What causes mental disorders...Brain chemistry? Genetics? or Environment?

[HereSince1628]

I wouldn't expect a single answer to be adequate for the many disorders; but, how you perceive a problem has implications for how you develop solutions and for how money allocated for research is spent. When it becomes about money it's become a thing that is actually fought over. Anyway, it's an interesting perspective, pointing out potential importance of environment in dysfunction, especially for readers in a nation like the US where the popular belief is "chemical imbalance, and where 'adjustment disorders' resulting from environmental events are taught as temporary, usually dx'd by elimination of 'more serious' disorders, and for which there is no consensus 'best treatment'.

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Mental illness mostly caused by life events not genetics, argue psychologist
Sarah Knapton, Science Editor

http://www.telegraph.co.uk/news/2016/03/28/mental-illness-mostly-caused-by-life-events-not-genetics-argue-p/

Mental illness is largely caused by social crises such as unemployment or childhood abuse and too much money is spent researching genetic and biological factors, psychologists have warned.

Over the past decade funding bodies like the Medical Research Council(MRC) have spent hundreds of millions on determining the biology of mental illness.

But while there has been some success in uncovering genes which make people more susceptible to various disorders, specialists say that the true causes of depression and anxiety are from life events and environment, and research should be directed towards understanding the everyday triggers.

Peter Kinderman, Professor of Clinical Psychology at the University of Liverpool, told BBC Radio 4’sToday programme: “Of course every single action, every emotion I’ve ever had involves the brain, so to have a piece of scientific research telling us that the brain is involved in responding emotionally to events doesn’t really advance our understanding very much.

“And yet it detracts from the fact that when unemployment rates go up in a particular locality you get a measurable number of suicides.

“It detracts from the idea that trauma in childhood is a very very powerful predictor of serious problems like experiencing psychotic events in adult life, so of course the brain is involved and of course genes are involved, but not very much, and an excessive focus on those issues takes us away from these very important social factors”

<snip>

[LiberalArkie]

1. I would agree with the title. Brain chemistry, Genetics, Environment

Along with parasites also, any or all of them. Also have to throw in society. What is normal to one society might be abnormal to another. What might might be perfectly ok to be sitting around all day reading and working in ones garden by themselves might be pleasant to some but to another it might seem to be withdrawn and out of touch to another.

[HereSince1628]

2. What is "pleasant to some but to another it might seem to be withdrawn and out of touch to another"

That presents another interesting point. One that really suggests how point of view greatly impacts concepts of mental disorders.

At the core of pathology is the notion that there is a deviation from 'normal' function. Which is to say by definition a pathological condition must present dysfunction to some degree.

Who gets to define dysfunction? The person whose path to full expression of their potential is blocked by a disorder, or therapists who represent the will of society to recognize an individual's path as deviant?

This isn't really a triviality. Since the beginning of the Cold War and the first edition of the diagnostic and statistical manual the APA has been pretty sensitive to how authoritarian regimes around the world have identified political/social deviance as mental illness and thereby wrongly institutionalized political deviants.

And it may go beyond the issue of deviants into other social issues...

Even if we pull ourselves into the narrow point of view that mental disorder isn't merely deviance, but rather patterns of dysfunctional cognition, emotion, and/or behavior, we are left to wonder what factor produces the 'lesion' that classical pathology tells us should be at the core of a disorder/disease.

That's what this news article explores. In the US poplar belief is that mental disorders arise from "chemical imbalances" in the brain. That's 50 year old idea that paved the way for the use of pharmaceuticals in mental illness. We in the US are a nation of people who have great faith in the magic bullets, be they produced by pharma or alternative medicine advocates.

We exist in a time when research in molecular biology, and molecular genetics in particular, are seen as the cutting edge of research. Research money flows to what is seen as that cutting edge.

Our president doesn't want American institutions to see mental illness as a character issue but as a consequence of the brain. And has directed Federal research money in mental health to focus on the biology of the brain.

