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Mental disorder in the past century and its relationship with wellness
Conception of the many descriptions of mental disorder and of wellness has transformed from the mid-20th century to today, altering from a clinically ‘diagnosis-driven’ to a ‘face to face-driven’ meaning of mental disorder. Additionally, from an “absence of disease” representation to another version that emphasises confident psychological meaning for people suffering from mental disorders. Throughout this essay the evolution of the concept of ‘mental disorder’ over the past century will be outlined. Moreover, this essay will argue that there is a negative relationship connecting the concept of ‘wellness’ and the concept of ‘mental disorder’. ‘Wellness’ suggests the level to which one feels optimistic and passionate about their self and their life, while the word ‘disorder’ indicates that an individual has a presence of a mental illness. The concept of wellness has been defined in multiple ways by a number of health institutions. While there might be diverse opinions on what the concept of wellness comprises, the National Wellness Institute, with the support of leaders in health and wellness, communicated their understanding of the concept of wellness (Hettler, 1976). Wellness is a mindful, self-directed and developing method of a person accomplishing their full capabilities (Hettler, 1976). Wellness has many dimensions and is in many ways holistic, it involves incorporating a particular routine to help form a peaceful existence, it takes you on a mental and spiritual journey to the state of well-being, and helps to give your surrounding environment value (Hettler, 1976). The concept of wellness is also someone who has a positive attitude about their life and sustaining peace. The meaning of wellness that has been used by the National Wellness Institute is that the concept of wellness is an energetic progression through which an individual becomes conscious of, and make choices toward, a more positive and fruitful existence (Hettler, 1976). The concept of mental disorder, given its polysemic nature and its vague borders, takes advantage of a historical outlook to be better appreciated by the health system (Jutras, 2017). The concept today is generally understood by many as “mental health” can have its roots tracked back to advances in the public health system, in clinical psychiatry and in other fields of knowledge (Jutras, 2017).
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In the early 20th century, a man named Clifford Beers published an autobiography that described in detail the humiliating and brutalising treatment he obtained while incarcerated in a Connecticut mental institution. He later led the creative of what became the National Mental Health Association, which was later renamed Mental Health America, the leading umbrella organisation for mental health and mental disorder (Jutras, 2017). Back in the 1930s, mental disorder treatments were in the beginning stages and convulsions, comas and fever which were brought on by electroshock, camphor, insulin and malaria injections were conventional practices, other common treatments involved disconnecting segments of a person’s brain this was called lobotomies (Manderscheid, et al., 2010). The lobotomy was performed on an individual commonly from the 30s to the 40s as a treatment for schizophrenia, severe anxiety and depression (Aragona, 2009). In the year of 1946, Harry Truman signed the National Mental Health Act which called for the organisation of conducting research into a person’s mind, their brain and their behaviour (Aragona, 2009). As a result of the National Mental Health Act, the National Institute of Mental Health (NIMH) was created in the year of 1949. Also, in 1949, a medication called lithium, was the initial truly successful drug for the treatments of mental disorders, it was initiated and quickly developed around the world and used to treat manic-depression (Aragona, 2009). In the year of 1952, the first antipsychotic medication called chlorpromazine, was discovered as well as many other antipsychotics that were brought onto the market (Manderscheid, et al., 2010). These types of medication did not heal patients with psychosis but did regulate its symptoms and 70% of patients with schizophrenia had a better quality of life on these drugs (Boysen & Ebersole, 2014). In the mid-1950s the amount of hospitalised mentally ill hit a record high of 560,000 people in just in the United States alone. This number, in addition to the beginning of effective psychiatric medication, led to numerous mentally ill people being removed from these types of institutions and encouraged to transfer to a local mental health facility (Jutras, 2017). In the year of 1980 the number of institutionalised patients that were mentally ill dropped dramatically to 130,000 (Boysen & Ebersole, 2014). The decline in numbers was due to support groups for the mentally ill such as the National Alliance for the Mentally Ill (NAMI) and the National Alliance for Research on Schizophrenia and Depression. These support groups were founded to advocate for mentally ill patients and further finance for investigations into mental disorder (Aragona, 2009).
