Posted 4th April 2013 by Tom Wade a 2nd Year Medical Student at Norwich Medical School and Headucate Committee Member
When you think of psychiatry what images does it conjure? Perhaps a serious authorative figure who sits pensively and quietly to listen to the patient’s problems, a character in the latest horror or psychological film (take Jude Law playing Dr. Jonathan Banks in ‘Side Effects’ which has currently hit the big screen), or a person who themselves are slightly mad to be able to deal with the nature of the work.
Mental health is termed as being a level of psychological wellbeing. What exactly is mental illness then and how is it defined? Is it an imbalance of this wellbeing homeostasis? How can it be considered as an illness if there is often no known biological or physiological manifestation? Does the medical world or society define it?
Medicine is supposed to be a caring profession. So how is it then that many medical students and doctors do not support mental health? In fact I have met many who even doubt conditions such as depression are even real. “It’s all made up” and “It’s just an excuse” are common phrases I come across on a regular basis. It worries and frightens me that the very professionals who patients with mental illness will pluck up the courage to visit when they finally decide they can no longer cope and are searching for help, will not really understand them, and in some instances, nor will they believe them.
Others think that the sister field of psychology is all “wishy washy fluffy stuff” and that “I couldn’t think of anything worse”. Whilst I might agree that a large amount of knowledge from the social sciences fall under the realms of ‘common sense’, it is because there has been a huge evolution in the way we see ourselves and start to begin to understand the marvel that is the human mind. It is thanks to the work of so many great psychologists that we are able to take this information for granted as ‘common sense’. For all his misforgivings, Freud coined some well known terms such as ‘ego’ and ‘libido’ which have entered everyday language. He may have been discredited in modern psychology but he was the first person to provide compelling evidence for the psychological origin and treatment of mental illnesses.
I have no great aspiration to become a psychiatrist; I have no idea what area I want to spend the rest of my life working in. That is partly the beauty and excitement of medicine: there are limitless different avenues open and during the progression at medical school I hope to find the one most suited to me. However what does interest me about mental health is that in many other specialities we already know a great amount of information about the pathology, the treatment options available and the progression of the disease. Essentially even if we know the patient can’t be treated, we still know if they will live or die and what is going to happen. Psychiatry is still somewhat in it’s infancy in terms of knowledge. It is one of the only areas in medicine where we are shooting unguided in the dark. The brain is the most complex organ in the body and we are only beginning to understand the vast elaborate neural pathways and how this translates into mental illness.
I had the pleasure of speaking to Professor Robert Plomin from the Institute of Psychiatry, Kings College London, when he came to give a rare lecture at UEA for Headucate. This man is a true pioneer, world leader and role model for behavioural genetics. There is not one of his latest papers which does not get published in Science, Nature or another high calibre journal showing that the academic world believe in his ground breaking work. He clearly shows through the use of genome wide association studies (GWAS) that it is down to subtle differences between our genomes that determine the quantative traits which we express. Complex phenotypes are often the result of just a few different base pair alterations within the 3 billion base pair human genome. This is cutting edge stuff: it will completely change the way we view not just mental illness, but many diseases. In fact mental illness may not be classed as ‘just a disease’ but as minute differences between genomes causing one individual to be ‘normal’ and another to express a certain mental health trait. I use the word ‘normal’ lightly as this research will blur the boundaries between what is common and what is not.
Perhaps the sceptical medical students are then bred from the type of social science teaching they experience in their time at medical school? Perhaps there needs to be a serious rethink and overhaul of how mental health teaching is delivered in order to capture the imagination and combat the ignorance of so many? Perhaps the way medicine is so competitive and the way we are ranked against our peers escalates the feelings of superiority which translates into arrogance and being out of touch with our future patients? Or perhaps it is just all part of the misunderstanding, misinformation and stigma surrounding this topic? I do not know all the answers to these questions but it will be interesting to explore.
It is without doubt that mental health will be the next big social movement of our times. We saw brave individuals such as Martin Luther King Jr, and Malcolm X fight the disgusting and shameful hatred of the black population in the United States during the 1950s to 1960s. Then came the movement to end intolerance to homosexuality, people who stood up to inequality despite the fact that being gay was once illegal and even thought of as a psychiatric illness. These movements changed the course of social history and being black or gay is now thought of as no different to being white or straight in most communities, the way it should be. Who will be the next courageous figure to stand up and represent the needs of mental health patients? Exciting times are ahead. Already many organisations have started laying the foundations ranging from national and local charities and organisations, early intervention teams targeting young adults and children, and of course local community projects such as Headucate: a new student society with its roots beginning in the Norwich Medical School. Mental health is also the latest political hot topic with everyone from David Cameron to Ed Miliband jumping on the ‘mental’ bandwagon.
I feel like I am in a good position to write this article as I am not ashamed to admit that I was once myself one of the sceptics I have spoken about. I was part of the ‘it doesn’t exist’ camp. My views have changed as my understanding has improved. I honestly believe that a lot of stigma, ignorance and hatred stems from fear, or misunderstanding of, the unknown. It is time to tackle the sceptics.
