All in the brain?

This article criticizes a TV program on mental illness hosted by Stephen Fry for making mental illness seem too physical, too brain-based, too much talk of “chemical imbalances.” It suggests, and rightly so, that many people are influenced by circumstances and trauma. Certainly, circumstances play a role or you wouldn’t have things like PTSD or situational depression.

What I found interesting here, though, was the idea that emphasizing the idea of a chemical imbalance somehow does a disservice to people with mental illnesses. I’m not sure I’ve heard that particular point of view before.

Additionally, I don’t see where he’s coming from by claiming that, just because people mention chemical imbalance, this somehow means conditions occur “out of the blue.” He then mentions genetic vulnerability, which seems likely since conditions often seem to run in families. But that still doesn’t mean they occur out of nowhere or have nothing to do with circumstances.

And again, I can’t comment on the television program because I haven’t seen it. If it shows up on YouTube or streaming services, I may try to watch it at some point in the future, though.

What I mostly found interesting was this fellow’s extreme emphasis on circumstances (“misfortunes,” as he puts it). While I don’t deny they can play a role, it goes against my own experience, I think. I feel like mental illnesses have largely caused my misfortunes in life, rather than misfortunes bringing on mental illnesses.

I also find it a bit baffling that someone would say that emphasizing the role that neurochemistry plays in mental illness would be doing a disservice to people with mental illnesses. I’ve used the diabetes comparison myself (namely, you wouldn’t tell a diabetic to just “be strong” and “deal with it;” you’d realize they have a problem with their pancreas producing insulin and require medication/insulin injections to remain healthy). Likewise, if a person is clinically depressed, it’s possible that no amount of “being strong” or “thinking positive thoughts” is going to fix it if it is a condition in their brain.

Patients’ dissatisfaction with an exclusively medical approach is well founded, because research has shown that this approach has been extraordinarily unsuccessful, despite what clinicians often assert.

I also can’t comment on the state of psychiatric care in Britain since I live in the US, but the quote above sounds like the way people (usually people with no history of mental illness) complain about psychiatric medications being over-prescribed. I’m sure that’s a legitimate problem in some cases, but people seem to extend this idea so far that they think no one is helped by medication, and that becomes a problem.

I saw something elsewhere today talking about how it’s “too easy” to get antidepressants. In the US, anyway, there are 2 problems with this: (1) when a person sees a doctor, they expect them to try to fix the problem, not send them to long-term therapy or to other specialists, except in extreme cases, and (2) some people can’t afford that long-term therapy or more specialists. That doctor appointment may be their only hope of doing anything about the problems they are having, at least in the immediate future. They want to feel like their doctors are doing something for them. It would be great if everyone had more time to spend with medical and mental health professionals for these discussions, but I don’t see it happening in the near future.

The more that ordinary people think of mental illness as a genetically-determined brain condition, and the less they recognise it to be a reaction to misfortune, the more they shun mental health patients.

I just find this bizarre. Why would something having a biological basis contribute to stigma? He even says earlier in the article that it’s a “predisposition,” which means the person isn’t “broken,” they are just predisposed to either having something go wrong with their mental health, or reacting badly to circumstances. But not all mental illness is a “reaction to misfortune,” that is just absurd. I may not be a professor of psychology like the author here, but from my own experience, I don’t feel like my mental illnesses are a “reaction to misfortune.” I feel like my mental illnesses, which I may well have been predisposed to genetically, have caused me misfortune.

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