Alzheimer’s disease, is it a mental illness?

Alzheimer’s disease is formally recognized as a mental illness. The disease and its symptoms are outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which is the main tool used to diagnose mental illnesses such as Schizophrenia and Borderline Personality Disorder. However, there is danger in viewing Alzheimer’s disease as a mental illness in regards to societal stigma and treatment approaches.

The Stigma of “Mental Illness”

Popular culture often paints a scary, intimidating, misunderstood, damaging, and unfortunate view of “mental illness.” When the words Alzheimer’s disease and mental illness are paired, the stigma knows no bounds. People who are unfamiliar with the symptoms and etiology of Alzheimer’s disease may take an equally negative stance toward individuals who live with the disease. The danger lies in the potential for individuals diagnosed with Alzheimer’s disease to be treated with disrespect, fear, and contempt. As addressed by Dr. Joseph J Sivak’s February, 18, 2010 blog article “I Hate Alzheimer’s,” societal stigma of mental illness may permeate the image of Alzheimer’s disease and could result in compromised care. Jaimie Robinson, Chicago Bridge Blog Writer, also wrote about this stigma in a recent post title Are you afraid of Alzheimer’s: 8 Considerations.”

Treatment Approaches

Approximately 90% of individuals who live with Alzheimer’s disease in the  late stage Alzheimer’s disease residen in skilled nursing facilities. There has been some attention from media outlets to the dangers of elderly Alzheimer’s patients living with individuals with severe mental illness in terms of general safety concerns for the older residents. Another important thing to consider is the regular use of psychotropic drugs in nursing facilities to suppress the behaviors of those with mental illnesses. With new approaches to Alzheimer’s care calling to limit the use of pharmacological interventions, nursing home staff must experience a shift in mentality and practice. Therefore, staff must begin to view and approach care for individuals diagnosed with Alzheimer’s disease differently than that of people with mental illness.

Eliminating Alzheimer’s disease from the DSM

While stigma and treatment approaches take time and dedication to change, the American Psychiatric Association has the power to make the first big step toward re-classifying Alzheimer’s disease by eliminating it from the DSM. Until that happens, medical and psychology professionals in training will continue to learn of Alzheimer’s as a mental illness. Many thanks to Emily Langendorf and Jaimie Robinson for editing this post.  And, schnaars for letting us use this photo.

For more information on Alzheimer’s disease, read the following Chicago Bridge blog posts.

Are you afraid of Alzheimer’s disease: 8 Considerations

Posted on May 13th, 2011 by Jaimie Robinson
Are you afraid of Alzheimer’s disease: 8 ConsiderationsWhat are you afraid of? Many Americans fear Alzheimer’s disease. It is clear that misunderstanding details of the disease and the lack of treatment or prevention will add more to the fear factor number. Fear can impede, fear can be perceptive, fear can motive and fear can advance research.
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Five Myths/Misnomers of Alzheimer’s disease and other related disorders

Posted on March 7th, 2011 by Jaimie Robinson
Five Myths/Misnomers of Alzheimer’s disease and other related disordersLet’s face it, Alzheimer’s disease and other types of dementia, are complicated to understand. In fact, we don’t even completely understand the various types of dementias — where it comes from, why it progresses, how it progresses or how to treat it or prevent it. But, there are things we do know about Alzheimer’s disease and other related disorders. It is important to clarify these points to help increase awareness and reduce stigma
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Early Detection of Alzheimer’s disease: The good, the bad and the big questions.

Posted on January 13th, 2011 by Jaimie Robinson
Early Detection of Alzheimer’s disease: The good, the bad and the big questions.Early detection. It is a phrase we hear a lot today in our health conscious world. Early detection of breast cancer, have a mammogram starting around age 35. Early detection of cervical cancer, stay on top of your scheduled Pap smear. After age 50 we should begin making plans for regular colonoscopies to detect colon irregularities. Many of these detection screenings are recommended after the age of 50. Will Alzheimer’s disease and related dementias become a part of this wave? Should you add the dementia screening to your annual plans after you turn 50, maybe even 40?
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Discussions in Alzheimer’s and Dementia Care: In case you missed it!

