By David Joel Miller.
Are Multiple Personality Disorder, Manic-Depressive Disorder, and Addiction real illnesses?
There have been some books, articles and blog posts recently saying that many things we are calling illness either do not exist or if they do exist they are not really illnesses but choices people make.
Some of the arguments these people are making seem to have some merit on the face, but when I look deeper there are some serious flaws in this kind of reasoning. All good lies have some truth in them and so these misconceptions about illnesses take some sorting out. Most of these efforts to deny the existence of a particular illness are cases of – if I do not believe in this it can’t hurt me.
Let’s look at some examples of ways people try to deny the existence of mental disorders.
1. Change the name and the illness ceases to exist – Denial one.
“There is no such thing as Consumption. When people believed in consumption they got it and died. No one gets it now because we know it does not exist.”
You buying that?
Consumption is the old name for Tuberculosis. Yes, people still get T. B. and die from it. We do have medication to treat it, but if you take no meds, you still can die from this illness. Changing the name did not erase the disease.
What about Manic-Depressive Disorder? No such thing right?
Well, we changed the name of that one to Bipolar Disorder so in that sense there is no such thing as Manic Depressive Disease. No difference really in the condition. Still, a serious illness and still needs treating, but no in the strict literal sense, there is no such thing as Manic Depressive disorder anymore at least not in the DSM.
Which brings us to Multiple Personality Disorder.
The name misled a lot of people into thinking that everyone who had this issue would look like Sybil. Truth is that there are lots of variations. The new name is “Dissociative Identity Disorder” so while technically, semantically, Multiple Personality Disorder no longer exists, there are still millions of people living with exactly these symptoms; we just call this condition by a new name.
Watch for an upcoming post on Dissociation Disorders. (Yes, there are more than one of these creatures.)
2. Second denial – There is no such thing as mental illness.
The argument runs – mental illness is not a “real disease” these are just people who think or behave differently from the rest of us and we want to force them to act and think like the rest of us.
A lot was made of thus a few years back. Again in a strictly semantically way, this has some truth to it. Just enough truth to be misleading.
One definition of illness or disease is a process of an organism, bacteria or virus, invading the body and damaging cells. The proponents of this “no mental illness” idea argued that if mental illness was a real illness we should be able to find the bug that caused it and a drug that removed this infection from the body.
Newer research on the brain is chipping away at this one. There are lots of changes that nerve cells undergo that cause a change in functioning. Thoughts and traumatic experiences can change the wiring and the chemistry of the brain.
Most mental issues are correctly referred to as “disorders” not technically diseases. The specific definition of a disorder is essentially something that causes you a thinking, feeling, or behavioral issue.
So if the emotional, mental or behavior problem cause you to have impairment in Social functioning, (You can’t get along with family and or friends) occupational functioning (the ability to hold a job) of subjective distress (You say it bothers you) then we diagnose it as a mental disorder. The DSM-5 adds “other important area of functioning” I am still not sure what all that might be but if we find that we can give you the diagnosis also.
So while there does not appear to be any Dissociative Disorder germ, I still think that the effects of trauma can alter your emotions sufficiently that we can say you have a disorder.
3. Denial three – I do not believe in Dissociative Disorders so they do not exist.
I take this to be the funniest reason of all to pretend that disorders do not exist. Still, some people cling to the notion that there was no evolution or that the sun does, in fact, revolve around the earth.
Personally, I have taken to believing that Arizona does not exist. California just runs all the way to New Mexico. Those of you that think you live in Arizona knock that foolishness off and start sending your taxes my way.
People have denied the existence of addiction for years saying those people just chose to be that way. Some of them say the same thing about schizophrenia. Now the medical people are saying almost all medications including prescribed ones can cause tolerance and withdrawal so they all met the old definition for addiction.
We are getting around this one by elimination addiction – it is no more. All of you that thought you knew someone with an addiction you were wrong – there is no such thing as addiction – We will, however, be treating a lot of people next year for substance use disorders and the key characteristic of that disorder will be a loss of control over their usage of a substance.
See how this works.
4. Straw man argument.
The way this one goes is: When you talk about Multiple Personality Disorder or Dissociative Disorder what you really mean is –
They then proceed to spend the rest of their post arguing about things that you never said and wouldn’t have said, but it makes them feel better to win an argument even if they need to misrepresent what you think to win one.
Oh, my – another long post. So in the future let’s talk some more about all the things that we have been learning about stress, trauma, and dissociation.
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