Tom Wade, April 2013
When you think of psychiatry what images does it conjure? Perhaps a serious authorative figure who sits pensively and quietly to listen to the patient’s problems, a character in the latest horror or psychological film (take Jude Law playing Dr. Jonathan Banks in ‘Side Effects’ which has currently hit the big screen), or a person who themselves are slightly mad to be able to deal with the nature of the work.
Mental health is termed as being a level of psychological wellbeing. What exactly is mental illness then and how is it defined? Is it an imbalance of this wellbeing homeostasis? How can it be considered as an illness if there is often no known biological or physiological manifestation? Does the medical world or society define it?
Medicine is supposed to be a caring profession. So how is it then that many medical students and doctors do not support mental health? In fact I have met many who even doubt conditions such as depression are even real. “It’s all made up” and “It’s just an excuse” are common phrases I come across on a regular basis. It worries and frightens me that the very professionals who patients with mental illness will pluck up the courage to visit when they finally decide they can no longer cope and are searching for help, will not really understand them, and in some instances, nor will they believe them.
Others think that the sister field of psychology is all “wishy washy fluffy stuff” and that “I couldn’t think of anything worse”. Whilst I might agree that a large amount of knowledge from the social sciences fall under the realms of ‘common sense’, it is because there has been a huge evolution in the way we see ourselves and start to begin to understand the marvel that is the human mind. It is thanks to the work of so many great psychologists that we are able to take this information for granted as ‘common sense’. For all his misforgivings, Freud coined some well known terms such as ‘ego’ and ‘libido’ which have entered everyday language. He may have been discredited in modern psychology but he was the first person to provide compelling evidence for the psychological origin and treatment of mental illnesses.
I have no great aspiration to become a psychiatrist; I have no idea what area I want to spend the rest of my life working in. That is partly the beauty and excitement of medicine: there are limitless different avenues open and during the progression at medical school I hope to find the one most suited to me. However what does interest me about mental health is that in many other specialities we already know a great amount of information about the pathology, the treatment options available and the progression of the disease. Essentially even if we know the patient can’t be treated, we still know if they will live or die and what is going to happen. Psychiatry is still somewhat in it’s infancy in terms of knowledge. It is one of the only areas in medicine where we are shooting unguided in the dark. The brain is the most complex organ in the body and we are only beginning to understand the vast elaborate neural pathways and how this translates into mental illness.
I had the pleasure of speaking to Professor Robert Plomin from the Institute of Psychiatry, Kings College London, when he came to give a rare lecture at UEA for Headucate. This man is a true pioneer, world leader and role model for behavioural genetics. There is not one of his latest papers which does not get published in Science, Nature or another high calibre journal showing that the academic world believe in his ground breaking work. He clearly shows through the use of genome wide association studies (GWAS) that it is down to subtle differences between our genomes that determine the quantative traits which we express. Complex phenotypes are often the result of just a few different base pair alterations within the 3 billion base pair human genome. This is cutting edge stuff: it will completely change the way we view not just mental illness, but many diseases. In fact mental illness may not be classed as ‘just a disease’ but as minute differences between genomes causing one individual to be ‘normal’ and another to express a certain mental health trait. I use the word ‘normal’ lightly as this research will blur the boundaries between what is common and what is not.
Perhaps the sceptical medical students are then bred from the type of social science teaching they experience in their time at medical school? Perhaps there needs to be a serious rethink and overhaul of how mental health teaching is delivered in order to capture the imagination and combat the ignorance of so many? Perhaps the way medicine is so competitive and the way we are ranked against our peers escalates the feelings of superiority which translates into arrogance and being out of touch with our future patients? Or perhaps it is just all part of the misunderstanding, misinformation and stigma surrounding this topic? I do not know all the answers to these questions but it will be interesting to explore.
It is without doubt that mental health will be the next big social movement of our times. We saw brave individuals such as Martin Luther King Jr, and Malcolm X fight the disgusting and shameful hatred of the black population in the United States during the 1950s to 1960s. Then came the movement to end intolerance to homosexuality, people who stood up to inequality despite the fact that being gay was once illegal and even thought of as a psychiatric illness. These movements changed the course of social history and being black or gay is now thought of as no different to being white or straight in most communities, the way it should be. Who will be the next courageous figure to stand up and represent the needs of mental health patients? Exciting times are ahead. Already many organisations have started laying the foundations ranging from national and local charities and organisations, early intervention teams targeting young adults and children, and of course local community projects such as Headucate: a new student society with its roots beginning in the Norwich Medical School. Mental health is also the latest political hot topic with everyone from David Cameron to Ed Miliband jumping on the ‘mental’ bandwagon.
I feel like I am in a good position to write this article as I am not ashamed to admit that I was once myself one of the sceptics I have spoken about. I was part of the ‘it doesn’t exist’ camp. My views have changed as my understanding has improved. I honestly believe that a lot of stigma, ignorance and hatred stems from fear, or misunderstanding of, the unknown. It is time to tackle the sceptics.
Tom Wade, April 2013
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