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Rock doc: A rapidly evolving medical landscape

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January 31, 2011 |

E. Kirsten Peters mug

Peters

Parts of medical science are highly developed areas where doctors can precisely nail down specific diseases and even sometimes eradicate them. The more vexing – and perhaps more interesting – pieces of medical science are those in which we still struggle to diagnose, let alone fully treat, major maladies.

Mark Vonnegut, M.D., the son of famous writer Kurt Vonnegut, has a first-hand knowledge of the challenging kind of illness where modern medical science is quite limited. Vonnegut-the-younger has recently written about his personal, lifelong tour of major mental illness.

Dr. Vonnegut has had several, full psychotic breaks in his adult life. In between times of the deepest illness, he also attended Harvard medical school and built a successful medical practice in pediatrics. You can read his newly published memoir, which is at times achingly funny. Just to give you a flavor of the book, it has the title “Just Like Someone Without Mental Illness Only More So.” If you have friends or relatives dealing with chronic mental illness, the book might be of interest in helping you understand one man’s journey through the landscape where the doctors are sometimes at a loss to successfully predict or usefully treat disease.

There was a time not long ago people in polite society simply didn’t speak about mental illness. Today research scientists and psychiatrists understand that schizophrenia and bipolar disorders are caused by chemical imbalances in the brain, not greatly unlike a chemical problem in your bloodstream or a growth in your organs that can make you ill. From this point of view, mental illness isn’t different from other diseases, it just affects the brain rather than the lungs or the liver. That new understanding has made it more possible for literally millions of Americans to seek medical help for garden-variety episodes of depression, and entire books have been written about simple anti-depressant medicines.

The loss of productivity that mental problems create for America’s young people is quite real. The New York Times recently ran a feature story on the increase in demands for serious psychiatric services that our nation’s colleges have been experiencing in recent years. Compared to a scant decade ago, the story said, the number of students seeking help with serious mental conditions is now double.

Many young Americans don’t go to college, but may enlist in our military. The armed services have become much more proactive in recent years in their response to the mental issues known as Post Traumatic Stress Disorder (PTSD).

In short, we as a society are trying to change the way we do business to help people with serious mental health issues contribute to their fullest potential to our world.

An impressive portion of psychiatry is still pea soup. That’s one reason it’s really impossible to say how many Americans are suffering from maladies like PTSD or bipolar illness at any given time. But even with imprecise knowledge and treatments that may be only partially helpful, many people with significant diagnoses do a lot for our society.

We need only look at some famous people to see evidence for what the mentally ill can contribute. As Bipolar magazine has reported in an interview with Jane Pauley, the television newswoman is bipolar. Forbes magazine has reported the same about Ted Turner, and the actress Patty Duke has written about living with what used to be termed manic depression. And, of course, there’s Dr. Mark Vonnegut, practicing medicine despite a mental health history that includes repeated and full psychotic breaks with hospitalizations to match.

New developments in the field of psychiatry focus on new medicines. The brain is obviously a complex organ to regulate, so new drugs are needed that address imbalances without crippling side effects. Research science at universities and pharmaceutical companies is ongoing in this field. For patients, progress is achingly slow. But compared to what was standard practice in the 20th century, we’ve come a long way. That’s all for the best, because there’s still a great distance medical science needs to travel to be helpful to literally millions of Americans whose only affliction is rooted in the chemicals that happen to be found in the brain.

Dr. E. Kirsten Peters, a native of the rural Northwest, was trained as a geologist at Princeton and Harvard. Follow her on the web at rockdoc.wsu.edu and on Twitter @RockDocWSU. This column is a service of the College of Agricultural, Natural and Resources Sciences at Washington State University.

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