Autism and mental illness

[Matthias]

Imagine the following scenario (which I think is fairly common) and tell me whether you think the imaginary person described is mentally ill:

An autistic person feels:
Sad/depressed because people exclude him or avoid him because he is different.
Anxious because people are overly critical of his differences.
Angry because people treat him unfairly because he is different.

This person moves to another neighborhood and feels:
Happy (no longer sad/depressed, anxious, or angry) because people like him, respect him, and treat him fairly despite being different.

His sadness/depression, anxiety, and anger return when he moves back to the intolerant neighborhood. A psychiatrist diagnoses him with depression, anxiety disorder, and an anger disorder. His symptoms go away when he visits friends in his previous neighborhood who accepted him and come back when he returns home to the neighborhood where no one accepts him.

 

[Slime_Punk]

Since I'm autistic I'm going to have to ask more about this person: is he being treated better at work for some other reason, and are his interpersonal relationships somehow better just because he switched neighborhoods? What about his relationship with his husband / wife? This is a tough one, but definitely requires more information because there's more to life than just where one lives.

He / she / them. I used 'he' as an example but I definitely mean 'person'

 

[Rodafina]

I agree with @Silhouette Mirage - more information is necessary.

Likely the diagnosis, from a competent mental healthcare provider, would require information about what level of functional impairment is present. Additionally, length of time, severity and consistency of symptoms, and previous interventions would all be used to make a formal diagnosis.

Depression, anxiety, and anger are common symptoms of a multitude of DSM-V diagnoses.

Even those with mental health diagnoses or “mental illness” can put themselves into physical situations, surrounded by supportive people in which they too can thrive.

A likely diagnosis for someone whose symptomology changes so quickly, as you described, could be adjustment disorder.

 

[Neonatal RRT]

Ohhhh, I wish things were that simple.

Once again, I will implore the importance of context and perspective.

Can one feel emotions of sadness and depression as a result of their interactions with people and their environment? Absolutely.

Are some of these feelings transient or chronic, can they run a range of mild to severe, can they be treated or helped with changing the people and the environment, meditation, or therapy? Yes.

However,...there are specific situations when things are clearly severe enough that "more help" is needed,...that it presents a clear and present concern to the person's well being,...or worse, other people's well being.

Again, don't get hung up on the terminology "mentally ill",...as all it means is that one is not "mentally healthy". A lot of specific conditions, very mild to severe, will fall under the umbrella of "mentally ill". An autistic is not a psychotic lunatic,...but both fall under the professional language of "mentally ill",...it's a very broad term. Language and interpretation. We may not like it, but don't let your ego get in the way of understanding this.

 

[Matthias]

Since I'm autistic I'm going to have to ask more about this person: is he being treated better at work for some other reason, and are his interpersonal relationships somehow better just because he switched neighborhoods? What about his relationship with his husband / wife? This is a tough one, but definitely requires more information because there's more to life than just where one lives.

He / she / them. I used 'he' as an example but I definitely mean 'person'

I agree with @Silhouette Mirage - more information is necessary.

Likely the diagnosis, from a competent mental healthcare provider, would require information about what level of functional impairment is present. Additionally, length of time, severity and consistency of symptoms, and previous interventions would all be used to make a formal diagnosis.

Depression, anxiety, and anger are common symptoms of a multitude of DSM-V diagnoses.

Even those with mental health diagnoses or “mental illness” can put themselves into physical situations, surrounded by supportive people in which they too can thrive.

A likely diagnosis for someone whose symptomology changes so quickly, as you described, could be adjustment disorder.

I'm referring to a hypothetical person who only suffers from depression, anxiety, and anger in situations where people treat him poorly but doesn't have any symptoms when people treat him the way he deserves to be treated. I'd like to keep it simple. If you need more details, let's assume he's a 25 year old man who is single, never married, with no children and that the only difference between the two neighborhoods is the way people treat him.

To say it another way, should people be considered mentally ill solely because they experience more sadness, anxiety, and anger than the vast majority of people who are treated much better or does there need to actually be something wrong with them (such as cognitive distortions, maladaptive thinking patterns, or a habit of thinking negatively)?

 

[Tom]

Well I think Sigmund would say it's because he moved away from his mother.

Skinner on the other hand would say there are more food pellets in the new neighborhood.

But I would say it's because he's closer to a Dunkin Donuts.

 

[Mr Alligator]

I suspect I’ve had depression several times, but never sought out a diagnosis.

Part of the reason for this is due to things not being great in my personal life, e.g. expectations to be married and have kids by a certain age.

When study or work is going well, I concentrate on that. When that’s not going great, then nothing is, and that’s when the depression hits me.

I work very hard, perhaps too hard. I have a fear of being sacked if I don’t. An irrational fear! I have imposter syndrome, I don’t think I’m that good, but feedback suggests quite the opposite. I’ve been very close to burnout a few times. I crash with tiredness during annual leave and some weekends too.

Since getting an a ASD diagnosis and meeting others, I feel more normal, I fit in with that group of people.

