Tim Hoffman 

M.A. Mental Health Counselling

Psychotherapy in Hong Kong

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There’s Nothing Wrong With Your Brain: Why Mental Illness Isn’t An Illness

January 6, 2019

 

3 minute read

 

In the bad old days, psychological problems were considered a failure of character, or a punishment from some divine being.  You’re depressed?  Stop feeling sorry for yourself, stop being lazy, get out of bed and go do what you need to do.  You’re anxiety ridden?  Just stop worrying about all those things, get a grip on yourself and don’t be a baby.  Your kid can’t focus or sit still?  Clearly, you’re a bad parent who doesn’t know how to discipline.  You hear voices and don’t know what’s real and what isn’t?  God is punishing you, and we’d better lock you up quickly.  There was tremendous stigma attached to anyone who had psychological problems.

 

Now we are — ahem! — so much more enlightened.  We ‘know’ that these problems just mean that there is something wrong with our brain, perhaps not enough serotonin or dopamine, or an overactive amygdala.  It’s not our fault that we’re depressed or anxious or hyperactive or psychotic.  We’re just ill, mentally ill.  And ever since we found that physical illnesses have biological causes, the race was on to find biological causes of ‘mental’ illnesses.  For example, it quickly became commonly accepted wisdom that serotonin deficiency caused depression.  (Spoiler alert — it doesn’t.)

 

One big benefit, it is believed, of treating psychological problems as an illness is that there’s no longer any shame to it.  It’s not our fault anymore.  It’s not a failure of our character that makes us suffer — we’re just sick!  And that means others will no longer look down on us, just as they wouldn’t look down on someone who has cancer.

 

Except it doesn’t work that way. Physical diseases have often carried, and continue to carry stigma.  Just think of AIDS, or leprosy.  Many of us are disturbed by, and shun, those who have serious illnesses.  (This may be for good reasons, such as the discomfort with our own mortality, or fear of contagion.)

 

Johann Hari, in his excellent book “Lost Connections: Uncovering the Real Cause of Depression — and the Unexpected Solutions” relates an experiment done on the stigma around psychological problems.  People were given the opportunity to inflict pain (as part of a supposed experiment on the effect of punishment on learning) on another person, who was acting as the ‘student’.  When told that the student had a mental illness that was a result of his biochemistry not working properly, and that his illness was a disease like any other, they tended to give bigger shocks.  When told that the student’s illness was caused by bad things happening to him in his life, they tended to give smaller shocks.

 

What does this mean?  It shows that, as Hari says, “Believing depression was a disease didn’t reduce hostility.  In fact, it increased it.”  It suggests that by telling others we have something wrong with our brain, or a chemical imbalance, we make people act worse toward us.  And it says that the whole mental health industry, by convincing society that it’s a physical problem, is actually making life harder for those who suffer from psychological problems. 

 

The truth is, that despite many decades of research, science has yet to uncover any physical causes for psychological problems.  For schizophrenia and bi-polar, there is certainly a genetic link: if a close relative has it, you’re more likely to have it too.  But even individuals who share 100% of their DNA with another person (ie. an identical twin) have only a 50-50 shot at developing the problem if their twin has it.  Perhaps someday we’ll discover a gene or imbalance or virus for each psychological problem, but I doubt it.

 

So there’s certainly downsides to telling people with psychological problems that they have an illness that’s just like a physical illness: First, as far as we know, it isn’t true, and second, it makes other people stigmatize them.  

 

But that’s not the worst part about this physical/mental illness myth.

 

When we have a physical illness, we put ourselves in the hands of our doctors and wait for the medication to take effect, the surgery to correct the issue or various other things to be done to us. We put ourselves in the hands of the experts.  Unfortunately, when we’re told we have a mental illness, the same thing tends to happen: we become passive and wait for the doctor to fix us.  After all, what can we do to fix a chemical imbalance in our brain?  Our brain is broken, and the only people who can fix us are the medical professionals.  

 

Yet being passive is the single worst thing that any of us can do to fix our psychological issues.  Being told that we have a biological problem that requires medication (which, by the way, has an extremely mixed track record ) takes away our sense of agency and our feeling that we have control over our lives.  We overcome most psychological problems by connecting to other people, resolving relationship issues, exercising more, changing the way we look at our lives and modifying our behavior.  The very things we need to do in order to feel better are the opposite of what we will do if we believe our brains are defective.

 

And so, when the mental health industry tells you (albeit with the best of intentions) that mental illness is a disease like any other, don’t buy it.  It isn’t true, and it isn’t helpful.

 

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