Discussion What makes some people incurable?

[Forever Sleep]

Firstly, are some mental illnesses incurable? Presumably some are treatment resistant. Is it really as simple as that though when it's mental? Assuming 'treatment resistant' largely refers to medication. But then, it's hardly like antibiotics that either do or don't clear up an infection. It's surely, far more complicated than that with the brain.

I assume it means everything: drugs, talking and behavioural therapies, right up to ECT. So- why don't they always work? Even for people who say they're eager to recover? I mean, they kind of must be to put themselves through that.

Is some of it will power do you suppose? (Not meaning to victim blame here.) I sometimes wonder if negative patterns of thinking and ideation become a sort of addiction. I definitely think self harm could be in some cases. In a weird way, does it make us feel 'better' or, at least as if we can cope, when we 'indulge' in pessimistic thinking and/ or self harm? That's not to say those things are pleasant in themselves necessarily but, they can certainly become familiar and require less effort in a way than to force ourselves to think and act possitively. (In my experience anyway.)

If it is a sort of addiction, I could compare it to something I really struggled with: binge eating. When that had hold, there would be an intensely strong compulsion to stuff my face with junk.

I suppose what made me finally break those cycles was hatred at being overweight and I suppose, a strong desire to be thin. It had to be overwhelmingly strong for me to actively eat healthy and lose weight though. I only really managed that properly once for any prolongued period.

But, maybe that's part of the problem with overcoming things like depression. Do we really have some great goal we're working towards? Can anything give us the sense of relief that self harm and ideation can? Are we repulsed enough by our more destructive thoughts and actions?

I think a part of the problem (mine certainly,) is that I've embraced some of these things as a part of my personality. So, I would be actively loathed to let them go. They've become easier and addictive to fall back on. Plus, there's no believable reward that makes me think my life would be so much better without them. For me in any case, whether I have a mental illness or not, I simply don't have the will to 'recover'.

I imagine that could be part of the problem. I'm not sure these drugs and other therapies work on their own. I think we have to so strongly want them to work and I think we have to be actively fighting all the other stuff. I just know I wouldn't put the work in there.

What are your thoughts?

 

[Pale_Rider]

Well in my case where I was put through traumatic abuse so that my brain couldn't develop properly. In fact I have Dissociative identity disorder. There is no fixing that. Nobody even says that can be fixed. Then I developed severe PTSD later. Sure the internet says it last a year, but it doesn't go away. The pro-lifers just say that so people dont ctb.

 

[Forever Sleep]

Well in my case where I was put through traumatic abuse so that my brain couldn't develop properly. In fact I have Dissociative identity disorder. There is no fixing that. Nobody even says that can be fixed. Then I developed severe PTSD later. Sure the internet says it last a year, but it doesn't go away. The pro-lifers just say that so people dont ctb.

I only really know the pop psychology version of DID. It sounds so fascinating but, terrifying at the same time. I'm sorry. I imagine that must be very difficult to live with.

Have there ever been cases where people revert back to one identity- do you know? Is that even correct? I'm assuming you have multiple alters? Do you get to control them- may I ask? Or, is it like they decide on who's forefront?

 

[identity0]

I don't really believe in the whole model. There are some exceptions where there's a clear neurological abnormality, but a lot of the time the "mental illness" diagnosis model is too deeply flawed to really categorise the problems that people have with living in society. "it is no sign of health to be well-adjusted to a sick society" and so on. Treatments like "take a SSRI" or "talk to this random person that doesnt even know you for an hour" are a joke when it is so complex to understand what truly caused someone's depression or anxiety. People are trying to solve the question of how to live and how society should be, which has to touch on all of philosophy, sociology, biology, chemistry... It's like a chimpanzee trying to build a quantum computer with a hammer.

 

[Praestat_Mori]

Firstly, are some mental illnesses incurable? Presumably some are treatment resistant.

An illness that is treatment resistant (=cannot be treated) = incurable. It's just worded in a different way.

Mental illness isn't a typical illness. There're possibly genetic issues, the brain not working as it should, trauma, abuse (and a lot more!). Our brain saves everything and nothing can be deleted.

Most likely someone who is suffering bc of a traumatic experience could be cured if exactly this experience could be deleted. But this not gonna work we have no means to format a brain or delete memories partly.

Depression by itself is also a protection mechanism we have when we're overwhelmed and just need rest.

 

[Pale_Rider]

I only really know the pop psychology version of DID. It sounds so fascinating but, terrifying at the same time. I'm sorry. I imagine that must be very difficult to live with.

