Mental Illness: Case Study and Theoretical Perspective

Paullette Ndungu
8 min readMay 11, 2021

The global mental health burden continues to grow every day with considerable impacts on health, social, and economic consequences. Many different forms of mental disorders manifest in various ways, such as abnormal relationships and behaviors, abnormal emotions and thoughts, and perceptions. Mental illness includes bipolar disorders, dementia, depression, schizophrenia, and developmental disorders such as autism (Sinha et al., 2020). Mental disorder treatment takes different approaches and ways of managing the associated suffering.

Studies indicate that about thirteen percent of the world’s population suffers from mental health and substance use disorders (Raphael et al., 2019). The number is likely to go up, especially when the world is fighting the coronavirus pandemic, and people are faced with difficult unprecedented times. It is critical to dismantling the stigma around mental disorders now more than ever. The following is a case study of an individual struggling with mental disorders followed by a theoretical examination of how the disease can be understood under two theoretical perspectives.

Case Study

The case refers to a 40-year-old male, whom I will call Jack for the purpose of this study, who was recently diagnosed with paranoid schizophrenia. Jim lives with his wife and the condition has made his wife to assume a caretaker role and she has to juggle between work and her new role. Jim’s wife is doing all she can to seek the best medical help for him. She prefers outpatient services because of the financial burden and the need to balance with other strikes a balance with her other chores. However, as time progresses, Jim develops medication resistance and general non-compliance to treatment. Consequently, Jim develops recurrent episodes of asocial behavior, sleep deprivation, and depressive symptoms. Her mental state is also aggravated by the concern of his job loss and inability to fulfill simple life obligations.

Jim is exhibiting signs of depression including the feeling of loss of self-worth, emptiness, social alienation, and general lack of interest for otherwise exciting activities. Jim can only communicate with her wife who is also reporting difficulties living with him. I met Jim at a community health facility where he had been referred by his general practitioner who believed the facility was better placed to manage Jim’s condition. After a casual conversation with his wife, I discovered that his condition has some historical roots because apart from his recent job loss, Jim experienced physical abuse at his tender age but has never sought professional help because of guilt consciousness and the thought that it will never amount to anything.

Theoretical Perspective

Symbolic Interactionism

Symbolic interactionism can be used in many ways to give a broad understanding of mental health and mental health illness in society. Symbolic interactionism is founded on three primary principles which focus on how people generate and interpret meaning in the social world. Symbolic interactionism examines the micro-sociological connections between people (Stryker, 2017). The theory focuses on how people create meaning through their routine interactions, how individuals behave and shape their interactions based on these meanings and the different ways meanings transform because of diverse social encounters. The principles of symbolic interactionism can be summarized as:

· Human beings actions towards something is based on the meanings they derive from that thing

· The meanings are a product of social interaction

· Social interaction emerges from individuals fitting together different lines of action

The symbolic interactionism theory holds that mental health and illness are social constructions. Considering illnesses as social constructions means that there is no objective reality about being mentally ill or healthy, rather they are only categorized as such if they are defined as such by society.

Symbolic interactionism approach has led to critical studies on the importance on the interaction mental health patients and healthcare professionals. Not many people accept they have mental challenges and that is probably why most people seek medical help at the advanced stage of their illness. In most other common disorders, we feel unwell and we rush to the nearest health facility or call the doctor to seek professional advice, however, for mental related challenges, it usually takes the people around us intervene. Looking at Jim’s case, he has always been tormented by his childhood experiences but didn’t want to accept they were impactful in his life. It took the deterioration of his state for him to seek medical intervention. Consciously or otherwise, physicians manage mental health issues to show their authority and medical capacity. Patients sometimes wait for long hours to see a healthcare professional who usually appears in a white coat. When doctors emerge, they typically address patients by their first names and use complex medical terms that potentially scare patients and create stigma among the society.

Severe mental illness is stressful adds significant burden to the already complicated life. Patients and their families as witnessed in Jim’s case, experience significant changes in their life. The theoretical foundation of symbolic interactionism can help healthcare professionals work more effectively with severe mental health patients and their families. Symbolic interactionists focus on how individuals, patients and their loved ones, define and experience the world (Stryker, 2017). Nurses and other clinicians are able to provide personalized care if they understand how family members define their experiences. For example, Jim has been severely affected by the feeling of job loss which ideally translates to losing his livelihood. As the patient, Jim is not much worried about the disorder, but largely concerned about how it is affecting his social and economic wellbeing. He is worried that he will no longer be able to support his family nor interact with his colleagues whom he considers as part of his life.

The symbolic interactionism approach can be used as a guiding framework for research and clinical practitioners. Nurses can use its guiding principles to focus on the wholeness of the family’s interactional process and come up with personalized, timely, and effective care. The interactionism approach views medicine as a social practice and disputes any claims that medicine is an objective science. There is potential for patient dissatisfaction in a patient-doctor relationship if the doctor superimposes their medical interpretation of on the experience of a patient by assuming they understand patient’s sufferings and ignoring their health beliefs.

