To think that the majority of mental health problems are not ' chemical', but are a result of our life experiences

[mychemicalromance]

I've had a lot of interactions with various people over mental health issues lately, and I keep coming across this idea that the majority of these problems are 'chemical'.

I do accept that some mental health issues are caused by biological factors - my DH has low testosterone which affects his ability to manage anxiety.

But I do feel that people (esp in the UK) are very quick to identify the cause of any MH Issue as 'chemical' rather than to attribute it to a reaction to something in their past or present life...

I think the attitude in the general population is also framed by their experience going to see a GP which depression and other MH issues.
And usually it's pills (anti depressant). When therebis sone counselling, it's CBT and often more about very simple methods to learn to deal with anxiety or to try and have a better outlook on life. There isn't a 'oh let's talk about the abuse/golden child syndrome/narcissic parent you suffered as a child'

As a consequence, people tend to think that MH illnesses are just chemical imbalances.

Imo the reality is much more varied and I wish counselling/psychotherapy was much more widely available. When someone has some severe MH issues, it's not because the issue is managed by medication that they wouldn't benefit from psychotherapy. But it's expensive. And Unlikely to be available on the NHS (or at least not where I am)

I also think there is a difference between the kind of experience that causes trauma in an otherwise healthy person and the fact that a person with underlying MH issues is likely to have those triggered by stress.

The latter is like my friend's coldsore being triggered by stress, the former is more like being run over by a truck. It's not the stress at work that gave my friend the coldsore, but it does bring up the symptoms. Otoh a truck rolling over somebody's leg would not be bringing up latent symptoms of a broken leg, it would actually break the leg.

I have no idea which of these two MH types forms the majority, but I am sure there is plenty of both types around.

I think the brain is fascinating and there's probably so much we don't know about how it really works. How the expression of certain genes is affected by the environment and how our mood is affected by the biochemistry. All the gene expression, the receptor expression, the neural networks, hormones, neurotransmitters and the effectiveness of them is so complicated.

Our mood, our sense of self, feelngs, everything is governed ultimately by our cells in the brain, the connections and the levels of brain biochemicals. How those levels are determined is complicated.

I think we have an extremely limited understanding of mental health, including the interplay of genetics and environmental factors. I certainly don't think the medical model, at least as it is now understood, is sufficient to explain all mental illness.

Indeed, the brain remains such a mystery to us, despite advances in research. Even conditions like epilepsy, which are of course unrelated to the issue of mental illness, can be utterly baffling. I remember a doctor discussing the ketogenic diet, a high-fat diet which can be remarkably effective for some people with epilepsy, especially children. When asked if he could explain exactly how and why the diet works, he said, "We have no idea why it works."

I am certain that in centuries to come, people will look back at medical knowledge of the early 21st century and shake their heads in amazement at all we did not know, at our confident pronouncements some of which will no doubt turn out to be completely wrong.

RedPeppers Sat 01-Jul-17 21:02:30
"I think the attitude in the general population is also framed by their experience going to see a GP which depression and other MH issues.
And usually it's pills (anti depressant). When therebis sone counselling, it's CBT and often more about very simple methods to learn to deal with anxiety or to try and have a better outlook on life. There isn't a 'oh let's talk about the abuse/golden child syndrome/narcissic parent you suffered as a child'"

This may be your experience but is completely the opposite of dd's. She had to wait for years, virtually incapable of functioning, before she got given any medication, and only after therapy and CBT avenues had been thoroughly explored. And even with all that in her medical notes, her doctor still insisted on talking about her childhood, not about her medication.

It's probably impossible to generalise as this may vary so much from region to region, and probably also dependent on the age of the patient. Dd is a young woman, so there is a strong a priori assumption that she will be hysterical and attention-seeking. Which is very far from being the case.

I'm currently reading an Oliver James book. I know he's not popular with everyone, but he agrees with you 100% and argues that the Human Genome Project showed how little can be explained by genes, as phoolani mentions above.

I think there are two main reasons why people focus on the 'chemical' aspect. The first one is that it's cheaper to throw pills at a problem or have what they call 'sticking plaster therapy' like CBT than to have deeper therapy and the second is that it's very difficult to confront parents and blame them for their children's mental illnesses, as that's what would need to happen really.

What it really comes down to, what we are ALL saying on this thread, is that you can't learn something about an individual's MH issues without actually LISTENING TO THAT INDIVIDUAL. And that is something that both doctors and laypeople seem to find very difficult to do.

When I had counselling I was told I had 'situational' depression. They're right. I'm fine when I'm not battling with a child with ASD (when he's with ExP for example) but when he's here I am miserable. Sad but true.

The first one is that it's cheaper to throw pills at a problem or have what they call 'sticking plaster therapy

I hate seeing these terms bandied around. Those pills saved my life. CBT is not a sticking plaster.

Gwenhyfar, as the parent of a child with MH issues, one thing I have never found is that doctors find it difficult to blame the parents for the child's issues. Or, to be precise, the mother.

cory definitely. I had a dreadful therapist who tried to pin my bipolar on my mother. She was actually my main advocate.

It's all very complicated and difficult.

I see both sides, more now since I started this thread..

But I also see, in my own situation..

My mother with Narcissistic Personality Disorder (diagnosed)

My mother's poorly attached son (my brother) who develops severe MH problems and also carries out years of physical sexual abuse on...

His sister (me) who develops CPTSD after growing up with years of weird emotional headfuckery from her mother and physical/sexual abuse from her mother.