Have there ever been cases where people revert back to one identity- do you know? Is that even correct? I'm assuming you have multiple alters? Do you get to control them- may I ask? Or, is it like they decide on who's forefront?

I can only speak about how it was for me, but it has been like living in a horror movies. Especially early on. In fact I blocked it, and couldn't accept it for 15 years. Just went about my life blissfully ignorant. Finally 10 years ago I committed suicide, and therapists then worked hard to have me accept this reality. It was very hard, but I eventually blocked that for another 8 years. Now the last two years have been very painful as those realities came back to me in pieces.

So as far as my research the best that can be hoped for is "co-consciousness". Which is what I have to the best of my knowledge. ( I dont have large period of missing time ) . What is different is we may, or may not see the world the same. We can, and do have different opinions. Basically yes there can be internal hard feelings, and strife. We are structured as a martial government so we respect chain of command ( for the most part ). That helps.

We have at least 6 alters. I understand the positions I believe of them. I can never really say exactly who is "fronting". Thats a weird part. Aslo we have tried to respect each other for the most part, but as we negotiate life an alter can become unhappy with a move, or position. We have to have consideration for each other I have tried to learn, but sometimes an alter can have a position that others just cant accept. That causes problems.

I can tell you for myself DID is nothing like TV. Dont expect to see obvious switching. At one time we had some obvious switching, but being the machine I am we worked to silence those.

More on "the machine". It has been explained to me by therapists that being a person with DID gives me special mental abilities, and controls not available to the mere mortal ( lol ) . We have at least one "gatekeeper". The gatekeeper is the key allowing us to will into existence new patterns of behaviors a normal psychology is not capable of.

So I may have rambled a bit, and I far from completely understand this stuff. I just have myself, and the internet research I have done, and what therapists have told me.

Thanks for listening.

 

[Hotsackage]

I don't think things can get cured, in some cases maybe, approach to how you are dealing with it and meds can negate it's affect, and limit mental illnesses impact on you.

 

[bankai]

That's because some people are incomplete. Probably since birth. I don't know what it is, hormonal, chemical,something very intrinsic to your well being is missing. As you grow up, therapists and doctors can try to fix that with medication. But those are just poor substitutes.

 

[Forever Sleep]

I can only speak about how it was for me, but it has been like living in a horror movies. Especially early on. In fact I blocked it, and couldn't accept it for 15 years. Just went about my life blissfully ignorant. Finally 10 years ago I committed suicide, and therapists then worked hard to have me accept this reality. It was very hard, but I eventually blocked that for another 8 years. Now the last two years have been very painful as those realities came back to me in pieces.

So as far as my research the best that can be hoped for is "co-consciousness". Which is what I have to the best of my knowledge. ( I dont have large period of missing time ) . What is different is we may, or may not see the world the same. We can, and do have different opinions. Basically yes there can be internal hard feelings, and strife. We are structured as a martial government so we respect chain of command ( for the most part ). That helps.

We have at least 6 alters. I understand the positions I believe of them. I can never really say exactly who is "fronting". Thats a weird part. Aslo we have tried to respect each other for the most part, but as we negotiate life an alter can become unhappy with a move, or position. We have to have consideration for each other I have tried to learn, but sometimes an alter can have a position that others just cant accept. That causes problems.

I can tell you for myself DID is nothing like TV. Dont expect to see obvious switching. At one time we had some obvious switching, but being the machine I am we worked to silence those.

More on "the machine". It has been explained to me by therapists that being a person with DID gives me special mental abilities, and controls not available to the mere mortal ( lol ) . We have at least one "gatekeeper". The gatekeeper is the key allowing us to will into existence new patterns of behaviors a normal psychology is not capable of.

So I may have rambled a bit, and I far from completely understand this stuff. I just have myself, and the internet research I have done, and what therapists have told me.

Thanks for listening.

It's really interesting from an outsiders point of view but I can imagine it must be incredibly difficult to live with. It's hard enough as it is dealing with things in life we dislike but to have multiple alters that like and dislike different things, even the same thing must feel bizarre. Do you almost develop a fear of upsetting an alter?

Yeah, I imagine initially, it must be terrifying to experience. Can you remember a time you were singular- as it were? But then, obviously don't if that means remembering trauma. The brain is such a complicated thing.