In the world of biology, both genetics and brain structure and function are "skins in" approaches. That focus would see mental illness as the result of processes inside of an afflicted person's skin.

In the world of biology, environmental/ecological forces are 'skins out'. This article says relationships of individuals with factors in their environment is where we should look for features that bring about psychological dysfunction.

In the US the Obama administrations policy approach has to a very large extent closed the door on the flow of research money to people considering those environmental factors. On the level of social consideration, it's quite possible to wonder if keeping the focus on -skins in- causes isn't a mechanism to avoid making social changes and leaving the population by and large feeling good about their lack of contribution to the mental disorders of others.

[LiberalArkie]

3. With me, I have had low testosterone level most of my life and started with a low

grade schizophrenia starting around 24 or so and the winter induced depression. I started feeling a lot better and wanting to do things with people after starting on HRT in my 60's and going to the gym and tanning. Started feeling like I was in my 30's, still a hermit, but a hermit that enjoyed things. Still not comfortable being around a lot of people, but then never have been. You will never catch me in a store during Christmas season. I tend to break out in a cold sweat. Football, baseball games Hell NO.

But once a person learns who they are, with a little help they can do quite a bit. Just not like everyone else.

[mopinko]

4. seems to me to be basically an irrelevant argument.

whatever the triggers, the more we understand about the biochemistry of the brain, and the well known genetic tendencies to mental illness, the more tools we have to help people get better.
the approach that they are talking about sounds like a lot of throw back to freud. understanding just HOW those childhood traumas affect the brain is the only way to move forward. hating on the mama is counter productive. you cant change the past.
this has been the prevailing attitude for a long time, and the widespread failures of these therapeutic models tell us that we need a better understanding of the "biochemical" basis for people's dysfunction.

jmho.

[HereSince1628]

5. Yes, I think the more we understand about -ALL- the factors

Last edited Mon Apr 18, 2016, 12:16 PM - Edit history (1)

the better off we are.

I think the point of the article is that environmental features are often dismissed, but to say that is threatening to those who stress other points of view as is pointed out in the closing para of the article.

Much rides on these things, culture biases/preferences of thinking certainly, not the least of which is the desire to not have individuals stigmatized with blame for having a mental illness.

Believing mental illness is a biochemical phenomenon is not only good for biochemical research and pharma, it's also largely seen as beyond the control of individuals making guilt hard to apply

[mopinko]

6. if there wasnt such a long history of false blame

especially of parent's actions, i would be more sympathetic to the argument.

besides, what is their prescription? it would be great to have a magic wand and save the world. i dont see one laying around, tho.

[HereSince1628]

7. I think you're sort of missing the point. It's not saying there is no role for genetics or pharma

Last edited Mon Apr 18, 2016, 07:03 PM - Edit history (1)

It's saying that MOST of the emergence of the dysfunction that was studied to produce the report was a direct sequel to environmental factors.

Yes, of course valium and more recent anti-depressants can relieve depression (even if they don't -cure- it or alter other factors that increase the propensity to become depressed). Yes there are indeed drugs that help with bipolar disorder... yes there are drugs that help patients deal with mental disorder.

That's not the point. The point , according to the research that was done, was that -MOST- which is to say at least half of mental illness plus a fraction is a consequence of environmental factors.

That's a very different view of what's happening and what needs attention. If we only saw mental illness as a chemical imbalance, we most assuredly should look for corrections that involve chemistry. If we saw mental illness as only or even mostly a matter of unfortunate genetic inheritance, then of course the way we address the problem should involve genetics.

What was found is that -most- of mental illness follows directly from environmental factors. In a honest world I would think that would mean attention would be given to environmental factors, perhaps 1) helping people with mental disorders learn to cope with environmental factors and 2) modifying the environment and the part of environment we call "society" to make it less likely to trigger initiation or recurrence of mental illness.

