That would be like saying that a doctor shouldn't go and see a specialist if for example they have a spinal problem.

In the Sign of Three Sholto asks John if he is still seeing the 'trick cyclist'; that expression has been around for a long time in the Armed Forces, and the attitude it reflects is one of the difficulties in treating people with a military background. It can be difficult enough at the best of times to get people to accept that they have a mental illness because our culture draws a dividing line between what is seen as 'real illness' and something which is all in the head, in which case all they have to do is pull themselves together and everything will be fine. People with mental health problems can't pull themselves together; it doesn't work like that.

For example, I have a severe and progressive lung disease and have therefore spent a hefty chunk of my life in hospital, which is very obvious and therefore perceived as 'real illness'; nobody suggests that I can stop my lungs bleeding by pulling myself together because it's self-evidently ludicrous.

But I also got blown up by an exploding oxygen regulator when I was 36 weeks pregnant and, unsurprisingly, developed PTSD; I can say from personal experience that pulling myself together so that I did not have a permanent video loop of that playing in my brain was just as impossible as pulling myself together so my lungs stopped bleeding. There is no way in which I could have been educated so I would not have developed PTSD.

And, also from personal experience, therapy is not a shoulder to cry on; CBT is hard work, though obviously very worthwhile hard work. People with mental health problems are just as ill as people with lousy lungs or dodgy hearts; doctors may be unable to cure them but then there are a lot of things which are incurable but treatable. Nobody suggests that it's not worth treating my pneumonia because I'll get pneumonia again in a few months time; treating me obviously improves the quality of my life.

belis may not be able to cure all her patients either but she may be able to make their lives easier and more enjoyable, and she may also be able to improve the quality of life of the people who interact with her patients. That is what medicine is supposed to be about.

Of course, John is not in an ideal position to make progress in his therapy because he can't tell his therapist about his (fake) wife being a killer who almost killed his best friend, but I suspect that problem is fairly rare...

While I would say that a bad psychiatrist or therapist is worse than none a good one can help you achieve miracles. Yes it's the patient who does the work themselves, but they would never be able to do it without the assitance of the psychiatrist/therapist.
Also educating children about mental health wouldn't help in all cases. To give an equivalent example with physical health I beleive that teaching people at whatever age how to eat healthily, rememeber exercise and treat minor injuries on their own, etc is important, I will be the first to call 999 if I break something and would never encourage anyone to try and treat that themselves. For that you need an expert.
It's the same for mental injuries. Most things we can take care of on our own, but when you have the psychological equivalent of a broken leg or ruptured speen, you need a professional.

belis wrote:

Ormond Sacker wrote:

It's the same for mental injuries. Most things we can take care of on our own, but when you have the psychological equivalent of a broken leg or ruptured speen, you need a professional.

That's a very good way to put the point across.

There is often an expectation that people with mental illness should be able to 'pull themselves together' or 'snap out of it' and that if they can't than they are clearly not trying hard enough. It's a serious barrier to people seeking help.
 

 
Oh God, I've lost count on the number of times I've run into the "well just pull yourself together" syndrome. I've even run across it in psychiatry, but that's a different story and a long one so I'll spare you. In fact the broken leg analogy was one I came up with during one of the many conversation I've had on this topic.

Concerning the OP I would like to add that I don't think you can say that one is more important than the other in this. Like simple first aid and complicated trauma surgery you can't compare them, but we need both.

Ormond Sacker wrote:

While I would say that a bad psychiatrist or therapist is worse than none a good one can help you achieve miracles. Yes it's the patient who does the work themselves, but they would never be able to do it without the assitance of the psychiatrist/therapist.
Also educating children about mental health wouldn't help in all cases. To give an equivalent example with physical health I beleive that teaching people at whatever age how to eat healthily, rememeber exercise and treat minor injuries on their own, etc is important, I will be the first to call 999 if I break something and would never encourage anyone to try and treat that themselves. For that you need an expert.
It's the same for mental injuries. Most things we can take care of on our own, but when you have the psychological equivalent of a broken leg or ruptured speen, you need a professional.

Yes; I didn't mean to suggest that I was the one doing all the hard work because the therapist was working very hard too: it's very much a joint activity guided by the therapist, and I was very fortunate in my therapist.

Which is just as well because when we started I couldn't even be in a room with any kind of oxygen source in it without being heavily sedated, which isn't very good if you are supposed to be giving birth shortly,  and generally isn't going to do much for the life expectancy of someone with a severe and progressive lung disease. It took years before I became comfortable enough to at least begin to pretend that I wasn't terrified, but nowadays I can fake it pretty well
 

belis wrote:

I assume that you live with a young person. It's a tricky stage and it's often difficult to draw a line as to whare 'stroppy teenager' ends and a disorder of some sort starts. People often put up with a lot attributing it all to hormones and growing up but actually there maybe something else going on.

