Why is it so hard to treat mental illness? Put it in perspective

According to Psychiatry Today, with conventional treatment, the relapse rate of people who have a new mental illness can reach 40 to 50 percent within two years, and even higher within five years, it can exceed 80 percent.

Each relapse of mental illness increases the difficulty of subsequent treatment.

Not only that, repeated episodes of mental illness can damage people's brains.

With each episode of mental illness, we lose about 11ml of brain tissue. If the "human command center" continues to shrink, it can lead to more serious consequences, such as social disability, having to leave school or the workforce, and losing confidence in treatment, creating a vicious cycle.

Many families of patients sigh that "mental illness is too difficult to treat". Although the diagnosis and treatment of mental illness is difficult compared with other common diseases, most mental diseases can be treated, and the overall treatment effect is relatively good.

As for the reasons why people think it is "difficult to treat", there are many influencing factors. In addition to the "severity of disease", "treatment compliance" and "number of attacks" that we have been emphasizing, the following aspects also have a great impact. Let's understand it together.

01- Age of onset

In general, the younger the onset of mental illness, the harder it is to treat.

Getting sick at a very young age often means that endogenous factors (which you can simply think of as some sort of Bug in us) play a decisive role in the development of the disease.

How do you understand that? For example, if you buy a house, but just moved in not long on the problem, that the house is likely to be a "shoddy slag project." But if it happens after 50 or 60 years, it's probably because the house is in disrepair, not because of the quality of the house itself.

For people with mental illness, genetic factors are common endogenous factors. Many studies have shown that patients with a family history of mental illness have a relatively early age of onset and a poorer prognosis. Do you think it would be more difficult to treat a genetic problem?

Most previous studies also found that the onset age is too early, the patient's nervous system is not fully developed, memory function, executive function, attention function, language learning, social cognition and other cognitive functions will be more damaged, which is not conducive to the treatment of the disease.

02- No comorbidities

Comorbidities, colloquially speaking, are the presence of two or more diseases at the same time, which is more common in people with mental illness. For example, some people with depression have personality disorders, and some people with bipolar disorder have higher rates of comorbidities with alcohol addiction.

In contrast to a single mental illness, comorbidities can make treatment for an illness tricky. Take bipolar disorder comorbid alcohol addiction, for example, a large number of long-term drinking affect emotional symptoms in patients with bipolar disorder, let patients pessimistic, low self-evaluation, remorse or regret, negative emotions and behavior more strongly, this affects treatment compliance, reduce, lead to frequent attacks, increase patients suicide attempts and behavior.

03- Degree of social impairment

If the patient's social function damage is more serious, such as unable to maintain and participate in social activities, unable to maintain marriage or family relations, it indicates that the disease is more serious, treatment will be difficult; If the patient can also study, work, and have a certain ability to communicate, it means that the disease is relatively mild, and the difficulty of treatment will be a little less.

At present, the degree of improvement of social function has become an important indicator to evaluate whether the symptoms of patients with mental illness can be improved.

04- Degree of disease differentiation

Here to give you a popular science concept: undifferentiated disease, refers to some symptoms of the patient, after examination can not be diagnosed as a specific disease. For example, some patients have a condition that looks like both depression and schizophrenia, leaving us confused.

If a patient's disease is in an undifferentiated stage, doctors may not be able to diagnose it clearly, let alone treat it effectively, or even have the opposite effect. For example, the standard treatment for bipolar disorder is mood stabilizers, and antidepressants, if given to such patients, can push them from a depressive to a manic phase, exacerbating the condition.

These four aspects can affect the effectiveness of treatment for mental illness, but it is worth mentioning that even if you have a difficult condition, don't give up on yourself easily. Although mental illness has the characteristics of "difficult to treat and easy to relapse", we do not need to despair, as long as receiving scientific and formal treatment, most patients can be well controlled and return to daily life.