I’d work part time if I could afford it - getting benefits as an intelligent autistic person seems very difficult (PIP) and painful (in the sense of having to list all the negatives and fight for it!).

So I think societies expectations, neurotypical behaviours and the environment (noise, lighting etc) can have a very negative impact - especially when you don’t know why you’re different.

 

[Streetwise]

I'm referring to a hypothetical person who only suffers from depression, anxiety, and anger in situations where people treat him poorly but doesn't have any symptoms when people treat him the way he deserves to be treated. I'd like to keep it simple. If you need more details, let's assume he's a 25 year old man who is single, never married, with no children and that the only difference between the two neighborhoods is the way people treat him.

To say it another way, should people be considered mentally ill solely because they experience more sadness, anxiety, and anger than the vast majority of people who are treated much better or does there need to actually be something wrong with them (such as cognitive distortions, maladaptive thinking patterns, or a habit of thinking negatively)?

think this way as im from england ,the english word is dis-ease [for instance the wild violet was called heartsease in old english]or disease, there are different forms of mental illness in subcategories, his is social anxiety arising from stress as opposed to a learning disability not understanding socialisation at all or a brain tumour,dementia

 

[Fino]

I think some of how this question is phrased represent somes of the fundamental misconceptions the general public has about mental health. First, the terms "sadness" and "depression" seem to be used interchangeably here. I understand that colloquially this happens. According to the dictionary, "depression" both means something along the lines of "intense sadness" and "clinical depression." This can make things confusing sometimes. Is this person responding to mistreatment with clinical depression or intense sadness?

Second, mental health often has a lot to do with whether or not our responses are generally considered to be logical responses to our environments. If these people mistreating him are simply glaring at him and refusing to make small talk, and he responds with the majority of the symptoms of major depressive disorder, the majority of the symptoms of generalized and/or social anxiety disorder, and the majority of the symptoms of intermittent explosive disorder, then a diagnosis makes sense. If he's being beaten up or mugged on a regular basis, we have a different story.

Lastly, a diagnosis often depends on whether or not we want psychiatric help. If I want to take an antidepressant to deal with my feelings of unhappiness, this necessitates a diagnosis of major depressive disorder, not only logically speaking but also as far as insurance is concerned.

In conclusion, mental health is contextual.

 

[Rasputin]

Mental health will logically deteriorate if the person is being mistreated, harassed or bullied on a regular basis.

Similarly, mental health can improve in an environment that is supporting of the individual.

The diagnosis makes sense in the first situation.

 

[Matthias]

I think some of how this question is phrased represent somes of the fundamental misconceptions the general public has about mental health. First, the terms "sadness" and "depression" seem to be used interchangeably here. I understand that colloquially this happens. According to the dictionary, "depression" both means something along the lines of "intense sadness" and "clinical depression." This can make things confusing sometimes. Is this person responding to mistreatment with clinical depression or intense sadness?

Merriam-Webster dictionary defines depression as "a state of feeling sad" so I don't think there is any difference between feeling sad and feeling depressed. Clinical depression is a disease label invented by the mental health industry. I'm not convinced the conditions they diagnose exist.

Second, mental health often has a lot to do with whether or not our responses are generally considered to be logical responses to our environments. If these people mistreating him are simply glaring at him and refusing to make small talk, and he responds with the majority of the symptoms of major depressive disorder, the majority of the symptoms of generalized and/or social anxiety disorder, and the majority of the symptoms of intermittent explosive disorder, then a diagnosis makes sense. If he's being beaten up or mugged on a regular basis, we have a different story.

Lastly, a diagnosis often depends on whether or not we want psychiatric help. If I want to take an antidepressant to deal with my feelings of unhappiness, this necessitates a diagnosis of major depressive disorder, not only logically speaking but also as far as insurance is concerned.

In conclusion, mental health is contextual.

I'm asking whether a person who experiences an emotion more often than the majority of people has a disease for that reason alone. It seems like psychiatrists (and people who are deceived by them) look at symptoms alone and tell people they are mentally ill without even considering that their emotions may be valid. To use your example of a person being beaten up and mugged on a regular basis, I suspect most psychiatrists would diagnose him with a mental illness despite his feelings being valid.

 

[Rodafina]

diagnose him with a mental illness despite his feelings being valid.

I don’t understand the connection between having a diagnosed mental health condition and invalid feelings and emotions. I’m pretty sure you and I will respectfully disagree with each other and I don’t want to waste anyone’s time trying to convince you, but I’m just curious what this connection means to you. Why can one not be diagnosed with a mental health condition and also have valid feelings?

 

[Matthias]

I don’t understand the connection between having a diagnosed mental health condition and invalid feelings and emotions. I’m pretty sure you and I will respectfully disagree with each other and I don’t want to waste anyone’s time trying to convince you, but I’m just curious what this connection means to you. Why can one not be diagnosed with a mental health condition and also have valid feelings?

An anxiety disorder means:
1. Person experiences more anxiety than most people
2. Anxiety results from a disorder (such as cognitive distortions, maladaptive beliefs, or abnormally negative thinking).