But in the US, there is very little serious thought given to environmental factors in modern research, our focus is on 'the biology of the brain. Current 'fashion' associated with 'cutting edge research' is about molecular level phenomena -inside- the brain (which we must remember is connected to sensory organs that constantly input information to the brain about conditions -outside- the person. It's sort of ridiculous to think that the environment can and should be ignored, and I think if pressed researchers, even researchers in molecular neuroscience wouldn't argue that should be done. But money is tight, money is directed by policy. In the US, the Obama admin has directed that money should be going to 'brain biology', political bias -is- in a quite real way impacting how money is being spent on psychiatric research. The solutions that produces are going to be about molecular phenomena and very likely targets of pharmaceutical bullets, even if as suggested by this article 'most' mental disorders have environmental triggers.

As a person with advanced biological training I sort of doubt many mental illnesses should be considered to be caused by any one family of factors. Biological things just don't usually work that way. The sources of variability that contribute to mental disorders are the -sum- of all the variability not just the source of variability that is the focus of where money is currently being spent.

I;m aware that this sort of discussion challenges people because it challenges status quo understanding of other people's circumstance. And other people have varied experience including many circumstances where 'chemical imbalance' thinking works just fine for them. Getting up above the individual experience and thinking in more global terms is to consider what our biases allow us to see as being ignored.

Separating ourselves from our personal experience enough to appreciate what considering what is being ignored may mean -generally- to mental health could be really important.

On edit:

This issue was a source of discussion in the US two years ago as the neuroscientists wrestled control of research money away from people interested in researching effectiveness of therapy. Now in the UK comes a study that suggests the choice the US system made is likely to be ignoring effectors that most commonly result in mental dysfunction

[mopinko]

8. just seems to me that we already milked that cow.

from freud on down, that has already been the focus.
obviously treatment has to have focus on what is/has been happening to a person. and obviously a more just world would result in fewer traumas.
but the failures of that approach are already legion.

let me try it this way- it seems to me that they are talking more about prevention than treatment. a valid point. a sticky wicket, for sure.

but i think the real promise for treatment is in understanding just how the brain works and why it sometimes doesnt. not necessarily talking about pharma. it may well reveal which talk therapies work, and which just ingrain and magnify traumas of the past. (which i think some do. )
if it turns out that yoga and meditation or wheat grass cocktails or cannabis are useful treatments, cool.
but we wont know any of that till we have a much stronger understanding of the brain and the mind.

[HereSince1628]

9. Just because something wasn't done well in the past doesn't mean that area should be ignored

Just as importantly, we should not be prejudiced to currently fashionable research just because its currently fashionable.

I'm not sure 'we' are talking about prevention, that's something of a presumption that discounts the potential importance of environmental factors I'm actually thinking we are actually mostly talking past each other about different things

By environmental factors I mean, for example, traumatic experiences, inconsistent and abusive relationships/parenting, as well as social catastrophes such as the collapse of systems of social order and social structures in failed states as happened in east Germany, as well as things like job loss, divorce, isolation, changes in daylength and exposure to light... things that we KNOW are important as effectors that drive dysfunction.

I think what we as people interested in people with mental disorders desire is to help people not suffer and lose out on fullest value of life because they experience dysfuntions of mental disorders.

It's not a question of focusing on prevention at all. It's about society and psychiatric research choosing to dismiss things for any of several reasons, the worst of which might include because 'they are old school and haven't produced profitable results in the past"

With reference to the article presented it's about the risks of ignoring things. Especially ignoring things we know are important... We know that environmental factors, such as parental and sibling abuse influence psychological development leading to dysfunction be it narcissitic disorders, borderline, phobias, compulsions etc. We know that environmental factors that change life circumstances following loss of job, geophysical and social catastrophes (sever storms, floods, earthquakes, fire, exposure to war and violence, etc) lead to dysfunction ranging from adjustment disorder to PTSD.