Mental illness: two incorrect perspectives

The other day on e2 I read a writeup under seasonal affective disorder, by Doyle. It was a well written writeup with some good thoughts behind it. The basic message of this writeup seemed to be: to call something as natural as "getting the blues" a "disorder" seems to be a departure from common sense. I mention this node because it is one of the most recent and because it bears on my recent experience this winter. However, there are quite a few nodes similiar to this on e2. The basic message of this is that emotional states, even negative ones, are not "disorders", and should not be treated as some sort of clinical problem.

This, of course, is not an attitude confined to e2. Today I was at the Multnomah County Library and I came across a book entitled "Depression is a choice : winning the fight without drugs". There is actually an entire school of thought, it seems, that believes that depression is just a myth, a wildly overdiagnosed label used by the medical profession and drug industry to sell lots of drugs. A school of thought that believes that depression, along with other mental illnesses, can be beat with sheer willpower. Perhaps we would be better kicking all of the mentally ill off of social security and letting them go get jobs, which would probably immediatly perk them up, and enable them to live as happy, productive citizens.

On the other hand are people who believe that mental illness is strictly a matter of chemistry, a strictly determined biochemical phenomenon imprinted in our genes. According to this view, the only way to deal with mental illness (if it can be dealt with at all) is with drugs, and lots of them. In this view, lifestyle changes are totally irrelevant since they can't change the genetic information causing the problem.

In my view, and I do admit that there is no way am I an expert on the issue of mental illness at all, both of these views are wrong. Of course, anytime you take a spectrum of views, the two most extreme views are going to be (probably) wrong. To my way of thinking, the truth about mental illness lies somewhere between the two. Mental illness is neither "all in the head", nor is it a strict product of biochemical factors. I think that people who cling to the first view are stuck on an a priori view that people are naturally independent and autonomous, and that the mind is a Cartesian substance that can control its own functioning through pure logic and will. People who believe the second view have a problem that can best be summed up by paraphrasing Sinead O'Connor: "First, all they know about is chemistry. Second, they don't know anything about chemistry." While serotonin may have entered our popular vocabulary, and the link between serotonin levels and depression is well established both in scientific thought and the popular mind, those who actually take the time to study the 2 dozen different serotonin receptor subtypes and their interlocking behavior, let alone all the other different types of receptors in the brain, would hardly say something as naive as "one type of neurotransmitter can directly affect mood all the time". On top of that, my common sense, if I can allude to something so common, would not tell me that a person with a history of sexual or physical abuse with financial problems, a lack of social support and the other such problems seen in depression's main problem was a slight fluctuation in catechol levels in a few cubic milimeters of brain tissue. Mental illness, to me, is something real, that can not be overcome by "wishing it away". However, being real does not mean "strictly tied to easily measurable physical phenomena".

This all relates to me on a personal level. This past fall I had a great drop in schoolwork, physical health and general quality of life. I tried to overcome it simply by setting my nose to the grindstone and muscling ahead, but it didn't work. If I had been a little less macho, I probably could have gone to the doctor and gotten a diagnosis for seasonal affective disorder. However, before it came to that, I got possession of a full spectrum light, and also begin volunteering quite a bit. I also got involved in a project that involved sociailizing with a lot of people who appreciated my unique abilities. And after several months of depression, I was feeling cheerful and energetic again, seemingly overnight. So I overcame my (admittedly softcore) depression not through willpower, but through a mixture of lifestyle changes and the possible clinical (if placebo based) effects of the full spectrum light.