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De-stigmatizing Mental Illness: When cause becomes important

An article in Psychology Today[i] raised a dilemma that I have been thinking about for many years.

The article asserts that all mental illness is a product of physical brain dysfunction.  For those disorders for which we cannot currently find said dysfunction (they list: “depression, bipolar, schizophrenia”), it is only a matter of time and technology until we do.

It has always remained hazy to me what the pie chart of mental health etymology really looks like.  How big a slice is inherited via genetics?  And how much overlap exists between this presumably “physical” inheritance of genetic predisposition and the more ambiguous, yet inescapable, environmental inheritance of growing up in an extended family that through actions (for example, abuse or addiction) passes on not a gene but harmful blueprints for living?

I understand the desire to find a specific physical cause for mental disorders.  If we can’t point to a missing neurotransmitter or an elevated level of some hormone, then we, as either people with a mental disorder or as working psychologists, have to contend with symptom recognition and alleviation as our primary means.  Not to mention, we can only “explore” a client’s personal history to try and speculate as to where things went wrong.

During my MA at MSP, I heard the process of meeting with a client to be like a puzzle.  The client keeps dropping pieces on the table and we keep sifting through, trying to make connections that fit.  This analogy feels right, but I would add that the room we are in is very dim and maybe we each have one hand tied behind our back.

There is something so tenaciously ungraspable and complex about each individual person’s mental illness.  Can it really be attributed to a mishap in the brain?  And even if this turns out to be the case – if in some distant future we can pinpoint an organic dysfunction for every disorder – I will be among the first to consider the next logical question – how did this brain injury occur?

Our brains don’t exist in a vacuum.  Naming brain injury as the cause for mental illness would add another layer of knowledge but still wouldn’t satisfy the same questions – was this brain dysfunction genetic or caused by environmental (physical abuse or neglect, pollution, poor diet, too much screen time) factors?

Doesn’t it feel like the never ending story?

At the heart of this debate is the desire to de-stigmatize mental illness by finding a root physical cause.  Then disclosing to friends and family that you are suffering from, for example, depression would illicit the same sympathetic and supportive gestures that you would receive if you had some recognizably physical malady like cancer.

We shouldn’t need a root physical cause to stop blaming people for mental illness.

It’s no more your fault that you are diagnosed with depression than that you are diagnosed with cancer.  Not because you inherited a gene or because your brain slowed its production of dopamine, but because you are a human being who has developed at the whimsical convergence of a nearly infinite collection of factors.  Your brain hasn’t failed you, your family hasn’t failed you, your particular place of birth, ethnicity, political persuasion, predominate diet as a toddler, relative measurable kindness of your grade school teachers, ability to make friends or learn to read on schedule, the employment opportunities of your great grandparents, or the expansion or contraction of a black hole in a nearby galaxy haven’t failed you…none and all of these things have combined to create you as you are today.

We may wish there was simple cause and an even simpler treatment for mental health disorders, but the truth is there may not be.  We should focus instead on the suffering of each individual person.  We should be working in the present to support the future, whatever the past may have been.

[i] https://www.psychologytoday.com/blog/hormones-and-the-brain/201602/should-we-stop-using-the-words-mental-disorder

Cynthia Ransley, MA, LLPCynthia Ransley, MA is MSP Social Media Copywriter.