 

[Griever]

No therapy and no medication can cure my mental illnesses

 

[evanescent_eva]

I have no intention of discounting OP or anyone else who feels like their particular experiences of ideation or self-harm are issues of addiction or willpower. With that said I think there are a *lot* of potential reasons why mental illnesses can be incurable that aren't issues of addiction or willpower. Let's start with depression, which seems to be the focus of the OP:

• It could be a neurotransmitter issue that current medical science doesn't have the ability to solve. For example, I received real, albeit temporary relief from my depressive symptoms when I was taking ketamine, which suggests that my issues are at least related to my brain's overproduction of glutamate. However, current science is literally currently incapable of optimally regulating glutamate production consistently enough over time in order to cure depression - there simply aren't drugs that can do that yet. But that doesn't mean that people suffering from glutamate overproduction are just "addicted" to suicidal ideation, any more than people in the 1940s were "addicted" to suicidal ideation because Prozac hadn't been invented yet.
• It could be a neuroinflammation issue that current medical science doesn't have the ability to solve. There are *lots* of ways this can manifest, but to take just one as an example: there are people who have had viral infections that were never fully cured, that simply hide out in those people's spinal columns. The body senses that a viral infection is still present in the spinal column, and so the body activates a hyper immune response. However, because the infection is hidden, the immune response doesn't actually cure the virus - but it does absolutely fuck up the brain and body. This can go on for years, causing literally irreversible damage to the brain, and consequently irreversible treatment-resistant depression.
• It could be that depression is a progressive illness, causing more and more structural changes to the brain over time the longer a person suffers from it. As a result, if you don't treat the root cause of the depression quickly enough - even if the root cause was initially treatable - the brain can be so fundamentally changed by the course of depression that treatments no longer work. (This is not my theory, there are Nature articles about this!)
• It could be something else entirely that science isn't advanced enough to even articulate. Neuroscience is so new that it wasn't even recognized as a unique discipline until the 20th century. We currently know next to nothing about how the brain works, in the grand scheme of things. A little intellectual humility on why people with depression continue to suffer might be warranted!!

But all that assumes that depression is the only mental illness that is worth talking about in the context of suicidality. We understand far less about personality disorders than we do depression, and many of them are considered incurable as a result. It is preposterously easy to find a mental health professional who will tell you that borderline personality disorder is incurable, for example - and equally easy to find accounts of people with BPD on this forum that describe just how difficult a condition it is to treat, not to mention live with.

As another example, schizophrenia and psychosis have ~30% rates of treatment resistance, but it immediately becomes kind of silly to think about treatment failure as an issue of willpower or addiction. Even trying to phrase what that would look like is a challenge: "I'm addicted to the feeling of hallucinating shadow people coming out of the darkness to strangle me, and that's why my clozapine isn't working?"

And the list goes on. I think this is all to say that each person is different, and so is their experience of their own mental illness, and so are the reasons and the extents to which their mental illness(es) can or can't be treated or cured.

 

[Pale_Rider]

It's really interesting from an outsiders point of view but I can imagine it must be incredibly difficult to live with. It's hard enough as it is dealing with things in life we dislike but to have multiple alters that like and dislike different things, even the same thing must feel bizarre. Do you almost develop a fear of upsetting an alter?

Yeah, I imagine initially, it must be terrifying to experience. Can you remember a time you were singular- as it were? But then, obviously don't if that means remembering trauma. The brain is such a complicated thing.

Well I thought I was singular at one time. Then I was in a psych ward, and they started trying to get me to see. Had me go think about what they were telling me. It was beyond terrifying! I went crazy to even think about it. I thought the Drs were actually demons, and they had put a spell on me. It felt like possession. There was more then one person in my body. I was beyond scared. So it was blocked pretty quickly. ( later on the second attempt to show me the therapist helped me to recover those memories. )

Then when you can make it past the terror, and see that its not a demon, or demons grief kicks in. Its very hard to accept the level of damage delivered by somebody who was supposed to love you, and nurture you. I felt completely separated from the world, and humanity.

I cant really comment on how the alters relate. We have been trying to get along, and we will keep trying to work towards some harmony.

As far as the brain the way this happens is a child at some point sheds his child personality, and starts to build the personality he will have as an adult. If that child is subjected to continued trauma the child self isnt discarded, but the adult personality will still work to develop. Once that first split is established the process can continue as the mind needs to. Thats how I understand it.

