So, are genes to take all the blame?

My posts so far have been inclined towards the plethora of social and interpersonal issues impacting mental health. The more I delve into these issues, the more it seems to me that there ought to be something more than genes that leads to the manifestation of mental illness. If mental illness was a mere matter of tweaked neurochemicals, we should have been much closer to developing cures for them....but this should have been equally true if they were just about disturbed psychological and social mechanisms.

A walk down the evolution of the causes of mental illness throws in varied conceptions for the manifestation of mental anomalies: faulty parents, faulty genes, faulty families, faulty pregnancies, and faulty thresholds...combining together to make an enormous faulty jumble of yarn, the threads of which still needs to be unraveled by experts. The blame game has veered dangerously from psychological extremism to biological determinism. So, while millions of stricken families in the 1950s and '60s reeled under the stigma and guilt of the highly criticized theories of cold parenting and peculiar communication patterns cited as potential causes of mental illness, in the '90s, genetic studies of questionable methodologies started building their arsenal of biological determinism of mental illness. These dichotomous camps gradually started towards an amalgamation of their viewpoints to emerge with what we today call the biopsychosocial perspective of mental illness; something that I had briefly touched upon in a previous post. The absolute answers, however, still remain elusive, partly due to the enigmatic nature of the human brain/mind. Researchers today are focusing on the minute details which might account for the diverse etiology of mental illness...right from specific genetic material, to specific cognitive mechanisms and pathways, to specific social exchanges in a bid to join the scattered pieces together. But how does this research meaningfully connect together to give a holistic view, a view that might explain most of the experiences of mental illness?

It would be ideal if advances in research answer the questions that are most bothersome for consumers. However, most practitioners themselves are fuzzy about the latest research and lack the skills or initiative to bridge the gap in the knowledge that patients have about their illnesses. Meanwhile, with this lack of guidance and unhappy with merely popping pills under the guidance of their doctor, consumers seek information from often-unreliable sources, which compounds the problems. What are the avenues we need to explore to bridge this gap between consumer knowledge and optimal service delivery? How do we ensure that research makes an impact on contemporary clinical practice? Does anybody have any insight into these questions?

P.S.: Its great to hear feedback from readers, so if you have any view on these questions, please leave your comments so we can turn this into a dialogue.

Its not always about the patient

A few of you reading this might have stumbled upon this blog while habitually searching for any available information on mental health so that you could better understand a family member or a friend who has a mental illness. Information gained through interactions with health providers is crisp at best, and may seem to crop up yet more unanswered questions. I know the anxiety that comes with the feeling of wanting to know and do all that you can, walking that extra mile, just so that you could help that person who means so much to you....
Acquiring information about the myriad aspects of any illness is not a simple 5 minute talk where the doctor tells you what the diagnosis is, what are the features of the illness, and what could be the probable prognosis. Its is a slow process. You have to wade through reams of material, decide which ones are relevant, decide what actually helps you take a step closer towards unlocking the awry mystery of the illness, sift through some more, nudge and poke through scientific garble, make sense of discussions with mental health professionals....and get your own meaning out of your exploration. With the constant awareness that each bit counts, you try to utilize your knowledge about mental health to improve your relationship with the affected person. I know there are millions of relatives and friends of people with mental illness reading all of of this with anxious brows, doing your homework on mental illness, worrying whether that remark you had passed the other day could have worsened the mental state of the patient, repeatedly questioning your actions toward the patient, wondering always what would be the best way to interact with him/her...
Caregivers often forget that there is life, emotions, and thoughts beyond the patient. They are often extremely tough on themselves and it almost seems as if they deprive themselves of the right to have a life independent of the worry about the patient. Subliminal anxiety often becomes a regular feature of the caregivers' mood. But do you know that its alright to feel frustrated? Its alright to walk away sometimes and take in the vision of the raindrops falling on earth while the soft fragrance of the wet soil wafts through the cool breeze.

P.S.: Please cross your fingers that technology remains on my side now and my internet doesn't play truant like it did the last month!

The Icarus Project

Time passes by, with so much to do each passing moment. With a problem where I have trouble concentrating, reading, understanding, thinking, and the pressure of trying to manage college after two years of some-mystery-imposed exile, I apologize to you (and myself) for taking such long breaks in writing, and to SoaringHeights for not continuing our dialogue. Exams after exams interspersed with project submissions have kept me busy, and will continue to do till the end of this month.

As SoaringHeights wrote in the last post, I recall what my doc once told me - "There is no mental health provider 100km. outside every one of the 5 metros in India" !! And the problem gets worse when you consider that it requires an enormous amount of money for medication alone, for the ill whose family members are earning maybe as much amount of money, if not less, as the monthly medication would require. India may have a very bad mental health system, but it is due to lack of sufficient amount of providers, rather than the quality of mental health providers, as in the U.S.

Changing the topic, I had, now I remember, read a book by the Icarus Project (Harm Reduction Guide on Coming off Psychiatric Drugs) on the side-effects of psychiatric medications and how they actually work (something that psychiatrists never tell). The book gave tips on how to manage getting off these medicines, if they are doing more harm than good. However, at every point they emphasized the need to consult your psychiatrist. I found it to be a well written piece that considered the subject from all aspects. However, the ending was a disappointment as they seemed to advocate the disuse of medication on the basis of, if I remember correctly, some sort of anti-psychiatry viewpoint, which I felt didn't do much good when you are not able to function. I will, in a later post, give an article written by me that was published in an Indian e-newsletter, which I think I have already mentioned in my earlier blog at schizophrenia.com. But it definitely is worth checking out the Icarus Project site as you do get helpful information in recovering and subsequently lowering your dosages. I did talk to my doc later and asked him how he planned to go about lowering my dosages, and he told me that he plans to stop my olanzapine within 6-8 months :) a good start.

However, I went into depression about 3 weeks back and am on an anti-depressant now. It was a tough but successful decision by my doc to put me on it along with lithium, for the risk of going into mania. My olanzapine, interestingly, has been halved! I'm going to try my best to recover soon so that I am able to cope without meds, and I wish you the best too!