The conventional wisdom about mental illness in this country is dangerously off-base. Apparently, most Americans believe that mental illnesses are caused by chemical imbalances, genetic anomalies and brain disorders. Not only is that belief not supported by scientific evidence. It is also very cynical, disempowering and harmful to people.
If you believe that, you are not likely to participate whole-heartedly in treatment that will help. Rather, you will take psychotropic drugs that will not help you address the causes of your illness and that will plague you with difficult and dangerous “side effects”. More than 20 percent of American women between the ages of 40 and 59 are doing that today.
It may come as a surprise that there is no scientific evidence to adequately support the conventional wisdom. In the case of major depressive disorder that belief is a result of the fact that drugs which increase the amount of serotonin in the brain synapses relieve some of the symptoms of depression. They make people feel better. But Irving Kirsch has demonstrated that that “feeling better” is due almost entirely to the placebo effect. And, even if it were due to the antidepressant drug, that is not proof that depression is caused by a deficiency of serotonin. After all, people who are feeling anxious feel less so after they drink two or three gin and tonics. But that doesn’t mean that their anxiety was caused by a deficiency of gin.
There is some evidence that certain states of being which we are classified as mental illnesses are associated with certain states of the brain and central nervous system. But that is not evidence that the brain states caused the symptoms of mental illness. That is merely a correlation. Correlations do not prove causation. On the basis of what we know about the most widely and deeply studied mind-body dynamic – the stress response – it is much more likely that the feelings and behaviors associated with mental illnesses cause the changes in the brain and central nervous system.
The stress response is a profound physiological dynamics which affects the brain, the heart, the muscles and the cardio-vascular system. But it doesn’t just happen. It doesn’t come out of the blue. It is a reaction to something that has happened to the person. It is a reaction to a perception of threat or the realization that something which must be done is going to be hard to do. Hans Selye, the man who first studied the stress response, defined it as “the non-specific response of the body to any demand placed upon it”.
The same is true of blushing. Blushing is a very noticeable and dramatic physiological dynamic. But it doesn’t come out of the blue. It doesn’t just happen. It occurs because something has happened to make a person embarrassed.
If it is clear to us that the stress response and blushing are a reaction to something that has happened to a person, why wouldn’t we think the same of depression, bipolar disorder, anxiety disorders and psychotic disorders?
If depression and other mental illnesses are not caused by chemical imbalances, genetic anomalies and brain disorders, then what are they caused by?
Mental illnesses are reactions to difficult, scary, terrifying, rage-creating life situations. They are reactions to things that have happened to the person. They are caused by the following kinds of concerns that arise in a person:
• Am I going to be able to live the way I want to?
• Am I going to be able to connect with other people in satisfying ways?
Am I going to be able to find a job that is satisfying and which pays enough to support me?
Am I smart, strong, personable, attractive, creative, resilient, flexible enough to be able to live the way I want to live?
Am I adequate or inadequate?
Am I going to be able to do what I want to do or am I going to have to shrink myself to fit into the only roles, jobs, relationships that I can have?
Some people are much more vulnerable to being hurt by these kinds of concerns than others. Some people are less able to deal effectively with these kinds of concerns than others. Those differences are due mainly to the kinds of early experiences that people have had. People who have not received the nurturance, support, affirmation and health discipline that young people need to receive in order to grow into health adults will be more likely to be troubled by these concerns and to have a hard time dealing with them.
There is scientific evidence to support this belief.
So the Empiricists have demonstrated that persons who derive their sense of self-worth from social relationships are more vulnerable to depression after interpersonal loss than those who obtain self-esteem from other domains (Johnson and Roberts, 1995); that women who use a ruminating style of thinking suffer more severely from depression than those who don’t (Lehmicke and Hicks, 1995); that people who score low on self-esteem and high on stress are more likely to be depressed (Kreger, 1995); that nursing home residents who had a bird in their room were significantly less depressed after being moved to a Skilled Rehabilitation facility than those who didn’t (Jensen, Cardello and Baun, 1996); that persons who score high on a Self-Defeating Personality Scale are more likely to be depressed than others (McCutcheon, 1995); that chronic pain sufferers are more likely to be depressed (Banks and Kerns, 1996); that persons with more emotional strength and resiliency and a higher level of ego control are less likely to be depressed (Hirschfelt et.al., 1989); that recovery from depression is facilitated by events that lessen ongoing difficulty or deprivation (Brown, Lemyre and Bifulco, 1992), and; psychotic depressed patients had significantly poorer pre-morbid functioning - particularly adolescent social functioning - than non-psychotic depressed patients (Sands and Harrow, 1995).