The Early Stages of Diagnosing Mental Disorders PHOEBE

AN HOLISTIC APPROACH TO MENTAL HEALTH SUFFERING

By Phoebe

In light of the recent mental health crisis affecting teenagers, especially due to the pandemic, I have become interested in looking at the ways in which Doctors and Psychiatrists diagnose or treat patients with mental illnesses, and whether there could be a better approach.

There are two standard systems used worldwide (ICD-10 and DSM-5*), both of which treat mental health as an illness, with a focus on a diagnosis based on symptoms. But I would like to investigate alternative options for clinicians to use, based on a more holistic approach.

One option is called ‘Psychological Formulation’. This process involves creating a story that helps patients understand the root cause of their problems and the ongoing conditions that exacerbated them. At the beginning of treatment, or when new information comes to light, this story can be changed and developed. This method is useful because it helps people understand that they are not necessarily to blame and that their environment had a large impact.

PSYCHOLOGICAL FORMULATION TRAUMA INFORMED APPROACH (TIA) POWER THREAT MEANING FRAMEWORK (PTMF)

*ICD-10 - International Classification of Diseases DSM-5 - The Diagnostic and Statistical Manual of Mental Disorders Trauma Informed Approach (TIA) is another method that stems from the belief that we shouldn’t be treating ‘patients with illnesses’, but we should instead be viewing them as ‘people with problems’. This encourages caregivers to not just look at the obvious issues, but to dig deeper and look at the underlying factors. It shows that trauma, particularly in childhood, leads to many various forms of distress, including anxiety disorders, Bipolar disorder or Schizophrenia. This approach allows room for people to come to terms with their emotions and memories.

“Don’t ask what’s wrong with me,

ask what’s happened to me”, is a phrase that encompasses TIA’s values. The Power Threat Meaning Framework (PTMF) is a nonmedical approach to why people struggle with their emotions and experiences. PTMF encourages clinicians to view mental distress as an inevitable result of our society and culture, rather than the individual’s actions. It doesn’t just focus on ‘mentally ill’ people, but instead everyone and, by doing this, the method helps people to realise that we need to change some of the terms we use, namely ‘illnesses or disorders’ to ‘emotional suffering or mental distress’.

Power is something that impacts everyone; it can be positive (good education, privilege, close family), however there are many circumstances where power, particularly an imbalance in power, can result in negative things (abuse, neglect, bereavement, and discrimination). It is therefore important to take the Power Dynamic into context when looking at diagnosing and treating mental distress.

One kind of power that PTMF looks closely at is called Ideological Power, which has a particular impact on young adults. This is the ability to shape social norms; for example, how one should look and behave and what people should aspire to. When this power is exploited, it can lead to vulnerability. One example of this would be the beauty industry hiring social media influencers to promote an unrealistic idea of what is beautiful. This could encourage dissatisfaction in young people towards their appearance and cause distress, making them more likely to seek out beauty products and services. Companies are putting profits before the mental wellbeing of the consumer. This ideological power causes people to struggle with self-worth and identity. Power is therefore considered first and foremost when using the PTMF approach.

PTMF looks at four core questions to base their approach on:

What has happened to you? POWER How did it affect you and what did you have to do to survive?

What sense did you make of it? MEANING

Encouraging people to consider the answers to these questions helps them feel more hopeful instead of blaming themselves. As a result of a threat, we all do our best to respond to it (our threat response). Threat response is an alternative term to symptoms, like self-harming, overworking, and panic. This method views the healing practices of non-western cultures as useful rather than unscientific. This process requires various forms of therapy and social support. It acknowledges the benefits of using medication in some cases, but alongside additional support to address the root causes of the mental suffering. PTMF looks to tackle the problems within society, whereas previous diagnostic techniques only scratched the surface, focusing on the individual’s problems. This method is not supposed to replace our current practices, instead complement them and provide a more holistic approach to mental health care.

Given the dual pandemic of COVID and mental health problems being experienced at the moment across the world, I personally believe that clinicians should be more open to alternative and perhaps more holistic approaches, drawing from the most successful elements from the different practices.

THREAT + THREAT RESPONSE

REFERENCES

https://www.bps.org.uk/power-threat-meaning-framework/introduction-ptmf https://iai.tv/articles/beyond-the-mental-health-paradigm-the-power-threat-meaning-framework-auid-1803