Today, there have been many new psychiatric treatments that have been founded and introduced, they have successfully treated most people with mental disorders (Jutras, 2017). There are very few people that are ordered to be placed into mental clinics for extended periods of time due to shortage of finance assistance and for most people in the community living with a mental disorder, medications can now cure symptoms of the illness. (Boysen & Ebersole, 2014). However, homelessness and incarceration of those who are mentally ill remain to be a huge problem as does the lack of beds and resources needed to treat people with severe mental disorders. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a publication of the American Psychiatric Association (Boysen & Ebersole, 2014). It was originally published in 1952 to provide a standardised means for making and coding psychiatric diagnoses (Boysen & Ebersole, 2014). All around the world, recognised diagnostic procedures for mental disorders are found in the Diagnostic and Statistical Manual (DSM) which was published by the American Psychiatric Association. The DSM has since then experienced five key modifications. The DSM’s classifications for mental disorder have transformed radically over the past century to merge and exhibit the ever-evolving state of psychiatric intelligence. The manual is now experiencing its fifth modification, preparation for such a major amendment has been on-going since 1999. This process of this modification has created a world-wide deliberation which has started to intensify as the publication day of the fifth amendment is near (Boysen & Ebersole, 2014). The DSM-5 was scheduled to hit the shelves of all psychiatrists around the world in May 2013. The primary manuals used by epidemiologists, health management officials, and clinicians for mental disease classification are the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM), now in its 4th version, and the World Health Organization’s Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death (ICD), currently in its 10th edition. Earlier types of the DSM and ICD systems have not been fully consistent so that the same diagnosis and treatments are listed in both systems (Boysen & Ebersole, 2014). However, doctors and medical insurers always need to be familiar with both the DSM and the ICD systems, especially in light of the new evidence on relations between physical and mental health. Thus, the DSM-V Task Force has been developing the next edition to more closely align it with the 11th edition of ICD (Aragona, 2009).
Wellness is described as an energetic development of becoming more aware of and making decisions towards leading a more nourishing and satisfying lifestyle (Hettler, 1976). It is beyond the feeling of being free from a mental disorder or illness, it is a dynamic progression of transformation and inner growth, a wholesome and pleasing condition of being; a state characterised by health, happiness, and prosperity; welfare. Wellness is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (Hettler, 1976). Irrespective of a person’s age, size, shape or perceived attractiveness, it is wellness that is the cornerstone of quality of life. It determines how we ultimately look, feel, interact with others and thrive in life and work. Wellness is the conscious development of the whole self (Hettler, 1976). Choosing to embark on a wellness journey means committing to a development process and searching for the appropriate “tools” to make you a healthier and happier human being, plus uncovering your own effective methods to use these “tools” for sustained growth and personal development (Manderscheid, et al., 2010). As there are countless variations on all characteristics of a person’s life, there are also numerus ways to nurture yourself on an ever-changing path of wellness. It is significant to be able to see that all of the different concepts of wellness should incorporate the following precepts: firstly, holism – a person’s overall health and their well-being are the results of the continuous dealings between the numerous natural aspects of life and wellness (Manderscheid, et al., 2010). Each aspect of wellness is connected with the all of the others. The overall objective is to be conscious of yourself as a complete human being, living one’s life as wholly as possible. Secondly, balance – while acknowledging the frequently fluctuating nature of a person’s life, you look to balance it by giving significant attention to each of the dimensions (Manderscheid, et al., 2010). Lack of sufficient attention to any one dimension will result in unhealthy development as a person, and has the possibility to lead a person to long-lasting discontent within that person’s life. Thirdly, self-Responsibility – a healthy person owns up to their responsibility for their own well-being and happiness and does not allocate the role of control to others when it comes to decision making. Self-responsibility presumes self-awareness, including the process by which one becomes increasingly more aware of both the causes and consequences of a person’s own behaviour (Manderscheid, et al., 2010). Lastly, positive and proactive – to live a life of wellness it involves largely positive values and perspectives in which people need to live by. It also requires a strong sense of purpose and conscious, deliberate action. These are only the starting assumptions, although they have endured well through time (Manderscheid, et al., 2010). However, these percepts only offer a modest structure. What each person decides to put inside his or her structure is endless.
