Brain Disease Or Mental Illness?

A lot of bogus pseudo-science is being bandied about in the media, folks, like in the following interview from Sarasota Florida with the current director of the National Institute of Mental Health (NIMH), Dr. Thomas Insel.

Q: What would you say has been the most significant recent breakthrough in mental health research?

A: Part of it is a conceptual breakthrough that is recognizing that mental disorders are brain disorders. That has shifted the conversation about how we diagnose them, how we treat them, and how we train people to help with mental illness.

Dr. Thomas Szasz, Columbia University Psychiatry Professor Emeritus, ends an essay Mental Health As Brain Disease: A Brief History with a quote from a famed neurologist as follows.

Neither the American Psychiatric Association nor American presidents remind people of the caveat of the great nineteenth-century English neurologist, John Hughlings Jackson (1835-1911): “Our concern as medical men is with the body. If there be such a thing as disease of the mind, we can do nothing for it.”

Although there is no mind without a brain, mind is not synonymous with brain.

Back to Dr. Thomas Insel’s interview…

Q: What is an example of a mental disorder we now realize is a brain disorder?

A: Depression. If you asked people 20 years ago what depression was, they would say it was a chemical imbalance. We often treated it with medication to increase serotonin in the brain because we thought depression was an absence of something, a lack of serotonin. We know now that it’s a change in how the brain in functioning in certain circuits. Just like we think of Parkinson’s and other disorders, we can treat it by altering brain circuits, such as through deep brain stimulation. That’s not a common treatment, but it helps us rethink this disorder in terms of the underlying basis in the brain and new treatments will have to do with that.

(Strangely enough, the questions directed to Dr. Insel immediately following the above questions have to do with the effect of environmental factors–the economic recession and hurricane Katrina–on mental health, er, brain disorders.)

Sadness, unshaken sadness then, what used to be referred to during the Middle Ages as Melancholia, is a “brain disease”.

I don’t see any proof here. I just see leading presumptions. “We know now…” “We” do? Where’s your proof?

The thing about the serotonin levels theory was that it was always ass backwards. Doctors presumed depression had something to do with serotonin levels because the drugs they used to treat it extended the life of serotonin in the brain. Yes, but that doesn’t mean doing so will alleviate despair.

If a man were in a very depressing situation, his situation didn’t change overnight, and he was said to be sad or symptomatic about it, he would be called chronic or clinically depressed. You are expected to change him despite his situation, but if he were happy in a sad situation, that is “inappropriate affect”, and a symptom of mental illness.

Hey, maybe he’s bipolar!?

Let me point out, there is no proof, and so this is all a matter of conjecture, of theory.

The same mistake is often made about the label of schizophrenia, that it’s a “brain disease”. If you go to schizophrenia.com you can get lost in such a theory posing as fact. Don’t be fooled. You are reading disinformation spread by people who, if they aren’t comforted by pathos, are more or less tools of the pharmaceutical industry.

Brain disease is the field of study for the neurologist; mental illness is the field of study for the psychiatrist.

If you don’t believe me, go to a search engine on your computer, such as Google, Yahoo!, or what have you, and type into the search box “brain disease”, and hit the search button. You will find a number of undisputable neurological conditions turning up in the links to pages listed from your search. Explore them. Next use “mental illness” as your key search term, and it’s likely to be mostly depression, schizophrenia, bipolar disorder, and lesser problems often referred to as behavioral that are turned up in the links. If you want to verify that we’re dealing with theory, and not with fact, use “mental illness as brain disease” as your key search term, and review the debate.

So we don’t know mental illness is a brain disease, but some people would like you to think we did. Curious, isn’t it?