Something occurred to me this morning. We hear so much debate about what causes mental illness, and how to treat it. The one that I’m most aware of is that depression is the result of a chemical imbalance, and that it can be helped with medication. I’m not sure where I sit with this argument, because I know medication has helped to a degree, but so have lots of other things.

One point that Therapist 2.0 consistently comes back to is cortisol – our threat protection system is triggered for whatever reason, it sends cortisol into our system to get us ready to fight or flee, then the tension this creates in our body reinforces the sense that we’re in danger, so releasing more cortisol, and the cycle continues. Brain sends messages to body, body sends messages to brain, and we’re caught somewhere in the middle trying to cope with it all. Does that make it a chemical imbalance? Ok, there’s too much cortisol in our system at times, but is that not a reaction more than a cause?

I was talking about this with my sister last week, and she wondered why there was no medication that could control this. But I guess if we were to tamper with our system’s ability to release cortisol, then we’d be putting ourselves in very real danger, in that at a time when we genuinely do need it, none is released. (I should probably point out that this is all very much just me pondering the issue. I don’t have the answers, nor have I done extensive research, but Therapist 2.0 is really making me think)

I think the crux of what I’m trying to figure out at the moment is whether bpd/depression is the cause or result of chemical imbalance, or if that even comes into it all. My brain thinks it’s helping. My body is reacting to signals from my brain. My mind is caught in the middle and often isn’t able to keep up. I feel like I almost understand, but not quite. Then when we throw medication into the mix……..what is it actually doing? It can’t ‘cure’ the problem, that’s for sure, although it can manage the symptoms to an extent. But maybe even symptoms isn’t the right word?! Maybe medication helps manage how these reactions manifest, and takes the edge off to such an extent that we can work on the root cause. I’d like to think that’s the case, because if it is, it means there’s a very real possibility that medication won’t be part of my future for ever and always. That would be really, really awesome.


This article has 3 Comments

  1. Hi Sunny
    The chemical imbalance/biological models have dominated mental health thinking and research for over 60 years. Today, the science of mental health is no closer to understanding anything about ‘mental illness’, and the numbers of people suffering with various mind problems continues to increase each year. In all that time, and across all of the scientific research completed over those decades, not a single piece of evidence has emerged to directly support the chemical imbalance model. This is because it is wrong.

    It is true that every experienced moment, and everything that happens in mind, is reflected biochemically in the brain. Is a ‘depressed’ brain, or a BPD brain, biochemically different than a brain with neither? Of course they are. That experience we call depression, or BPD, is a normal and natural brain function that alerts us to the presence of an emotional wound, in the same way physical pain compels us to take steps to heal a physical wound. The brain of a person with a physical wound is biochemically different to one with no wound. Taking psychiatric medication is the equivalent of taking paracetamol for a broken bone. It might diminish the pain a bit but in the end the bone has to be reset if it is to heal.

    The broken bone(s) that is depression, anxiety disorder, BPD and virtually every other disorder of mind is emotional trauma, which is painful, frightening or overwhelming experience that the brain was unable to process. In most cases these things happen in childhood when the brain is very inexperienced and finds it difficult to process new and complicated experiences, particularly when those experiences are painful. ‘Processing’ means ‘making sense of’ the experience and discharging the pain of it. Most traumas can be identified as memories of painful experiences in the past that cause pain in the present when they come to mind. That pain doesn’t belong in the present. Other traumas are suppressed and unknown to the sufferer but the pain of them is still there. If you have a mind problem then, by definition, trauma is present whether you are aware of it or not.

    Traumas can be identified and removed, most of them quite easily. Check out Trauma Incident Reduction (TIR) and Eye Movement Desensitisation and Reprocessing (EMDR), which are methods of removing the worst kind of traumas associated with PTSD. But even small and simple traumas can result in a lifetime of emotional imbalance and mind problems. Both TIR and EMDR models can be distilled down to one very simple principle. Painful experience can only be processed in the conscious mind, where the brain can see it and do the processing work it needs to do. Unfortunately we tend to keep painful experiences out of mind because we want to avoid the pain. Which means we just hold it in and keep it.

    To be clear, I’m saying that many mind problems can be quickly and completely healed, particularly Depression and Anxiety. I started using the trauma model In my work as a therapist about 5 years ago. Today I expect 8 out of 10 clients to walk away from therapy completely ‘cured’. I also expect these people to have a quality of life that exceeds that of ‘normal’ people. Virtually all people carry old emotional wounds within themselves. Those who have been through proper therapy should have very few, or none, and they also reach a better understanding of how the mind really functions, which protects them in the future.

    I understand that this is not easy to accept. This is because people don’t like to believe that their ‘expertise’ is wrong, particularly if that expertise is a central part of their identity. But as long as sufferers, mental health professionals, researchers and policy makers believe that mind problems are about incomprehensible biochemistry and brain wiring gone wrong, and therefore too complex to solve, they will not think to look for a complete solution. They will simply accept the idea of managing life long illness. Of course this is encouraged by the pharmaceutical industry, and the psychiatric establishment which runs our mental health services.

    It is the ‘incurable illness’ model that maintains the stigma associated with mental health problems. It is our acceptance of this model that inspires the hopelessness, and absence of options, that leads so many suicides.

    It is my intention to promote the ‘optimism model’ aggressively in the coming years but so far it has proved extraordinarily difficult. I’m hoping that you, and other influential commentators, will actively explore the possibility that the complex illness model is largely bogus. I do accept that psychotic disorders are more complex, but the existing research suggests that they too have their origins in painful experience.

    Michael Fox
    Clinical Psychologist

    Fyi – it is my view that “Personality Disorder” is a catch-all psychiatric diagnostic category for clients who present in ways that do not fit neatly into the conventional diagnostic boxes.

  2. Very good post Michael Fox! I’m undergoing EMDR for my BPD an since the start 6 months ago I’m much less triggered and the PTSD symptoms I had from a breakup are not nearly as severe. Finally getting better.

    I agree with everything you write and hope that this knowledge can reach the public soon. Hopefully there can be more studies done on EMDR for the resolution of BPD (and other emotional issues), that would really help.

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