing not only drugs, but a belief that the disease of depression is widespread as well. Here is an excerpt:

Greenberg devotes much space to tracing the history of ideas about depression, going back to Hippocrates, who identified melancholia as a distinct disease. He gives much attention to Emil Kraepelin, who believed the chief origin of psychiatric diseases to be biological and genetic malfunction. These are not ideas that he accepts: he views them as neurological tautologies. Psychiatry, he thinks, has been led astray by attaching itself to science, thus losing sight of humanity.

He is very critical of the Diagnostic and Statistical Manual of Mental Disorders, which is intended to help diagnosis by listing key symptoms, or scoring the answers to questions. This, he says, is “a way for the doctor to keep his eye on his notebook and not on the patient”. He is right that there is no unequivocal diagnosis of depression, and psychiatrists may quite often give a different diagnosis for the same patient. However, he does not point out how being depressed can in many cases render people unable to work, and ignores the fact that severe depression can result in self-harm, plunging the individual into a world unrelated to anything in everyday life. Nor does he mention research showing that almost all people who end their life by suicide have a mental illness, most commonly depression.

Read more…

Lindsay Beyerstein responds to Jonah Lehrer‘s interesting article in the NYT titled “Depression’s Upside” that we commented a previous post” in her post at big think “Is Depression an Adaptation?” Here is an excerpt:

It’s easy to see why a capacity for intensive introspection or analytical problem-solving would have survival value. However, we also know that people think this way all the time without becoming clinically depressed. Highly analytical thinkers are at increased risk of depression. But that suggests that depression is a malfunction rather than an adaptation. The systems that give us useful cognitive abilities can also cause us pain when they go awry. If analytical thinking and sustained attention reliably yield life-saving insights, insightful people will pass on their genes.

Read more…

There is legitimate cause to be suspicious or dismissive of someone who is given the diagnosis of sexual addiction. We have commented in previous posts about issues surrounding sexually related pathologies and the idea of having an actual addiction to sex. The effort to make a clear distinction between “normal” to unusual or excessive sexual behaviors and what is a real sexual psychiatric disorder is challenging for the layperson to understand. We know that great harm can be caused through infidelity, sexual manipulation and deceit. Our bodies, hearts, and minds are involved and on the line when it comes to sex. So identifying a line that exists between accountability for our behaviors and what we try to get away with and a person who is in fact not able to control himself, ultimately crossing a diagnostic threshold, is a complex process. Read more…

There are many legitimate reasons to be depressed, to feel down. Loss, grief, loneliness, and exhaustion are unavoidable aspects of being alive. Certainly we must be concerned when someone is unable to lift himself out of the grip of depression, but can we learn from and use the episodes of being depressed to see our lives and the lives of others more deeply? In a culture that values being happy and feeling up at all times, balancing the myths of happiness and positivity we are currently living in with the human reality of sometimes being depressed can go along way toward stabilizing our individual and cultural mental health and identifying who in fact is suffering from a psychiatric disorder. The challenge remains making the distinction between depressive emotions and symptoms that are based on life’s challenges and a real and lasting pathology that needs treatment. On this note Jonah Lehrer has a must read article in the NYT titled “Depression’s Upside.” Here is an excerpt:

To say that depression has a purpose or that sadness makes us smarter says nothing about its awfulness. A fever, after all, might have benefits, but we still take pills to make it go away. This is the paradox of evolution: even if our pain is useful, the urge to escape from the pain remains the most powerful instinct of all.