And so for me, people going "oh, it's all chemical" is frustrating to say the least.

But it's been really illuminating to see the other side of that coin. So I genuinely am grateful to people for sharing.

Sorry that should say:

"and physical/sexual abuse from her brother"

You've created a nice thread OP. Obviously the topics discussed are harrowing but I think people on both sides feel heard.

And so for me, people going "oh, it's all chemical" is frustrating to say the least

Ultimately, the 'feelings' inside are going to be down to biochemicals.

But as has been pointed out, the actual cause that results in the biochemical changes is far far more complicated and the treatment is going to be complicated.

agree with alpaca

you have started a thread where we can share experiences about how frustrating it is not to be heard, or (in my case) to see our nearest and dearest not being heard

the frustration is the same regardless of how you are not being heard, it's that same "oh, but I know your problems far better than you do"

and very sorry to hear about your childhood, OP; it sounds absolutely horrendous

Ah, sorry, didn't mean to thread kill. It's ok, really.

Thanks for sharing alpaca and others, everyone in between. MH is so much more nuanced than we can really imagine.

It's genuinely been useful to hear other people's perspectives, so thank you, and I think I have been talked out of my defensive stance. So very worthwhile.

"Those pills saved my life. CBT is not a sticking plaster."

I'm not against anti-depressants, but they are easier and faster than proper therapy. I'm not a therapist so I can't argue in detail about CBT, but isn't it true that CBT teaches people how to manage the symptoms rather than get down to the core reasons for a problem? Also, that it's generally a short treatment and therefore cheaper for the NHS.

"Whereas I see that there is trauma - you treat the trauma - the person recovers."

This is not my experience.

I did suffer quite a lot of trauma 9 years ago which ended up with me severely depressed. I had counselling and took medication. The trauma is very much in the past and I don't have anything in my everyday life which would cause anything like that kind of trauma.

However, the brain patterns that emerged during the depression are still there. These are not 'negative thoughts' but specific patterns such as paralysing indecision; emotional numbness and mental blankness; cyclical thought patterns and so on. These things don't need any particularly trigger, and they can make it very difficult for me to function normally. This is why I continue to take medication which mostly prevents these happening and allows me to deal with any emotional stresses in a rational way.

Seems to me that if the problem can be solved medically, it's a medical problem.

I'm not against anti-depressants, but they are easier and faster than proper therapy

And that's bad because? Should people have to suffer for much longer because you think ADs are some kind of easy choice?

They have a lot of side effects and take weeks to kick in. When you're trying to kill yourself, 6-8 weeks is a hell of a long time.

And the fact that "proper therapy" doesn't actually cure something like bipolar or schizophrenia.

Well, Gwenhwyfar, if the core reason is an (as yet) incurable genetic disorder then getting down to the core reason doesn't actually do much to stop the patient throwing themselves out of a window.

Dd knows that both her (painful) physical disorder and her MH issues are most likely going to be with her for life. Talking about them isn't really going to make her feel better: it's just reminding her that the odds are stacked against her and that that isn't going to change.

What she needs is something that enables her to bear that knowledge without giving in to the feeling that maybe it would be better to be out of it all. This is what CBT does, it's what the anti-depressants do, it's what the painkillers did until she managed to come off them (a pretty brave decision for an 18yo). They are things that make the pain (mental and physical) bearable, either by numbing it chemically or by focusing her thoughts away from the pain (CBT).

Maybe it's a sticking plaster, but if you have a bleeding wound a sticking plaster is a pretty useful thing.

And absolutely what alpaca said about the TIME. Dd is trying a new medication now. What we have been told is that it takes 7 weeks to kick in. I am SHIT SCARED. Every day of those 7 weeks I'm going to be shit scared! From where I'm sitting, faster and easier doesn't actually look like a problem.

Depression is chemical. The physical symptoms of depression are caused by structural and chemical changes in the brain. The cause of these structural and chemical changes are linked to genetics, stress and previous life experiences which alter our ability to deal with certain situations. Some research suggests that if you were exposed to high levels of stress during critical brain developmental periods then you are more likely to have an increased sensitivity to stress hormones. Release of stress hormones causes the chemical balance of the brain to alter and is also purported to cause brain cells to die.
Anti-depressants work by restoring the balance of hormones in the brain. This reduces physical symptoms. Exercise has the same effect.
Therapy then acts as a compliment because it enables someone to develop strategies and begin to understand the cause. Learning also promotes neurogenesis so the positive cycle continues.
As someone who has suffered from MH issues I find it comforting to understand the physiological and biochemical processes. It doesn't matter to me that my issues might have originated from the environment but it matters that when I feel myself sinking I have an understanding of what I need to do to stop it escalating. It might be that those processes invlove elements of CBT but they also help me restore a biochemical equilibrium.

Psychiatrist here. I like to look at all illness, mental and physical, as a biological, psychological and social issue, in different ratios for each individual and each disease. With a bit of luck thrown in for good measure.

Lung disease might occur in an unlucky smoker with a family history. If he/she is prone to stress, will produce more cortisol which is widely enough accepted to weaken the immune system.

Depression might occur in an unlucky person who had awful experiences and had genetics stacked against him/her. Being a worrier beforehand probably didn't help.

Therefore, a combination of biological (e.g. meds), psychological (e.g. The right therapy) and social interventions (e.g. supporting someone get out of a bad living situation) are all fairly important.

It's a little more complex than my quick summary here, but most of my colleagues agree more or less.