Actually I live with a much older person. The best way to describe it is to imagine PMS & multiply that by about 100 & you'll get somewhere close Also, PMS only occurs once a month. This is non-stop PMS symptoms for an average of around 3 years (usually more), after which you will be hormone free for the rest of your life & you can celebrate happily. However during those years where your hormones are leaving your body, the b!tch button that you can usually turn off when you are your normal happy self never gets a chance to switch off. You become a permanent b!tch for the duration of the hormonal drainage. 

I think menopause being one of those taboo topics that no one ever talks about is very poor preparation for when you have to go through it. Most women do not look up any info related to this condition until they are well into their forties or something, by which time it is usually too late to change their frame of thinking. We like to think that we're open to new ideas but as adults, how you think pretty much becomes set by the time you're in your mid-twenties so for a much older woman to learn about an inevitable part of life when they are so near it is a big ask.

The psychological symptoms related to menopause have been compared with schizophrenia in very severe cases. The good thing is that this kind of "schizophrenia" if you wanna call it that, ends when the natural time frame of menopause ends (couple of years). The bad news is that if you are not told about it in advance, you start to question if you really are going crazy & so does your family.

saturnR wrote:

belis wrote:

I assume that you live with a young person. It's a tricky stage and it's often difficult to draw a line as to whare 'stroppy teenager' ends and a disorder of some sort starts. People often put up with a lot attributing it all to hormones and growing up but actually there maybe something else going on.

Actually I live with a much older person. The best way to describe it is to imagine PMS & multiply that by about 100 & you'll get somewhere close Also, PMS only occurs once a month. This is non-stop PMS symptoms for an average of around 3 years (usually more), after which you will be hormone free for the rest of your life & you can celebrate happily. However during those years where your hormones are leaving your body, the b!tch button that you can usually turn off when you are your normal happy self never gets a chance to switch off. You become a permanent b!tch for the duration of the hormonal drainage. 

I think menopause being one of those taboo topics that no one ever talks about is very poor preparation for when you have to go through it. Most women do not look up any info related to this condition until they are well into their forties or something, by which time it is usually too late to change their frame of thinking. We like to think that we're open to new ideas but as adults, how you think pretty much becomes set by the time you're in your mid-twenties so for a much older woman to learn about an inevitable part of life when they are so near it is a big ask.

The psychological symptoms related to menopause have been compared with schizophrenia in very severe cases. The good thing is that this kind of "schizophrenia" if you wanna call it that, ends when the natural time frame of menopause ends (couple of years). The bad news is that if you are not told about it in advance, you start to question if you really are going crazy & so does your family.

Well, no; if you were hormone free then you would be dead, or so my endocrinologists tell me. I suppose this in itself is evidence of your point that women are undereducated about the menopause; if you had been taught more you would realise that we continue to produce a whole bunch of hormones. The tricky bit is that it takes time for the body to deal with the adjustment to lower levels of a number of hormones, and there are symptoms which can be unpleasant.

But there is a huge natural range; some women have few symptoms and others have a dreadful time, but it really isn't possible to know in advance which ones are going to be the unlucky ones. The 'permanent bitch' is a very rare phenomenem; I'm sorry that someone close to you is very unhappy, and obviously making you unhappy too, but this could not be prevented by telling young women that they are going to do this because the vast majority of them won't.

If they were then the murder rate would be a great deal higher than it is, though probably not in a way which would interest Sherlock; telling people that something really horrible will inevitably happen to them is not a good method for improving their mental health. I'm all for education, but am firmly against miseducation, and I think you are generalising from your own situation without realising that your situation is uncommon.

There are treatments which can help; I realise it can be difficult to persuade someone to see their doctor but trying to do so is really a much better option than convincing yourself that this is all doomed and inevitable. It isn't.
 

Mouse wrote:

Psychiatrists attend med school, but I wouldn't want one trying to take out my appendix. I imagine it works the other way round...just because John's a health professional doesn't mean he should be treating anyone for mental health issues, least of all himself.

Lol, you deffinitely wouldn't.

It does work the other way round. Believe it or not but it takes just as long to fully train a psychiatrist as it does to train a surgeon. Very different skills sets and not readliy transferable.

Yes, I agree entirely.  Does depend on type and degree of mental illness. However, I does make it difficult, of not impossible for some people to make any sort of rational decision. Hence my use of the word 'grip'.