Adverse effects of latent onset characteristics of mental illness on treatment onset time

According to modern psychiatric understanding, the site of pathology in almost all psychiatric disorders is in the brain. Or rather, it is pathological changes in the patient’s brain, which are not yet clearly understood by modern medical research, that cause them to manifest mental illness. According to my tracing of the course of mental illness in patients with mental illness, most mental illnesses are abnormal long before others or even the person themselves become aware that they are mentally abnormal, and a variety of mild but definite symptoms of that mental disorder appear, which some regard as precursors or very early symptoms of the illness. This is particularly common with depressive episodes or certain anxiety disorders. In the past, this phenomenon was considered to be a “subhealth state”, especially when the patient’s physical symptoms were prominent. From the point of view of professionals, such phenomena are more in line with “subsyndromal depression” or “subsyndromal anxiety disorder”, which are essentially disease states. Given that the lesions of psychiatric disorders are located in the brain, especially in the brain, even when the disease manifests only at a mild subsyndromal level, the brain lesions have already begun a progressive process of development from mild to severe. As the disease progresses and worsens, the degree of brain lesions deteriorates, and the external abnormalities and functional impairment of the patient become more severe, reaching a clinical syndrome state that meets the diagnostic criteria. At this point, most parents and relatives become aware of the serious impact of the patient’s condition on the patient’s social functioning and quality of life, and begin to seek professional explanations and solutions for the patient’s disease phenomenon. However, in the initial stage most parents and relatives of the patient will be lucky. On the one hand, they think that their child will not have a major problem or even that it is more likely that they are allergic and making a fuss about it. On the other hand, after they realize that their child is really sick, they also think that the doctors will have the magic hands and the elixir to get rid of the disease so that their child can recover instantly. Even if the recovery is not instant, they tend to believe that once the treatment is given, there will be an immediate effect. As a result, parents and relatives of these patients often have unrealistically high expectations for treatment, believing that their children do not need to be hospitalized or take long-term medication like other patients. In fact, their judgment and expectations are wrong. The reason is that both the length of a mental disorder and its severity, by the time a patient develops clear symptoms of the illness, are equivalent to an iceberg floating in the sea, and we see the part that floats above the surface. First, the long course of the illness is the fundamental reason why it is difficult to produce an immediate cure for mental illness. Because the majority of mental disorders only begin to receive attention and treatment after a long course of latent and worsening illnesses in adolescence and even childhood. As revealed by contemporary psychiatric research, most of these disorders are caused by developmental defects in the nervous system that may be genetic in origin, and the brain lesions slowly and comprehensively worsen and deteriorate according to their own pattern before receiving regular treatment, and may not tend to improve until regular intervention. Moreover, the long course of the disease leads to long-term isolation from the peer group, which in turn has the knock-on effect of impaired social functioning and poor psychological development. Such a process is obviously “it takes more than one day to freeze three feet of ice”, and the treatment process is bound to be “it takes more than one day to penetrate the stone”, and it is impossible to achieve quick results. Secondly, the severity of mental illness is also an important reason why treatment is difficult to achieve quick results. Many patients not only have the aforementioned characteristics of latent onset and long duration of illness, but also have the problem of a more serious degree of illness. On the one hand, the severity of the disease is such that the symptoms of the disease are so prominent that it is not enough to treat them effectively without hospitalization. On the other hand, in addition to the psychiatric disorders that have attracted the attention of the family and can be diagnosed as serious by the physician, there are a variety of psychiatric co-morbidities that are not necessarily serious but have a significant negative impact on the patient’s quality of life and social functioning, complicating the condition. The third aspect is the low level of psychological development and poor social functioning associated with the young age of onset, the prolonged course of the illness, and the prolonged absence from a social environment suitable for growth. These three aspects of the disease are reflected in a greater degree of severity, which makes it more difficult to