Biochemical imbalance? Mental illness is not an illness like any other.

Misinformation in Psychiatry by Dr Terry Lynch

If you live in the developed world, and have psychotic experiences (for example, hearing voices that other people cannot hear, or holding beliefs that have no rational basis), any professional help you receive will almost certainly be based on the idea that the primary cause of your problem is some disturbance in your biology. A psychiatrist, a medical doctor of the mind, may diagnose the patient as having a serious mental illness, typically “schizophrenia”, and will prescribe medication (referred to as anti-psychotics). The central assumption of the psychiatric team will be that the disorder being treated is an illness of the mind, in the same way that a disorder such as diabetes is an illness of the body.

Despite over a century of scientific research, much of it funded by multi-national drug companies with a vested interest, there is little evidence to support the idea that schizophrenia is a discrete illness of the brain, directly caused by some biological disturbance. Even with this lack of evidence, biological psychiatrists continue to peddle the myth that severe mental health problems are the direct consequence of genetically determined brain diseases. This is not to deny a role for some medical treatments; medication undoubtedly helps a lot of people who suffer distressing hallucinations and delusions. However, viewing psychotic experiences as a discrete illness of the brain results in five important disadvantages for people who present to psychiatric services:

1. Increased Stigma

People who use mental health services often report that the most difficult problem they face in their lives is the stigma associated with having a mental illness. Myths abound about “schizophrenics” (for example, that most of them are violent and dangerous) and research has shown that labelling psychotic experiences as an “illness like any other” is more stigmatising than making sense of it in terms of past trauma and stressful life experience.

2. Passivity

Being told you have a biological illness tends to convey the message that the only option is to take the medication and wait for improvement to occur (like one would with antibiotics for a chest infection). Clearly this is not a helpful message, as a wealth of evidence now supports the valuable roles self-help, peer support and psychological therapies can play in recovery. Furthermore, the fact that sickness and disability payments are often dependent on a formal diagnosis of a biological illness can further encourage people to adopt a passive role, submissively accepting the directives of the expert doctor.

3. Crushed Hope

Psychotic experiences commonly first emerge in a person’s late teens or early adulthood. A psychiatrist telling a young man that he has got a brain disease and will need to take medication for the rest of his life will often unnecessarily stifle ambition at a crucial period in the sufferer’s personal and vocational development.


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4. Medication side-effects

Although helpful for many people experiencing psychotic symptoms, particularly during times of high arousal and agitation, anti-psychotic medications cause a range of unwanted side-effects. Common side-effects include muscle stiffness, hand tremor, movement disorders, weight gain and sexual dysfunction. More serious, albeit rarer side- effects include potentially fatal blood disorders.

5. Invalidates many forms of human distress

If a person presents to mental health services in a state of high distress and is not diagnosed as having a “proper” mental illness that person may endure a range of negative responses from professional staff. Because the presentation doesn’t fit the psychiatrist’s (largely arbitrary) criteria for a diagnosis of severe mental illness, the person’s emotional and behavioural disturbances can often be viewed as being of less importance and the responses from professionals may be undermining or even dismissive. Such negative attitudes from psychiatric staff are commonly reported by people suffering with Emotionally Unstable Personality Disorder (an enduring condition characterised by rapidly shifting moods, relationship difficulties and deliberate self-harm).

So in conclusion, when it comes to problems of the human mind, it may be that the doctor doesn’t always know best.



How much do you know about mental health problems?

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Comments 10 comments

samtenabray profile image

samtenabray 4 years ago from uk

This was a great read, very interesting thank you for taking the time to write this. Voted up.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Thank you for your generous feedback, samtenabray, it is appreciated.


kimh039 profile image

kimh039 4 years ago

Good points, gsidley, about the stigma and being discounted. I've heard of people described as having "just a situational depression" and of course the references to Axis II - personality disorders. I'm not a big fan of Szasz and am not particularly anti-psychiatry, but sometimes I like to consider extremely unconventional points of view. They have a way of balancing and humanizing conventional wisdom.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Kim, I appreciate you taking the time to comment (and for the fan-mail!). Thank you.

Although I by no means agree with all of Szasz's views, I do respect the man for being brave enough to speak out for several decades against the conventional wisdom in western psychiatry, a "wisdom" that I predict will have the same status as witchcraft at some point in the future.

I look forward to many more interesting debates with you in the future.

Best wishes


carol7777 profile image

carol7777 4 years ago from Arizona

Some really interesting thoughts here. thanks for sharing the information.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Carol, I appreciate you dropping by.

Best wishes


Nicola Tweedie profile image

Nicola Tweedie 4 years ago from East Sussex, United Kingdom

Again, such an easy and interesting read. You have a great way of communicating. I think the personal meaning in any mental struggle is the most important and the most moving. Putting symptoms and people into categories in order to diagnose them, erodes this so quickly, that the whole communication of the distress is obscured and I think it makes it harder to help.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Thanks for your generous comments.

I share your antipathy for categorising.

Take care.


SomeReduction 2 years ago

You write: "... little evidence to support the idea that schizophrenia is a discrete illness of the brain, directly caused by some biological disturbance." What organ, then, is the substrate for the hearing sounds that are not there, having delusions, perceptual abnormalities, uncontrollable anxiety with little relationship to the environment? Of course it resides in the brain (not the spleen or the pineal gland). The definition of illness is perhaps the fight you will have more success with, but you can't really argue in this day and age that these thoughts and emotions are not the result of brain activity.


gsidley profile image

gsidley 2 years ago from Lancashire, England Author

SomeReduction

Thanks for reading and taking the time to comment.

Of course there will be biological correlates for any kind of human experience: anger, grief, love, voice-hearing, despair and so on. Our bodies (and brains) comprise a complex mass of molecules and will inevitably provide the organic stew that mediates all human perceptions, emotions, experiences, cognitions and behaviours. But co-existence does not correspond to causation.

The bulk of biological research in the psychiatric arena has involved (and still does involve) searching for biochemical/neuronal/genetic abnormalities that co-exist with the psychiatric phenomenon under investigation (often classified under meaningless labels such as ‘schizophrenia’ – but that’s probably another debate) and, once elucidated, there is the assumption that the disorder in question is ‘caused’ by the biological abnormality in much the same way as a tumour in the frontal lobes might cause personality changes, or a lack of insulin may cause Type 1 diabetes. Any discovery of biochemical aberration is assumed to be a necessary antecedent of the phenomenon; that the ‘depression’ or ‘schizophrenia’ only emerged as a direct consequence of an existing biological aberration. This reasoning is illogical.

If I get cut-up when driving home tonight, and feel an angry rage, there will be a multitude of biological changes co-occurring in my brain and body. Yet it would be ludicrous to suggest that my rage was caused by adrenaline/cortisol etc when, clearly, the key reason for my anger is a combination of other drivers’ behaviour and my interpretation of it.

A huge amount of psychiatric research time and resource has been devoted to the mission to demonstrate that ‘schizophrenia’ or ‘depression’ is primarily caused by a genetic brain disease. To date, not one person with mental health problems has benefited from this enterprise. I believe a paradigm shift is long overdue rather than continuing with this futile pursuit of psychiatry's Holy Grail.

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