I believe that “mental illness” is a frustratingly vague term. To be sure, there are cases in which a person’s suffering is so profound, and so obviously rooted in physiological dysfunction, that aggressive measures must be taken to treat the disorder. At the other end of the spectrum, however, are the day-to-day inconveniences that we all experience, and which disturb our equilibrium to the point of discomfort and transient suffering.
Between these two extremes lies a vast spectrum of mental states, and what constitutes “disorder” varies among individuals, among professionals, and even among societies as a whole. My personal philosophy is that illness is individually defined; a person will only comply with—and therefore benefit from—treatment only if he or she believes that a problem exists in the first place. In other words, only by recognizing that something might be “broken” does one set out to “fix” it.
I have two major responsibilities as a psychiatrist. First, I work with my patients to help understand the situation which brings them to my attention: How do they see their condition? How did it arise? Do they believe that they could be “better” (in however they choose to define that term), and have they exhausted all resources to achieve that goal? Do they truly need help, and are the tools of psychiatry capable of providing the help they need?
Secondly—and importantly, this can only happen after the patient agrees that there is some degree of suffering that is amenable to change—I work with the patient to design a treatment plan that not only attempts to achieve his or her self-identified goals, but sets out a plan of action to take the necessary steps. Sometimes this plan includes medications, other times only therapeutic interventions. Sometimes a higher level of care (such as hospitalization or long-term rehabilitation) is most appropriate. At times the treatment can be brief, lasting only a few weeks, while at other times a lifelong treatment and recovery plan is necessary.
Whatever the situation, human suffering deserves the attention of a professional who is skilled in the assessment, diagnosis, and treatment of conditions that prevent us from living to our full potential. That professional must also understand that each person’s goals—each person’s “potential”—are different, and the unique needs and desires of each person must be addressed. This is the way I believe psychiatry should be practiced, and I welcome you in your search for a better life.