treat and also makes the treatment period longer. Third, the lack of rapid onset of treatment is also a characteristic of current psychiatric treatment programs and treatment medications themselves. For one, almost all psychiatric medications are symptomatic, and the current mainstream view of treatment emphasizes the principle of single medication, which fails to take into account all the symptoms present in patients, affecting the efficacy or slow improvement of the condition. Second, the dosage of medications for patients is limited by the evidence of so-called “evidence-based medicine” studies, and the dosage is relatively inadequate or relatively fixed, which makes it difficult to tailor the dosage to the individual and the disease, and may also be a factor affecting the time to effect. For example, heavier patients may require a higher effective dose and a later onset of treatment; heavier patients require a higher dose of medication due to a larger apparent volume of distribution. Third, almost all psychiatric medications require progressive dosing to reach a dose that is considered effective by the physician. This process can be prolonged by physicians seeking to be prudent and cautious, or it can be delayed by patients who cannot tolerate it and need to change their medications and restart treatment. Fourth, the slower onset of psychiatric treatment is also related to the patient’s compliance and motivation and actual effort to function and recover. In most cases, patients with mental disorders are not self-aware, and even those who only suffer from generalized anxiety believe that their emotional problems originate from somatic causes, or even that their somatic symptoms are the problem that needs to be addressed or the illness that needs to be treated. Thus, overall, patients with mental disorders are a group that lacks self-awareness. Due to the lack of self-knowledge, patients have poor compliance with treatment and lack of motivation to pursue the best possible outcome. On the one hand, their motivation and incentive to follow medical advice and cooperate with various treatment measures are lacking, and it is extremely common for them to skip medication and reduce dosage on their own, which, together with insufficient motivation to change maladaptive behaviors, will inevitably affect the efficacy of treatment. On the other hand, patients often mistakenly believe that psychiatric treatment fails to be symptomatic, especially for their somatic symptoms, and are concerned about the adverse effects of psychiatric medications, often intentionally choosing their own medications, reducing and stopping them at will. They may also seek non-psychiatric treatment for their somatic symptoms, such as Chinese herbal medicine, which may be ineffective due to drug interactions, thus affecting the efficacy of treatment. In some cases, patients do not believe that they are sick and do not trust their doctors’ expertise, so they are treated according to their physical illnesses, such as taking drugs for arrhythmia and hypertension to treat the cardiovascular symptoms of anxiety, and consuming certain supplements and Chinese herbal medicines to treat the lack of energy of depression, which are obviously the opposite of curing their mental disorders. approach. The personality and behavior of most patients with mental disorders also have many factors that affect the effectiveness of treatment. For example, patients’ more introverted, passive, and stubborn personalities make it more difficult for them to actively establish connections with the outside world, more likely to be deeply involved in introverted mental activities for longer periods of time, or what is commonly referred to as “bull-headedness,” more difficult to engage in active social activities, and more often to adopt an avoidance behavior pattern of “knowing when to quit. “These characteristics often contribute to the patient’s inability to enter into socially active situations. These characteristics often cause patients to fail to enter a good and positive recovery mode, delaying the time and process of improvement. Due to these and other adverse factors, it is often difficult for patients with mental disorders to achieve the desired outcome in a relatively short period of time after receiving treatment. If we hope that patients with mental disorders can be cured through standardized treatment, we need not only reasonable treatment strategies and programs, but also the right type and dosage of medication, longer treatment period and more active and comprehensive rehabilitation measures. Only through such comprehensive treatment can the patients’ brains, which have initiated the lesion process very early, finally be fully repaired and their social functions fully restored, so that they can become healthy individuals who are completely free from mental disorders. The above analysis of mental disorder treatment is difficult to obtain immediate effect can be briefly summarized as follows: the disease process is frozen three feet is not a day’s cold, the healing process is also naturally a drop of water through the stone is not a day’s work. Patience and persistence are necessary to win a comprehensive victory against mental disorders.