How is the brain relevant in mental disorder?

The Psychologist has a fascinating article on how neuroscience fits in to our understanding of mental illness and what practical benefit brain science has – in lieu of the fact that it currently doesn’t really help us a great deal in the clinic.

It is full of useful ways of thinking about how neuroscience fits into our view of mental distress.

The following is a really crucial section, that talks about the difference between proximal (closer) and distal (more distant) causes.

In essence, rather than talking about causes we’re probably better off talking about causal pathways – chains of events that can lead to a problem – which can include common elements but different people can arrive at the same difficulty in different ways.

A useful notion is to consider different types of causes of symptoms lying on a spectrum, the extremes of which I will term ‘proximal’ and ‘distal’. Proximal causes are directly related to the mechanisms driving symptoms, and are useful targets for treatment; they are often identified through basic science research. For example, lung cancer is (proximally) caused by malfunction in the machinery that regulates cell division. Traditional lung cancer treatments tackle this cause by removing the malfunctioning cells (surgery) or killing them (standard chemotherapy and radiotherapy)…

By contrast, distal causes are indirectly related to the mechanisms driving symptoms, and are useful targets for prevention; they are often identified through epidemiology research. Again, take the example of lung cancer, which is (distally) caused by cigarette smoking in the majority of cases, though it must be caused by other factors in people who have never smoked. These could be genetic (lung cancer is heritable), other types of environmental trigger (e.g. radon gas exposure) or some interaction between the two. Given the overwhelming evidence that lung cancer is (distally) caused by smoking, efforts at prevention rightly focus on reducing its incidence. However, after a tumour has developed an oncologist must focus on the proximal cause when proposing a course of treatment…

The majority of studies of depression have focused on distal causes (which psychologists might consider ‘underlying’). These include: heritability and genetics; hormonal and immune factors; upbringing and early life experience; and personality. More proximal causes include: various forms of stress, particularly social; high-level psychological constructs derived from cognitive theories (e.g. dysfunctional negative schemata); low-level constructs such as negative information processing biases (also important in anxiety); and disrupted transmission in neurotransmitter systems such as serotonin.

It’s not a light read, but it is well worth diving into it for a more in-depth treatment of the brain and mental illness.

Link to Psychologist article neuroscience and mental health.

8 thoughts on “How is the brain relevant in mental disorder?”

  1. I really feel that mental illness in particular, other than organic brain injury, is a spiritual malady or disconnectedness.

  2. How sad is it that it has reached this point of extreme measurements to treat depression, either by implanting a stimulator in your chest that connects to your happy centre in your brain or wearing a hat that sends magnetic impulses as a form of therapy? Why are people so miserable? And when you consider all the negative effects that these devices have, then it might be better to just stay unhappy

    It has become to easy for people to seek quick fixes than dig deep and faces their problems head on. Instead of allowing the sadness to consume us we should make a mental shift to see the positive in each day, eliminate what is draining you and surround yourself with uplifting people. It sure isn’t as easy as I make it out to be but take it day by day and just try.

    1. I think the reason why people are so sad is because we are slowly losing ourselves in a rat race life. The stress that people have to endure everyday is bringing us down. I say put down the technology and go indulge in mother nature with family and friends (“uplifting people”). We have the ability to chose to be happy and no one can take that away from us.

  3. I strongly believe any form of disease- even if it is just mental is connected to our genes. Two individuals could experience the same trauma but one will be less affected because it is imprinted in their character how to deal with the situation while the other person will simply snap or shut down because it is not in his genes to handle such stress. This example could be linked to two people eating the exact same amount of calories but one might gain weight faster than the other because of genes.

  4. After reading this posted I tested the theory of the unconscious mind being smarter than it is given credit by starting a school assignment and the leaving it a while. When I started working again I worked twice as fast and could focus better, therefore I do believe that the unconscious mind functions better than the conscious mind.

  5. There’s no such thing as “mental illness”. The mind is a transitory, evanescent phenomena, so how can it possess an “illness”? You can claim that “mental illnesses” are real, but only subjectively. Like truth itself, they are “real” only because you subjectively believe them to be real. The entire mythology of “mental illnesses” as unique objects was fabricated beginning in the late 19th Century to justify the sales of very profitable drugs, and to act as agents and tools of social control. Likewise with the ridiculous “spectrum” idea expressed above. How long is that “spectrum”? Of what *elements* is it composed?
    Once again, so-called “mental illness” is PROVEN to be no more than a set of illusory mental constructs. Our current delusional belief in “mental illness” is the 21st Century equivalent of the witch hunts and the Spanish Inquisition.
    Sure, there’s CRAZY people, and people can become crazy, and yes, sometimes some people do better on some medication. But the pseudo-science of psychiatry, like its’ ancestor “Phrenology”, has been kept on ideological life-support far too long. I *DARE* you to give an honest reply_____?

  6. Also, we need to bear in mind the lessons we learned from Broca’s “The Origins of Consciousness in the Breakdown of the Bi-cameral Mind”. We have 2 clearly defined “hemispheres” – the right and left, in our cerebral cortex. Thus, we are self-aware. But because as a race & species we have yet to fully re-capitulate those “poles”, we tend to fall into the “either/or” trap. The “one or the other” trap. The truer reality is that it’s most often “both/and”.
    And, every night when we dream, we are in a psychotic state of mind, just as we are then under the influence of a naturally occurring narcotic produced by our brains. As for “depression caused by low serotonin levels”, well, that’s pure drug company hype and propaganda. OH? Well cite me even *ONE* valid study showing otherwise…. The so-called “mental illness” known as depression is in fact a natural state of mind which we allow to fester. No, we can’t “snap” out of it, but we *CAN* work our way out of it. And, it usually abates naturally, which is why drugs *sometimes* *seem* to “work”.
    Hey, SSRI’s have been proven almost as effective as placebos….
    I DARE a serious challenge…..

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