WHAT REALLY IS MENTAL ILLNESS

The mental processes here described are complex and difficult to untangle in individ­ual cases, but they are not mystic and com­pletely unfathomable. Mental illness does not strike without warning. It is the cul­mination of unsuccessful reactions to life problems and long-time failure to adjust to real-life situations.

A precipitating factor in the illness can usually be identified. Often it is the depriva­tion of a source of emotional support a be­loved spouse, parent, or child. Psychiatrists also identify an "old-sergeant syndrome." This apparently tough-minded army person­ality breaks down emotionally when all the individuals upon whom he has previously depended are one by one removed by com­bat or transfer. The ability to rise above grief  and   snap   back   from   deprivation   is one of the hallmarks of the truly mature person. Over prolonged grief at the loss of a loved one unfortunately (and needlessly) embitters many lives.

As against the precipitating factors in mental illness, there are a host of predispos­ing factors. The most important of these can be summed up as current physical condition and all previous emotional experiences, espe­cially the emotional conditioning in infancy and childhood.

CAUSES OF MENTAL ILLNESS

Mental illness, thus conceived, is a reaction to external and internal stress. In much the same way fever is a reaction to the presence of infecting microorganisms in the body. The stress goes beyond the breaking point of the individual's particular personality structure. Even the most stable personalities have a breaking point—as World War II experiences often revealed.

When we seek the causes of mental disease, therefore, we must look first to the underly­ing personality structure of the individual in whom the disease appears. Of course, the search does not stop here. Whatever else may be said about the causes of mental illness, this much is clear: multiple factors are in­volved. It is misleading to attribute them to a single cause or to one traumatic event of childhood.

It is sometimes easier to put a finger on the immediate, precipitating causes of mental breakdowns, but even here great caution in the interpretation is necessary. Situational stresses or external events may precipitate the difficulty as in a sailor, shipwrecked in icy waters and picked up nearly dead from exposure, or in a young woman jilted by an intended husband. In some instances constant exposure to a "psychogenic," "emotionally contagious" individual, like a tyrant boss or parent constantly getting on other people's nerves, may either precipitate or predispose to mental illness.

In tracing the causation of mental illness, physical factors, reflecting the intimate rela­tionships of mind and body, must always be considered. In a certain percentage of the cases actual damage to or destruction of nerve cells in the brain can be located. But in a far larger percentage, and to some extent in all cases, purely psychological mechanisms and stresses are at work.

A distinction can be made between "or­ganic" and "functional" mental illnesses. In the "organic" class some definite and presum­ably primary damage to the nerve tissue of the brain can be demonstrated. In the "func­tional" cases, no such injury can be found.

Among the causes of direct damage to the brain can be listed infections, meningitis, syphilis, head injuries (trauma), drugs in­cluding alcohol used to excess, poisons, tu­mors, and hardening of the arteries in the brain (causing "little strokes," which are part of the aging process). Late syphilitic infection is responsible for general paresis. Alcoholic psychoses, which include delirium tremens, are typical of brain damage and malfunction induced by drugs or poisons.