Posted on January 1st, 2011 by Jaimie Robinson
Discussions in Alzheimer’s and Dementia Care: In case you missed it!What is dementia? How is it different from Alzheimer’s disease? As a person working in the field of aging, how can I help someone with a dementia or who maybe having cognitive changes, like memory loss? What about people living with a behavioral type of dementia, how can we best help them? Chicago Bridge members discussed these questions and more in the December 2010 meeting. Find out some of the solutions and answers the group came up with.

3 Comments

  • Sallie Schwartzkopf

    I am an architect of 25 years, but fascinated with Alzheimer’s Disease and advocacy for the elderly, and looking to change careers. I found this blog very interesting. My father suffered from bi-polar disorder and my mother now suffers from Alzheimer’s disease.

    In the early 70’s when my father was diagnosed, the stigma was fierce. It was not openly discussed with friends or relatives and counseling for him or the family was not mentioned. My mother struggled pretty much alone, even though, she later found out, close personal friends of her and my father’s were going through the same crisis. They did not share with eachother their struggles nor their mutual support – what a missed opportunity. I attribute this to the stigma; their freinds, I surmise, didn’t want it known that they were dealing with mental illness too. Later, when my father became functional again and rejoined the work force, he worked so hard to create for himself all the job opportunities anyone without a mental illness would have in his field. He so wanted to be”‘normal”. Who wouldn’t. But it is the stigma, I believe, that led him to repeatedly try to go without his meds, to try to prove he could be “normal”. He would relapse of course; this was a poor choice. My father was a complex human being outside of the mental illness so I recognize to attribute all negative behavior to a stigma would be oversimplfying, but I believe support, or lack of it, can make a difference. Why apply a stigma to mental illness? My theory is that people see in themselves confusion and weeknesses at times when stress and life challenges can take a huge toll, they get lost; they fear they will become “wacko” too. It hits too close to home; they don’t want to be one of “them” so they try to distance themselves.

    With Alzheimer’s, my experience is different. I am the care giver of my mother, being her only child in this city with her; she lives in an assisted living facility. My brothers have cared for her in their homes as long as they could; wives and small children were too demanding. I take my mother when I can to family/friend events back in our hometown and she is welcomed with open arms, participates socially. People in her Chicago community, outside her home, treat us with respect and consideration. I believe the general population today knows or has been exposed to so many people with Alzheimers that it has become familiar to them. I also think the unknown factors of the disease, how it is generated, other than getting old, suggests to them that anyone is open to getting it. We all feel like this could be me through no fault of our own.

    I ask different questions about the DSM. Granted, I have not seen first hand the prejudice subjected to Alzheimer’s Disease sufferers. From my point of view I ask:
    What if the familiarity of, openness and compassion towards Alzheimers Disease shed new light and understanding on other mental illnesses? especially when the stresses were just beginning to take their toll and manifest themselves as mental illness?
    What if we recognized that we don’t really know exactly what causes mental illness, that it is a complex development too, and we all could fall to it without the support and education it takes to understand it and/or grow in a healthy way?
    What if the compassion, at least consideration, I see offered to my Alzheimer’s Diseased mother, were offered to my suffering stressed out father? I would bet it could have turned out differently.

  • brian gordon

    The classification of alzheimer’s disease in the dsm has some very real and practical impacts on the victim of alzheimer’s disease and their families. Many victims and families rely on the insurance policies for disability benefits that may have been purchased by the victims prior to awareness of the diagnosis. Many of these policies provide for a 24 month “mental and nervous disorders.” With alzheimer’s categorized as a mental illness can result in the insurer terminating benefits on the basis of alzheimer’s being a mental illness! In fact, same insurance companies actually define mental illness as anything listed in the dsm despite the fact that it has an organic basis that can now be used to perform a lab test as diagnosis. victims are being financially hurt by having the diagnosis included in the dsm despite the fact that the dsm iv tr (test revision) work group has clearly indicated that the manual was never intended to be used to define what is or is not mental illness. So, the inclusion of alzheimer’s disease in the dsm actually results in financial injury to the patient and their families!

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