What Has Behavioral Health Got to do With Serious Mental Illness?

Joseph Merlin Bowers

Perhaps partly because people refrain from using the politically incorrect term “mental illness,” the term “behavioral health” is now often used by people talking about mental illness. While this term may have some applicability when discussing substance abuse it has nothing to do with any mental illness that I know anything about. I find its use when referring to my disease highly insulting. It’s insinuating that all I need do to successfully deal with my serious brain disease is modify my behavior. I wish to God it were that easy.

Mental illnesses are physical brain disorders with biological and chemical causes according to current best science consensus. Brain imaging shows differences in brain structure and function between people with and without mental illnesses. One can not fix this through simple behavior modification. I have been mostly symptom free for thirty years now through medication, developed coping skills and a strong support system consisting of professionals, friends and family. I have found an effective medication through trial and error. I have learned about precursors and triggers and ways of reacting to them. I have found an outlet and resolved personal issues and demons through writing an autobiographical book and blogging. And I have learned to openly and effectively communicate with professionals as they can’t help with the goings on in my mind of which they are unaware. Some of that may be behavior modification, but I consider it mostly acquired knowledge and maturation. Also, as with most of us, none of the rest of it could possibly have allowed the largely rewarding and productive life I have led without the medication.

There are two major schools of thought as to what causes these brain abnormalities: the trauma school and the biochemical school. There seems to be a genetic factor in mental illness and trauma certainly can cause serious mental issues. There are exceptions and problems with both explanations. I tend to think things like schizophrenia, bipolar disorder and major depression have biochemical causes while things like PTSD are caused by serious trauma. Problematically, with the former there sometimes can not be found any relative or ancestor with a similar disease and with the latter not everyone who experiences serious trauma develops PTSD or something similar. For us to truly get a handle on causes and treatments, much genome and neurological research is needed.

A substance abuser at least initially can choose not to take a potentially addictive substance. In this sense his affliction can perhaps be thought of as poor behavioral health. To end his addiction he needs to quit the substance which involves changed behavior. I think there is a lot involved in getting clean, but behavior is a major factor.

My psychotic, bizarre behavior was caused by my disease. There was never any choice involved. My behavior did not cause my disease. I don’t foresee the mental health system getting, as it needs to, much more effective in treating serious mental illness until it is thought of and referred to as serious mental illness and not behavioral health.

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