As a graduate of the ever evolving field of Neuroscience, who has since committed their professional life to mental health work, the inevitable link between the two areas has cropped up in discussions more times than I count. It’s a connection I can’t help but think about, given that the potential implications are so far-reaching.

The current drug treatment model is largely based on the assumption that if you remove the associated neurological changes i.e. changes in the level of various chemicals in the brain, then you also remove the problem. Increasingly often this is being paired with more holistic therapeutic techniques such as CBD, and this dual approach is one I certainly see as being more effective.

However, what if the actual underlying problem that has caused someone to become ‘mentally ill’ is far deeper, and by treating the neurological symptoms you’re thereby missing out on areas of their history or lifestyle that, if ignored, will only lead them to return to this unpleasant psychological state. It’s a possibility that would potentially completely undermine the current medical model, and yet this line of thought is continuing to gather momentum.

Based on my experience of mental illness – both personally and of the many people I’ve met, and my time spent studying the brain (somewhat ironically, in between killing my own brain cells with alcohol, like a true student) I’ve come to my own conclusions on it and it’s something I’d like to share, especially in the context of how we approach helping people who are psychologically distressed. At this point I’d like to throw in a couple of key points that will impact upon the context of the rest of this piece.

1. This is not a scientific article, and nor is it intended to be. It’s a blog. There is a great deal of literature and research out there, but I’ve chosen not to reference it here. This is part because I’ve seen how exceptionally competent scientists are at failing to explain their conclusions to the average member of the public, and partly because…well it takes a bloody age. I’m just going to provide an outline and I’ll leave it up to you if you really want to look it up (there’s a ton of stuff out there). Otherwise you’ll just have to take my word on the sciencey-stuff and assume I’m not just making stuff up for kicks.

2. I’m using the term ‘mental illness’ and associated disorders such as ‘depression’ and ‘anxiety disorder’ because they are widely understood. For the record, it’s not language I actively promote because of the negative associations it creates, and I’m also not a fan of grouping such varied symptoms and personal differences in to the narrow categories currently used. The mind is a tad too complex for that. But that’s a whole other topic…

So let me start by saying that there is a well-established link between mental illness and abnormalities in the brain, which has been accepted for several decades. There’s not really any argument about this. Which part of the brain, however, has caused a great deal of dispute. A chemical named dopamine was once thought of as the ‘happy’ or ‘pleasure’ chemical of the brain (what a revelation that would be!), but this theory has since been disproved. Modern research in to depression has brought a lot of attention to a chemical named serotonin, and led to the advent of a popular drug type called ‘selective serotonin reuptake inhibitors’, which is indisputably catchy.

The point I’d like to make here, is that the brain is not so simple that one chemical is assigned to one particular function, such as mood in this context of this blog. Physical and psychological changes are brought about by changes in levels of neurological chemicals in relation to one another, and it also entirely depends on which area of the brain these changes are occurring in. We have a series of chemicals that can either inhibit or stimulate a chemical pathway, and depending on the brain network, an inhibitory chemical could have completely opposite effects on your mood in two differing areas of the brain. Are you beginning to see how damn complex it is? So even if you’re changing serotonin levels, you need to target a very low percentage of those serotonin pathways to have the desired effect. The shotgun effect, which is seen in every drug treatment, produces a whole range of responses to the drug – both good and bad.

What you may also start to realize from this, is that no two brains are identical – quite the opposite. The design of the pathways in your brain and your level of chemicals is completely unique – which is one of the few things I can say with certainty in this commentary. You can imagine the headaches researchers get when trying to draw conclusions about mental health when looking at large samples of people who are all presenting different results.

I’ve spoken with many people who have shared their experiences of drug treatment for a mental illness with me and a few common themes have come out. Firstly, that they may have to try a few different types of medication before they find one that works. Secondly, that they often feel worse to begin with before they start to notice an improvement. Thirdly, the dreaded dependency effect.

What became apparent through my experience of depression, and many others I’ve spoken with who have experienced ‘mental illness’ is that there is a cause, and a trigger. Some of us are genetically more susceptible, but life experience plays a big role. There’s a bigger picture here. And our brains have not evolved to just ‘imbalance’ and cause us to become mentally ill. Doing so is maladaptive.

One of the biggest realizations in the field of neuroscience in the 20th century was that the brain remains plastic for its entire life i.e. it continues to change, develop and adapt. This happens throughout our lives. And these are potentially fairly considerable changes too. And even on a daily basis, there are notable changes. A moment of excitement , of disappointment, a spark of happiness…they all cause a change in the brain. It’s absolutely plausible that events in our life that are too much for us emotionally can have strong, and potentially long-lasting effects on the brain. In fact, it would be completely counterintuitive for someone who is depressed to not demonstrate some notable changes in their brain.

I feel that current attitudes and the medical model fit with our way of western thinking – to find a quick fix and put the cause as being out there somewhere. The fact that we can actually be the biggest drivers of change in our own lives is an intimidating and, often, ignored concept.

I believe we need to depend less on the medical model, accept how different people are and understand that each experience of mental illness is unique so it can’t be treated the same way. Rather, it should be treated holistically, with drug treatment only if so severe they can not manage their everyday life or are very high risk.

What I’d also like to mention, is that sometimes changes we make in terms of what we put in to our bodies could trigger these changes in the brain. A different diet, drug treatment for a physical problem, the contraceptive pill…these can all lead to changes in the our chemical balance and lead to mood or personality disorders.

Where it gets very blurred and unclear for me is in some of the severe cases of mental illness, such as with bipolar disorder or forms of schizophrenia. My conclusions don’t extend to this – partly due to lack of evidence, knowledge or experience. The strike me as being more long-term, with possibly more of an underlying neurological dysfunction and thus drug treatment has more of a role. The brain is so incredibly complex, and we’re learning more all the time.

Whether these changes in the brain are definitively a cause or symptom of emotional and psychological distress, or even a combination of both, remains unclear, and it’s likely that it varies depending on the situation. What is clear given the huge implications, is that like all things related to mental health, we need to talk to get it out in the open and explore it from the point of view of what will be the best for people.

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