 

[Forever Sleep]

I have no intention of discounting OP or anyone else who feels like their particular experiences of ideation or self-harm are issues of addiction or willpower. With that said I think there are a *lot* of potential reasons why mental illnesses can be incurable that aren't issues of addiction or willpower. Let's start with depression, which seems to be the focus of the OP:

• It could be a neurotransmitter issue that current medical science doesn't have the ability to solve. For example, I received real, albeit temporary relief from my depressive symptoms when I was taking ketamine, which suggests that my issues are at least related to my brain's overproduction of glutamate. However, current science is literally currently incapable of optimally regulating glutamate production consistently enough over time in order to cure depression - there simply aren't drugs that can do that yet. But that doesn't mean that people suffering from glutamate overproduction are just "addicted" to suicidal ideation, any more than people in the 1940s were "addicted" to suicidal ideation because Prozac hadn't been invented yet.
• It could be a neuroinflammation issue that current medical science doesn't have the ability to solve. There are *lots* of ways this can manifest, but to take just one as an example: there are people who have had viral infections that were never fully cured, that simply hide out in those people's spinal columns. The body senses that a viral infection is still present in the spinal column, and so the body activates a hyper immune response. However, because the infection is hidden, the immune response doesn't actually cure the virus - but it does absolutely fuck up the brain and body. This can go on for years, causing literally irreversible damage to the brain, and consequently irreversible treatment-resistant depression.
• It could be that depression is a progressive illness, causing more and more structural changes to the brain over time the longer a person suffers from it. As a result, if you don't treat the root cause of the depression quickly enough - even if the root cause was initially treatable - the brain can be so fundamentally changed by the course of depression that treatments no longer work. (This is not my theory, there are Nature articles about this!)
• It could be something else entirely that science isn't advanced enough to even articulate. Neuroscience is so new that it wasn't even recognized as a unique discipline until the 20th century. We currently know next to nothing about how the brain works, in the grand scheme of things. A little intellectual humility on why people with depression continue to suffer might be warranted!!

But all that assumes that depression is the only mental illness that is worth talking about in the context of suicidality. We understand far less about personality disorders than we do depression, and many of them are considered incurable as a result. It is preposterously easy to find a mental health professional who will tell you that borderline personality disorder is incurable, for example - and equally easy to find accounts of people with BPD on this forum that describe just how difficult a condition it is to treat, not to mention live with.

As another example, schizophrenia and psychosis have ~30% rates of treatment resistance, but it immediately becomes kind of silly to think about treatment failure as an issue of willpower or addiction. Even trying to phrase what that would look like is a challenge: "I'm addicted to the feeling of hallucinating shadow people coming out of the darkness to strangle me, and that's why my clozapine isn't working?"

And the list goes on. I think this is all to say that each person is different, and so is their experience of their own mental illness, and so are the reasons and the extents to which their mental illness(es) can or can't be treated or cured.

That's all very well put and true- it makes it seem silly to generalise all mental illness or even depression as an addictive or compulsive pattern of thinking. I maybe meant in certain cases rather than all. I'm not meaning to suggest that mental illness, including very serious conditions don't exist and can simply be willed away! That would be so dismissive.

I think maybe it's my frustration with modern medicine which is supposed to (and does in many cases) work wonders yet, so many people seem to still be suffering. The bigger frustration I suppose is when it's seen as a cure-all solution when it actually seems very hit and miss.

I suppose I didn't really phrase it properly in that I was probably just considering my own experience. If I even have any mental illness, I have a feeling I would almost be reluctant to get rid of it! Certainly to put in the effort to fight it anyway. So, rather a selfish and narrow perspective really. I should have thought about it for longer and phrased it differently really.

I suppose that is an issue that bothers me deeply about psychiatry though really. Why don't we know more about how the brain works? I just get the impression that so much focus is placed on theories rather than the organ itself. It's a bit like a 'philosopher' knowing all the different philosophers and their ideas without thinking about life themselves. I could be totally wrong again of course. Maybe there is extensive research but, to little avail.

Your examples were fascinating though. Some I'd never even heard of. The immunity response for instance. That makes a lot of sense. Thank you for your response.

Well I thought I was singular at one time. Then I was in a psych ward, and they started trying to get me to see. Had me go think about what they were telling me. It was beyond terrifying! I went crazy to even think about it. I thought the Drs were actually demons, and they had put a spell on me. It felt like possession. There was more then one person in my body. I was beyond scared. So it was blocked pretty quickly. ( later on the second attempt to show me the therapist helped me to recover those memories. )

Then when you can make it past the terror, and see that its not a demon, or demons grief kicks in. Its very hard to accept the level of damage delivered by somebody who was supposed to love you, and nurture you. I felt completely separated from the world, and humanity.

I cant really comment on how the alters relate. We have been trying to get along, and we will keep trying to work towards some harmony.

As far as the brain the way this happens is a child at some point sheds his child personality, and starts to build the personality he will have as an adult. If that child is subjected to continued trauma the child self isnt discarded, but the adult personality will still work to develop. Once that first split is established the process can continue as the mind needs to. Thats how I understand it.

Shit, your experience sounds terrifying. It's awful that you went through that on top of everything else.