Brains, genes, and chemical imbalances – how explanations of mental illness affect stigma

People who attribute mental illness to brain disease or genes tend to blame affected people less, but see them as more hopeless and dangerous.lauren rushing/Flickr

Depression, schizophrenia, and other psychiatric conditions increasingly are linked to findings in the brain and in our genes. Many professionals believe these developments hold the key to better treatments and their enthusiasm spreads. The public now endorses biogenetic (biological and genetic) explanations for mental health problems much more so than we did in previous decades.

One possible desirable side effect of these developments is a reduction in stigma. If the cause of psychiatric misery is in our brain chemistry or our DNA, then the miserable cannot be blamed for their symptoms. Advocates argue stigma will diminish if we come to see mental health problems as biologically-caused illnesses, no different from diabetes or cancer.

This is an appealingly optimistic view, linking scientific advance to social progress.

Unfortunately, it may also be wrong. Many writers argue seeing mental health problems as biogenetically-caused diseases increases the stigma associated. Believing a person has a deep-seated biological defect may lead us to see “them” as unpredictable, incurable, and categorically different from the rest of us.

My colleagues and I recently tried to resolve these conflicting views. We synthesised 53 studies of the links between biogenetic explanation for mental health problems and stigma by meta-analysis.

These studies examine several forms of stigma: Some consider whether people are blamed and held responsible for their conditions. Some assess the belief “they” are unlikely to recover. Some measure the desire to keep away from “them.” Finally, some measured the perception people with mental health problems are dangerous or unpredictable.

Our findings indicate biogenetic explanations are decidedly mixed blessings. People who attribute mental health problems to brain disease or heredity tend to blame the affected people less. However, these people also tend to be more pessimistic about recovery, more willing to socially exclude the affected people, and more likely to see “them” as dangerous.

Attributing mental illness to genetics and biology is a double-edged sword. martinak15/Flickr

One notable example of a biogenetic explanation is the “chemical imbalance” view of depression.

The belief this condition is caused by unbalanced brain chemistry is now widespread.

A recent Australian study found 86% of people believe “chemical imbalance” is a likely or very likely cause of depression, and is the most frequently mentioned cause Americans named in another survey.

Seeing depression as being caused by a “chemical imbalance” accords with evidence that abnormalities in brain chemicals accompany the condition. It is also intuitively plausible because medications that alter brain chemistry can be effective treatments. Indeed, the chemical imbalance view fits hand in glove with the growth of antidepressant prescribing.

A recent study suggests the chemical imbalance view of depression has troubling implications. The researchers interviewed 3,642 German adults and presented them with brief descriptions of a person with depression or two other conditions. They rated how much the person’s problems were caused by ten different factors, including a chemical imbalance, a brain disease and heredity. They also rated how much fear and anger they felt toward the person and how much they would socially accept them.

People who endorsed the chemical imbalance explanation had consistently more negative reactions to the depressed person than those who did not. They were more fearful, angrier and less socially accepting. The same negative pattern held for people who endorsed the brain disease and heredity explanations.

The negative implications of the chemical imbalance view of depression may adversely affect depressed people themselves. A recent study recruited adults who had experienced an episode of depression.

Because there is no test for “chemical imbalance,” these people were given a bogus lab test purported to determine whether or not their depression is caused by a chemical imbalance. A saliva sample was taken and purportedly assayed for levels of serotonin, a neurotransmitter.

Half of the experimental participants were told their depression was caused by low serotonin levels and shown an official-looking bar-graph to prove it. The other half, a control group, were told their depression was not the result of a chemical imbalance and given test results to match. All participants then rated themselves on a series of questionnaires.

Participants in the chemical imbalance group blamed themselves as much as their control group peers. They were also more pessimistic about their chances of recovery and less confident of their ability to manage their depression.

Further, only participants in the chemical imbalance group believed pharmacological treatment to be more appropriate and effective than psychotherapy.

In sum, the chemical imbalance view leads people to feel less hopeful and capable in the face of their problem,s and more disposed to use medication.

People who attribute their mental illness to a chemical imbalance may be less optimistic about their chances of recovery. minds moving/Flickr

Biogenetic explanations are ascendant in psychiatry. Writing on a new biomedical makeover of psychiatric classification, the head of the United State’s powerful National Institute of Mental Health said as much, recently declaring “mental disorders are biological disorders.”

This statement is true in the same way “humans are biological organisms” is true: correct on one level, yet also fundamentally incomplete.

As this revolution gathers force, we need to be mindful biogenetic explanations for mental health problems can and will have troubling implications for the myriad people who suffer them.

Evan Rachel Wood Shares Her Experience In A Mental Hospital

The Media and the Chemical Imbalance Theory of Depression

Psychiatry’s Incurable Hubris

 

 

3 thoughts on “Brains, genes, and chemical imbalances – how explanations of mental illness affect stigma

  1. In terms of actual scientific research of causation, the most probable causes of mental illness in most cases involves some combination of social and other environmental factors, such as stress and toxins (high inequality being a major element of stress according to Keith Payne, Kate Pickett, and Richard Wilkinson), along with diet and nutrition. Neither biological determinism nor individual blame is necessary, much less good for anyone involved.

    Liked by 1 person

    1. There is also trauma, personal and collective, including transgenerational which touches upon epigenetics (e.g., one generation experiencing famine can lead to several generations of obesity). Also, long-term stress studies shows can be more traumatic than a single major event of harm. The accumulation of multiple harms and multiple other factors creates a barrage of slow degradation of all aspects of health. The individual factors may even be invisible to human experience, but they can still have powerful effects.

      Liked by 1 person

  2. The first realization is what we call “mental illness” isn’t monolithic. It isn’t ONE thing but rather many different things under one umbrella.

    We can say this “chemical imbalance” thing is not what is going on. It’s actually a really stupid model once we look at what it means.

    For example, bipolar disorder is not a lithium deficiency though exogenous lithium is often used to treat it.

    I will try to write something up because this is an important concept to get and most everybody has family, friends, self with some mental illness.

    Liked by 1 person

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