Tuesday, January 21, 2014

Biology of “Mental illness” – fact or fiction?

The majority of physical illness diagnoses can be verified by objective clinical tests. The majority, if not all, of psychiatric 'mental illnesses' cannot be (those caused by alcohol, drugs and certain real diseases, Alzheimer’s and Huntingdon’s excepted). Many medical diseases have verifiable causes. Psychiatry has none. 'Mental disorders' are simply categorizations of behaviours or thought processes which are then given labels.

The truth is finally – after too long a period of denial – “coming out”:

There have been claims, published in professional journals and in the media for decades, of gene discoveries and that mentally disordered patients have faulty genes and chemical imbalances in their brains. All are now shown to be wrong.

The American Psychiatric Association (APA) has now officially admitted that there are no genes for mental disorders. In an official APA press release dated May 3rd, 2013, Diagnostic and Statistical Manual for mental disorders version 5 (DSM-5) Task Force head David Kupfer MD stated, “In the future, we hope to be able to identify disorders using biological and genetic markers that provide precise diagnoses that can be delivered with complete reliability and validity. Yet this promise, which we have anticipated since the 1970s, remains disappointingly distant. We’ve been telling patients for several decades that we are waiting for biomarkers. We’re still waiting.” 
 In this statement, American psychiatry has at last come clean about its failure to support its claims of a biological basis for “mental illness” with actual scientific findings.

The hope is that one day, as David Kupfer MD plaintively tells us, research may, “culminate in the genetic and neuroscience breakthroughs that will revolutionize our field. In the meantime, should we merely hand patients another promissory note that something may happen sometime? Every day, we are dealing with impairment or tangible suffering, and we must respond. Our patients deserve no less.”

I have raised the fact before that almost by definition, psychiatric disorders are not medical conditions. If they are shown to have a biological basis, they cease being psychiatric disorders and are transferred to other areas of medicine, such as neurology. This point has been made repeatedly by others more qualified than I. As far as I can determine there is no evidence that DSM “mental disorders” are true medical conditions, but if such evidence comes in, they will be treated as medical conditions and not psychiatric disorders.

As I understand it, psychiatry and psychology have been trying to reconcile the irreconcilable. There is an attempt to reconcile the objective, quantitative, scientifically measurable aspects of the biological brain with the subjective, qualitative and immeasurable aspects of the mind with the hope of arriving at some meaningful answer.

I know that various scanning techniques have identified parts of the brain that “light up” when emotions or thoughts are invoked. But no one has ever been able to determine what comes first; do the thoughts “light up” the neurons or do the “lit up” neurons generate the thoughts?

We need to know the answers to this conundrum because the present level of psychiatric research conformity demands that any mental disorder can only be the result of some biological/chemical deficiency in the brain which can be cured by pharmacological products alone. The fact that the APA (above) has had an unusually reflective moment and realised that it may be wrong in promoting the quest for biological markers for mental disorders is illuminating to say the least and well over due.

Pharmaceutical drugs are not the answer – so what now?

I suggest that if it took years for any particular individual to develop whatever mental disorder symptoms are presented to the health professional concerned, popping a pill may, temporarily, alleviate the problem but will not cure it. What is needed is a long and time consuming, gentle, empathetic, holistic approach to the person concerned – listen, LISTEN to what the person has to say. There is always a message in there somewhere. It may need deciphering. The message will undoubtedly be garbled and may, for example, be an attempt to interpret an event which occurred when the person was an infant who would have lacked the relevant emotional or cognitive abilities to arrive at a satisfactory answer.

Once more, pharmaceutical drugs are not the answer. They are only marginally more efficacious than a placebo (and in some cases – generally not reported by the pharmaceutical companies concerned – may actually perform worse than placebos). Drugs, without exception, have severe side effects and have physical effects on the body, which often reduce life span by many years.

So, to answer the question posed at the beginning of this post - it now accepted that the assertions mental disorders are caused by biological factors are myths and based on fantasy, not facts.

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