Biology or Psychology?

I wrote this 20 years ago in order to educate the staff of a local psychiatric clinic. They were somewhat less than enlightened.

BIOLOGY OR PSYCHOLOGY?

The best answer to this question may be either and both.

Most of us here have been diagnosed as having a major mental illness. Mental illnesses are not
mental weaknesses. The diagnoses that we are most familiar with include:

1. Major Depressive Disorder (MDD - Unipolar Depression)
2. Bipolar Disorder (BD - Manic Depression)
3. Dysthymia (Minor Depression)
4. Seasonal Affective Disorder (SAD)
5. Schizophrenia
6. Schizoaffective Disorder
7. Obsessive-Compulsive Disorder (OCD)
8. Post-Traumatic Stress Disorder (PTSD)
9. Generalized Anxiety Disorder (GAD)
10. Social Anxiety Disorder
11. Panic Disorder

All of these illnesses have one thing in common. They are not our fault. Each disorder has both
biological and psychological components. We all begin our lives with a brain that is built using
the blueprints contained within the genes we inherit from our parents. Later, hormones change
the brain to prepare it for adulthood. It is continually being changed by the things we experience.
The brain determines the mind as the mind sculpts the brain. Unfortunately, the brain can also be
changed in negative ways by things such as drugs, alcohol, injury, trauma, and chronic stress.

How we think and feel are influenced by our environment. Probably the most important
environment during our development is that of the family, with the most important time being
our childhood. We all have both positive and negative experiences as we travel through life.
How we are as adults is in large part determined by these positive and negative experiences.
They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy
negative experiences.

Some of us are also hurt by unhealthy brains. Medical science has long recognized that many
mental illnesses are actually biological disorders. Even Sigmund Freud, who we know for his
development of psychoanalysis, proposed a role for biology in mental illness. He was, after all, a
neurologist. The first solid evidence for this concept in modern times came with the discovery of
lithium in 1947. Lithium was found to reduce the symptoms of bipolar disorder (manic-
depression) or cause them to disappear completely, allowing previously disabled people to lead
normal lives. Lithium helps to correct for the abnormal neurotransmission in the brain that is the
cause of bipolar disorder. Subsequent medical discoveries included the observations that the
drug, chlorpromazine / Thorazine (an antipsychotic), successfully treated schizophrenia, and that imipramine / Tofranil (a tricyclic antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these disorders. Since then, a great many drugs have been added to the arsenal of doctors to treat mental illness. In addition, there are some newer brain stimulation techniques that work without the need for medication.

What about psychology? What role does it play in mental illness? This can be a two-way street.
The abnormal biology that occurs with some mental illnesses affects our psychology how we
think, feel, and behave. On the other hand, our psychology can also affect our biology. As we
now know, the emotional stresses and traumas we experience change the way our brains operate.
This is especially true of things we experience during childhood. These stresses can trigger the
induction of abnormal brain function that leads to major depression, bipolar disorder,
schizophrenia, and other major mental illnesses. In order for this to happen, however, there must
be a genetic or some other biological vulnerability to begin with.

It is important to remember that not all psychological and emotional difficulties are biological in
origin. Again, we are all products of our environments family, friends, enemies, school, work,
culture, climate, love, war, etc. Environments that are unhealthy often produce unhealthy people.
However, this, too, is not our fault.

In conclusion, regardless of the cause of our mental illnesses, it is important that we treat both
the biological and the psychological. We will all benefit most if we do.

By SLS

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.

Biology or Psychology?

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