This second semester I took Abnormal Psychology, and spurred my thinking about mental disorder. I would like to propose a new hypothesis for most mental disorder: I think that ALL mental disorder is the result of an inability to adapt quickly enough to change. It is akin to limping when you hurt your leg, it is what you get from a brain in the process of mending itself.
Our brain”s are like muscles, sensitive and reactant to being used and what they are exposed to. When a stress is placed on a muscle or bone that is greater than its capacity to handle it, you get an injury. There is damage, or change in the tissue, that needs time to heal. It doesn”t matter how you get it – the injury might be incurred slowly over time, as an athlete develops a stress fracture, or happen suddenly, like snapping something in half. Ouch. Either way, the healing is a must to “adapt.” And no, we won”t always heal and be exactly the same as before, but the body will fix itself in the best way it knows how, to achieve balance again. Our bodies are really good at that balance thing
It isn”t so surprising that so much of mental disorder occurs in concordance or after change, namely stressful life events, whether positive or negative, or forced changes in behavior. I would say that a lot of disorder comes from a forced change in behavior as a result of a change in life circumstances.
Our body has these systems as ways of telling us that we need to change our behavior to find balance again – it isn”t aware of the resultant behavioral effects on the body – the effects and consequences of change and adaptation, when they are noticeably large, are “mental disorder.” Our body alters us to changes in the environment with things like pain and temperature, reactions to motion, color, and sound, through cravings what food we might need, aversion to things that made us sick, or even when it”s time to sleep and we feel tired. A lot of life is about listening and reacting to the demands of your body, when you think about it. These cues are more somatic and therefore “obvious” than something like a “gut feeling,” which I would argue is just as informationally rich and salient.
So what happens when we have an injury and go against these responses? The injury gets chronic: it doesn”t heal. The same is true for mental illness. From a neurobiological perspective, it”s probably time needed for rewiring. As life demands change, our brains change too to make new connections, and prune ones that aren”t as important anymore. When a life event occurs that demands a change that is too big or fast for us to handle, this is when disorder sets in: when the brain is unable to process the new demand. Perhaps a change might happen so quickly that one area of the brain is fundamentally changed, and then other areas must form new connections or “grow around” that new change.
Why do many current methods of treatment “work”?
So why does something like psychotherapy, or drugs, or even time alleviate disorder? It either helps to speed adaptation, fill in a missing piece, or facilitate connections. Of course it is possible to have instances when the brain has been stressed to a degree that would require extreme time or change to “return to balance” and I think that there are circumstances when the brain simply cannot adapt, and goes into complete dysfunction.
It would be interesting to focus in on specific disorders, and think about them as the brain adapting to some change. I would imagine that different levels of damage require different times, you could perhaps try to study time with relation to each disorder? Treatment might be more about best managing that time, maybe accelerating it with psychotherapy, or encouraging/facilitating connections with medication. The CORE of this treatment might be focused around what caused the damage and how severe it is, how to protect the brain during healing, and ways to best promote recovery.
And then what is balance between “slapping on a bandaid” (so treating symptoms to promote current happiness and ability to exist in society) vs. leaving the brain be and letting it adapt, or tending to underlying injury? How do we deal with the demand for functionality when it might go against healing? It probably depends on the disorder, as I would imagine there might be some that require so much time that it makes most sense to treat those symptoms and focus on the present. That”s a pretty broad and challenging question, and I don”t have an answer.
Mental Disorder: My Equation
Mental disorder is at the core, neuro-biological, and is the body”s inability to adapt to change, or reaction to a change that is too sudden to adapt to. Here is a summation!
Mental disorder = change (in external environment (diathesis) that demands brain to adapt (reward system, stress, etc) at a speed that is TOO fast for the normal creation of neurons, wiring (pruning, growth, etc). Then we are encouraged to act in ways to protect this vulnerability and promote healing.
Diathesis that demands change –> inability to adapt (shock) –> change in behavior cognition to promote healing
or a simplified version
Change –> brain as deer in headlights –> Reaction
What does this mean about our expectation of change?
Expectation might be a good thing. When we EXPECT change, that is almost giving our brains a heads up, to either start adapting early, be better prepared for the shock, or think of ways to avoid it. Expectation can also be dangerous for disorders for which the brain might need a lot more time to heal. For someone with schizophrenia, hope is lost after 1, 2, 5, 10 years, but what if that adaptation just takes a lot longer, yet we place some sort of time expectancy on it, and get our hopes up? The same goes with depression, anxiety, mood, or body image disorder – when we create some sort of expectation around the timing of getting better, that can”t be great for treatment”¦ We attribute a patient waking up from a long coma as a “miracle,” but suggests that our brains can heal, we just have no idea about the timing. Isn”t it the same for mental illness? Think of it as a spectrum of time needed to heal, something like coma on the far extreme right, something like a bad day on the less extreme left side”¦ everything might fall somewhere along that spectrum.
What does this mean for how we view mental disorder?
I”m not sure what to do with this idea, but I think that it has huge implications to change the way that we view mental disorder. I am thinking that my idea can be taken from a public policy standpoint, it might be an idea that can be good because if “spread” it might change the way people think about mental illness and consequently how the mentally ill are treated, thought about, or it could take a more treatment-specific spin.
It could be woven into hypotheses about what the brain looks like “before and after” for specific disorders, or maybe something as simple as the brain”s response to getting hurt, and the timing of that response, and how its correlated with changes in thinking and behavior, and based on that timing, what are the best treatment options/implication for treatment? Or the worlds of public policy and science might make some combined effort: start in the lab, get some results, and use those results to influence public”s perception/idea of mental illness.
Can we err away from words like “crazy,” “psycho” and move towards something a little more sympathic, a little more human? Falling and breaking your hand and going to see Dr. Handsy sure comes with a lot less negative stigma than talking with a “shrink.” It”s just harder to look at any sort of maladaptive behavior in the same way as an injury gushing out blood and rocks. What”s the difference? We give a lot more value to pain that we can see, even though in both cases it is our body”s way of alerting us that something needs healing/adaptation. The funny thing is that in both cases the experience of “crap, something is off” goes on in our heads. At the same time it might make it very easy to “pretend,” and use that for manipulation, and knowing that leads to even more skepticism. How do we distinguish the two?
Where does the negative stigma come to begin with? Many behaviors of those with mental booboos are very noticeable and unacceptable in the eyes of society, and that lack of acceptance only serves to alienate those with mental illness even further.
Final Point – Have compassion for the brain.
Give your noggin a little more flexibility to get hurt, and have more acceptance when it does. In essence, mental illness is less a negative thing, or something being “wrong” with the person, and more a brain booboo that needs time to heal.