Legitimizing Brain Disease: The Case Against "Mental Illness"

The following is based on an article by Enid Peschel, PhD (deceased) and Richard Peschel, MD, PhD, of the Yale University School of Medicine in The Journal of the California AMI .

Schizophrenia, schizoaffective disorder, bipolar and major depressive disorders, autism, pervasive developmental disorders, obsessive compulsive disorder, Tourette's disorder, anxiety and panic disorders, and attention deficit hyperactivity disorder are physical brain disorders. Scientifically verifiable abnormalities in brain anatomy, brain chemistry, and brain function help explain these disorders. Computerized tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) scans show the abnormalities in the brain.

These revolutionary advances in neuroscience require a revolution in language. It's time to get rid of the language of the past and start using accurate, non judgmental, medical terms to describe these brain disorders. It's time to connect these disorders to the affected organ: the brain. Disorders of the nerve cells or neurons of the brain should becalled Neurological Brain Disorders (NBD). This designation puts brain disorders where they belong: in the brain.

The brain is an organ of the body just like any other, only infinitely more complex. And, like the kidneys, lungs, or heart, the brain can malfunction. Language colors and defines how people react to other human beings, things, and illnesses. Think, for example, of the different information conveyed when you say or hear:

"Mental illness" is non-scientific, judgmental, and prejudicial. Not only is it time to use the term NBD for all the physical disorders of the brain, it's also time to re-name some of the NBD's that have confusing or stigmatizing connotations.

Schizophrenia is an example. Because this word is overlaid with so much prejudice, fear, and misunderstanding (varying from associations of madness, violence, dangerousness, and "split personality"), it's time to use a new term for this collection of thought disorders. Because it's not known yet which regions of the brain are most important in this disease, it would be premature to name it after a specific brain region or malfunction. However, medical disorders are sometimes named for the person who first described them: for example, Alzheimer's disease, Parkinson's disease, Down's syndrome, Tourette's disorder. Thus, schizophrenia could be re named Kraepelin's disorder (KD) in honor of the doctor who first described it, Emil Kraepelin (1856- 1926).

Many civil rights movements have shown that changes in social consciousness cannot occur unless there is a corresponding change in the language used to refer to oppressed groups. Language promotes change. Language is a powerful instrument of justice or an injustice. Let's work together so that, by the year 2,000, the ugly words "mentally ill" will be a thing of the past.

This article has been posted by D.J. Jaffe of the Alliance for the Mentally Ill/Friends and Advocates of the Mentally Ill in NYC.

In April, 1997 new guidlines for the treatment of the brain disease schizophrenia were published by the American Psychiatry Association. Click here for more information on these guideline: First Publication of Practice Guidelines for the Treatment of Patients with Schizophrenia




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