Las políticas de la psiquiatría

En todo el mundo, las inversiones anuales en investigación científica para curar patologías mentales devastadoras como el trastorno bipolar, la esquizofrenia y la depresión clínica son gigantescas -comparables con el gasto destinado a encontrar una cura para cualquier otra enfermedad-. Pero si bien los trastornos mentales son efectivamente enfermedades médicas, con sus propias moléculas culpables y anatomías aberrantes, también son significativamente diferentes de las enfermedades "físicas". Ya que no importa cuán absolutamente "médicas" sean las enfermedades mentales, también son absolutamente sociales. Las razones para esto surgen de la naturaleza de los propios trastornos mentales.

No hay duda de que patologías como las enfermedades cardíacas, la neumonía o la diabetes tienen un fuerte impacto en la personalidad de quien las sufre y su lugar en la comunidad. Pero sólo en enfermedades como la esquizofrenia, el trastorno bipolar, el desorden obsesivo-compulsivo y la depresión encontramos procesos de enfermedad que transforman directa y profundamente la personalidad y la identidad de una persona así como su lugar en la comunidad.

Una persona con esquizofrenia puede experimentar su personalidad como otra, experimentar su identidad como si estuviera controlada por otros y considerar que toda la comunidad es sospechosa y amenazadora. Una persona en la fase maníaca del trastorno bipolar, además de fallas de criterio graves y hasta riesgosas para la vida, tiene una sensación extraordinaria de bienestar que quienes están mentalmente sanos rara vez experimentan, si es que alguna vez llegan a experimentarla. El individuo con desorden obsesivo-compulsivo teme y a la vez se siente avergonzado por las obsesiones y compulsiones irracionales y, al mismo tiempo, incurrir en estos pensamientos y acciones le resulta irresistible. La persona con depresión clínica considera que todo su ser es oscuro e insípido, desprovisto de sentimientos humanos comunes como la expectativa, el placer y la significancia.

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