Approximately thirty years ago, both the concepts of wellness and mental disorder were suggested to be not two ends of the same field, but two independent continua. The term wellness signifies the degree in which a person feels more optimistic and fervent about what’s happing in their life. It embraces the competence to control a person’s feelings and related behaviours, including the accurate evaluation of a person’s limitations, increase of independence, and ability to manage stress effectively (Manderscheid, et al., 2010). The concept of attaining wellness in your life is an operational process of becoming mindful of and making decisions for a healthier and fulfilling way of existing. Wellness is more than being free from illness, it is a dynamic process of change and growth. upholding an ideal personal level of wellness is extremely essential to live a higher quality of life. Wellness matters to people because everything they do and every emotion they feel relates to their well-being. In turn, our well-being directly affects our actions and emotions. It’s an ongoing circle. Therefore, it is important for everyone to achieve optimal wellness in order to subdue stress, reduce the risk of illness and ensure positive interactions (Manderscheid, et al., 2010). By contrast, mental disorder indicates to the existence or absence of a disease and illness. A treatment of care that takes into consideration the full person would address both wellness and mental disorder. A healthy outlook on a person’s life can lessen the intensity and duration of an illnesses or disease, creating the so-called mind-body interaction. The reverse is also true. On average, public mental health clients, the people that served through State mental health care systems die 25 years younger than other human beings (Manderscheid, et al., 2010). Further investigation shows that disorders like clinical depression and its related medical indicators are key hazards for the expansion of the research of coronary heart disease and as critical as death after an original myocardial infarction. This is because of refusal of patients to take part in medical therapy and rehabilitation, adverse health behaviours, metabolic changes involving biomarkers linked to atherosclerosis and cardiac function, and the precepts that are linked to the concept of wellness (Aragona, 2009).
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To conclude, the concept of wellness has an open effect on our general health, this effect is vital for living a healthy, blissful and content life. The crucial variation between the concept of mental disorder and the concept of wellness is that mental disorder is a clinically important behavioural or psychological condition. The condition arises when a person that is linked to having signs of present distress or disability or with a drastically amplified chance of suffering death, pain, disability, or an important loss of freedom. Dissimilar, the concept of wellness is a positive approach to existing and the quality of state of being in good health especially as an actively sought-after objective. Additionally, wellness is an active and dynamic process of change and growth to reach one’s maximum capability and aims to improve their overall wellbeing. Wellness is also contain eight different factors, including emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual wellness. Recognising the major differences between the two concepts for many reasons, including by acknowledging that while a person does not always have the ability to choose the state of their mental health, people do have the conscious choice to make active decisions towards living a fulfilling life of wellness.
- Aragona, M. (2009). The Concept of Mental Disorder and the DSM-V. Dialogues in Philosophy, Mental and Neuro Science, 2(1), 1-14.
- Boysen, G. K., & Ebersole, A. (2014). Expansion of the Concept of Mental Disorder in the DSM-5. The Journal of Mind and Behaviour, 35(4), 225-243.
- Hettler, B. (1976, n.d n.d). National Wellness Institute. Retrieved from the six dimensions of wellness: https://www.nationalwellness.org/page/Six_Dimensions
- Jutras, M. (2017). Historical Perspectives on the Theories, Diagnosis and Treatment of Mental Illness. BC Medical Journal, 59(2), 86-88.
- Manderscheid, R. W., Ryff, C. D., Freeman, E. J., McKnight-Eily, L. R., Dhingra, S., & strine, T. W. (2010). Evolving Definitions of Mental Illness and Wellness. Preventing Chronic Disease, 7(1), A19.
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