People with anxiety disorders can have valid feelings such as getting angry when they are treated unfairly or experiencing anxiety is new situations. However, if all of their anxiety occurs due to a natural reaction to their environment, they aren't mentally ill because their anxiety isn't caused by a disorder.

 

[Rodafina]

Hmmm, I’m having a little trouble keeping up with this logic. Let me ask a different question.

Given the following scenario: Two identical people exhibiting the exact same symptomology (obviously hypothetical, because this would be impossible) – one of them seeks psychiatric care, is diagnosed with a mental health condition, or perhaps mental illness, as you say, and subsequently he uses a mixture of treatments available to better manage the symptoms. The other decides not to go this route because to them, there is no illness, and there are better ways to understand the challenging symptoms. So they do their own research, work to address issues from their childhood, and use valuable resources (like advice and support forums) to better manage symptoms.

Are both courses not valid? Why does it have to be one or the other? Your way sounds absolutely fine if it works for you, but I fail to see how it is helpful to adamantly push this quackery idea. Again, I am sure we will come down upon respectful but firm disagreement at the end of this; I only speak up because I want to say that your post feels disdainful toward people who seek therapy and other mental health services.

And please, don’t tell me again that your words are not hurtful. It is not up to you to decide how people feel about the things that you write. Obviously, it is not your job to protect my feelings and if I am hurt I am hurt, my problem. I really just wish there was room to validate each person’s unique experience, yours and mine included.

 

[Leo Zed]

The word “depression” is the worst word that has been used to designate the mental illness commonly referred to as clinical depression or major depression. The feelings or emotions of feeling sad and depressed are just one symptom of major depression. It is an illness that affects much of the brain. Other symptoms include the inability of the brain to regulate sleep, appetite, physical pain, sex drive, etc. I believe that going through a bout of depression (as a response to an event) and having major depression (the brain‘s inability to regulate its chemistry) are two different entities. They both share the same emotional features, but that is pretty much it.

There is a tendency for people to assume that someone who is experiencing depression can get over it through psychotherapy or other forms of therapy. This is a dangerous assumption since those who suffer from major depression need medical attention.

 

[Matthias]

Hmmm, I’m having a little trouble keeping up with this logic. Let me ask a different question.

Given the following scenario: Two identical people exhibiting the exact same symptomology (obviously hypothetical, because this would be impossible) – one of them seeks psychiatric care, is diagnosed with a mental health condition, or perhaps mental illness, as you say, and subsequently he uses a mixture of treatments available to better manage the symptoms. The other decides not to go this route because to them, there is no illness, and there are better ways to understand the challenging symptoms. So they do their own research, work to address issues from their childhood, and use valuable resources (like advice and support forums) to better manage symptoms.

Are both courses not valid? Why does it have to be one or the other? Your way sounds absolutely fine if it works for you, but I fail to see how it is helpful to adamantly push this quackery idea. Again, I am sure we will come down upon respectful but firm disagreement at the end of this; I only speak up because I want to say that your post feels disdainful toward people who seek therapy and other mental health services.

And please, don’t tell me again that your words are not hurtful. It is not up to you to decide how people feel about the things that you write. Obviously, it is not your job to protect my feelings and if I am hurt I am hurt, my problem. I really just wish there was room to validate each person’s unique experience, yours and mine included.

You misunderstood what I wrote. The issue isn't words or labels but whether a disease/illness/disorder actually exists.

Here's an example:
Two children are frequently angry and behave poorly as a result of their parents inconsistency, threatening behavior, and lack of concern for their feelings. One couple goes to church, feels guilty, and decides to adopt a virtuous lifestyle. After becoming better people and treating their child better, he is no longer angry and his behavior improves as a result of it. The other couple turns to a psychiatrist to avoid accepting responsibility for their bad parenting. The quack helps them alleviate their guilt by shifting the blame onto their child by diagnosing him with a mental illness and prescribing drugs to control his emotions. As a result of the quackery, the poor parenting continues, his emotional needs are neglected, and he ends up becoming convinced his brain is defective (chemical imbalance) so he keeps taking drugs to suppress his anger. Since the quackery prevents him from understanding what causes his emotions, he suffers from poor relationships and social isolation for the rest of his life.

Do you think it's better to validate the parent's experience and ruin the child's life or tell them the truth in the hope that they will change which would resolve the child's behavioral and emotional problems?

 

[Rodafina]

Do you think it's better to validate the parent's experience and ruin the child's life or tell them the truth in the hope that they will change which would resolve the child's behavioral and emotional problems?

I think it is important to validate the parents’ experience and also provide this truth that you speak of to hopefully work to resolve the problems. So, you see? Every time you ask a binary question, I am seeking the third option. In this rare moment of my life, I am truly in the gray here. There is no black-and-white to mental health.

I truly appreciate that you took the time to read my posts and to respond thoughtfully, and I think I have a better understanding of where you’re coming from now. I am going to move from respectful disagreement to respectful disengagement.

 

[Fino]

Mental illnesses are not meant to exist. They were made up. That's not up for debate. The DSM is a book of descriptions. Having a label for something is a matter of practicality.