The Biological Perspective

Medicine is increasingly becoming a molecular discipline and causing a significant stir in the psychiatry field (Freitas-Silva & Ortega, 2016). One of the reasons why there is a sizeable stir in these specialties because it has traditionally been dominated by subjective approaches that diverge significantly from quantitative science. It is challenging to draw a clear line on the actual definition of the term mental illness. It is hard to determine at what point one would be classified as mentally ill because the border between normality and illness is not strictly defined. There is a disagreement on whether being normal it means one is ideal or normal. However, there is a general agreement that certain patterns of behavior are abnormally uncomfortable and maladaptive that illness would be a suitable designation (Freitas-Silva & Ortega, 2016).

An exceptional feature of mental disorders is that they come in different forms. The acknowledgment that there are diverse origins of mental disorders has confused some scholars who believed that all behavioral abnormalities have psychological causes. While it is true that psychological factors play a critical role, studies have shown that most psychiatric disorders are associated with brain pathology.

Schizophrenia is a medical disorder whose symptoms and signs, and cognitive characteristics are plainly described. There are pharmacological treatments for the disorder although most are likely palliative. It is a chronic recurring psychotic disorder which lasts a lifetime. Prodromal symptoms often appear before the acute psychosis. To date, there has been no clear determination on whether schizophrenia is a syndromal diagnosis or a single illness (Frank et al., 2016).

The defining characteristics of schizophrenia include disorganized behavior, hallucinations, delusions, and disorganized speech. The symptoms vary from one individual to the other, both in severity and pattern and manifest in multiple sensory modalities in emotion, thought, and cognition. It is the loss that rather than the malfunction of various functions that characterize psychosis. The characteristics can change in intensity throughout the various stages of the disorder.

Some risks of schizophrenia are inherited and passed from generation to the other. Various twin studies have been used to study the genetic predisposition and results have indicated that the more closely one is genetically related to an individual with schizophrenia, the greater the risks of contracting the disease. Its prevalence stands at about one percent of the general population and affects people from all cultures, races, and origin. Multiple studies have identified schizophrenia as a complex multigenetic illness and have isolated many genes linked with it (Frank et al., 2016). Each of the risk factors presents a small risk, with the genetic factors presenting the most potent. The risk factors are believed to be multiplicative.

Critical Analysis

The two perspectives represent the different ways of looking examining the causes and consequences of mental illnesses and the different ways people interpret the disorders. Proponents of the biological approach look at the symptoms of mental illness such as the ones manifested by Jim as an outward sign of the inner physical illness. The symptoms can be grouped together to create a syndrome helps in determining the true cause and designing appropriate interventions. The biological perspective holds that Jim’s condition has a physical and organic cause and focuses on the role of genetics, neuroanatomy, and neurotransmitters in the disease’s occurrence.

Critics of the symbolic interactionist find fault in its assumption that illnesses have no objective reality. There are many existing challenges that put people’s health at risk regardless of personal beliefs or society’s perception. The opponents of the interactionist approach hold that it neglects the impact of social inequality on illness and health.

According to Jim’s experiences, he is ill by all means. The point of contention is the cause and origin of mental illness. Jim has a history of physical abuse that occurred during his childhood. He has now been diagnosed of schizophrenia at the age of forty. The connection between his childhood and his current situation is made from the interactionist perspective.

The two perspectives affect how Jim, his wife, and the people around him look at his condition and influence the relationship. Persons guided by the biological approach are likely to see Jim as an individual who requires medical attention. Diseases are common biological that affect every human being. On the contrary, interactionists are likely to perceive Jim’s condition as a product of his doings through his interactions. Under the interactionist approach, Jim can only be mentally ill if society believes in that respect.

Mental disorders are increasingly being examined under the biological approach. Studies suggest that biological explanations eliminate perceived blameworthiness against persons with mental illnesses which potentially translates into increased empathy. Still, using a biological explanation in isolation can portray mentally ill patients as different from other people and as directed by neurochemical abnormalities rather than a human agency. The explanation suggests that biological explanations can potentially eliminate empathy. The explanations suggest that the biological approach can reduce healthcare professionals’ empathy. The consequence of this potential outcome is reducing the therapeutic connection between mentally ill patients and healthcare professionals, which is critical in predicting positive healthcare outcomes.

Conclusion

Mental health is an issue of significant great concern in our society. As indicated in the paper, about one percent of the world’s population suffers from mental and substance-related disorders. We have examined the causes and consequences of mental health disorders from a symbolic interactionist and biological perspective. Although the two perspectives differ in their explanation and approach to mental health, there is a consensus that it is a challenge that’s worth addressing.

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