Mental Illness Doesn't Need Biology to be Real
There has been a concerning trend within psychology lately, which seems to be spreading to popular media about psychology: an emphasis on biology legitimizing mental health. If you look for psychology-related articles online, it's easy to find articles discussing how depression is now a "real" illness because it has been found to affect the body in various ways. While the pursuit to identify biological components of mental illness is important, it's concerning that it's considered necessary for people to view them as real illnesses, as if they weren't before. Here, I want to describe how I feel mental illnesses are very real, regardless of their biology, and why we can't discount their psychosocial aspects.
The Problem with "It's All in Your Head"
Prior to this "legitimizing" of mental health problems through biological findings, many people held the notion that all of these problems were just "in your head." What's odd about this is the fact that it implies our "head" (i.e., mind) is in some way separate from our body. Some people have certainly made that argument in the past, but now we know that there is at least some link between our minds and our bodies through the brain. That means illnesses that are "in your head" affect the brain in some way, which is a pretty basic understanding within psychology.
But as simple as that point is to make, it's important for one major reason: our brains coordinate and control many of our bodily functions. Different areas of our brain release hormones that act as communicators to our other organs, which influence how they operate. There are also the direct links the nervous system has from the brain to our different systems. Although not everything relies 100% on the brain (our digestive tracts have a sort of brain of their own and operate somewhat independently, for example), it's clear that our brains play a role in a lot of our bodily functions.
With all of the nerves in the brain connected in many ways, we should expect that changes in our thought patterns can affect our bodies in various ways. Even if some neural pathways keep things somewhat separated into distinct areas, it's never 100% cutoff from other pathways. Many of the areas related to bodily function are also relevant to our cognitive pathways (e.g., the fight-or-flight response when we think there is a threat).
So even before we had these studies proving a biological component to mental health, we should have expected that to be the case and not have considered mental health to be in some way separate from the body. The research is still important, but it's not the "proof" of mental illnesses being real.
Mental Health Goes Beyond the Body
Psychology research has taken a biopsychosocial approach for a number of years (at least in some areas; others seem resistant to embracing this approach). Some of the research within this framework has focused on gene/environment interactions. In all cases, genetics have failed to explain 100% of the outcomes. Some mental health outcomes are more closely linked to genes (e.g., bipolar disorder), but most are heavily influenced by environment.
That is because humans exist within a complex world that involves a lot of different contexts/systems: families, neighborhoods, nations, religions, political groups, school, professions, hobbies, and so on. All of these involve social interactions, various exposures, and unique cultures. Some are protective, while others increase stress.
Not only do these different contexts/systems play a role in determining whether or not a person will develop a mental illness (along with genetics), but a person's mental health affects how they function within each of these areas. We have known for quite some time that mental health challenges like depression have a real impact on things like job performance and productivity. Social relationships can suffer because of strain caused by mental health symptoms. People may disengage from hobbies, reducing not only their own social network but the social supports of those they interact with. Lifestyle changes, like poor diet and sedentary behaviors that can lead to physical health problems, often occur when a person has mental health challenges.
Given all of these interactions we have known about for some time, why would there be doubts that mental illnesses are real? Even before we had biology to "confirm" the effects of mental illnesses, we could easily see them in how a person behaves and interacts (or fails to interact) with others.
It's Something We're All Exposed To
Most of us will go through life without qualifying for a mental health disorder. But that does not mean we do not experience the symptoms of mental illness. Diagnoses are based on a categorical approach to symptoms, but reality looks much more dimensional. That means we all experience mental health challenges to varying degrees. Usually these experiences do not prevent us for functioning in our day-to-day lives, but they present as a struggle for us to work through.
Having these experiences, it's possible for us to understand how mental illnesses can affect a person. Sure, it may be difficult to imagine what it's like to have delusions or hallucinations, but we all have some degree of familiarity with depression and anxiety (two of the most common mental illnesses). Given that some of these challenges are a part of the human condition, why do some feel the need to act as if they don't exist?
To be fair, some would argue that "normal" levels of these challenges are easy to "just get over." And to some extent that is true (even if many people struggle and self-medicate more than they may be aware). But we cannot look at the experiences of others and assume they are the same as our own. That is, just because we only experience mild/moderate anxieties doesn't mean that others do not experience more severe anxieties that are more difficult to manage.
After all, do we expect people to have the same (more or less) levels of strength, eyesight, height, and so on? No! Everyone's physical experience of the world is different, which we understand, but so is everyone's mental experience of the world. Some of the generalities are the same, but the degree and challenge posed by different things can vary a lot, and in ways that we can imagine/understand. Just because most of us are able to cope effectively with our experiences of challenges does not mean that everyone else should be expected to be able to do the same.
Mental illness has always been real. And it will continue to be real. Despite claims that biology is "legitimizing" mental health concerns as real problems, we have known this basic fact for a very long time. The biological research is important to help inform treatment, but it is not the be-all and end-all of mental health. The psychosocial factors are also important, and there is no getting around that fact.
Have thoughts on this topic? I'd love to hear about them in the comments!