There is a common rhetoric which circulates that mental illness is caused by faulty brain chemicals. This narrative serves the function of attempting to reduce cultural stigma associated with mental health issues. If someone’s brain is “broken,” a mental health issue is beyond their control, and therefore they cannot be at fault for it. It doesn’t mean they are bad, lazy, selfish, etc. This narrative legitimizes mental health symptoms and attempts to fit mental health care into the existing medical model (get a diagnosis, get treatment from a healthcare provider, take medication, etc).
While the intentions of this narrative may be good, it is still founded in ableism, and perpetuates a false binary between “healthy” and “sick” brains instead of embracing a wide range of human experience as healthy and normal. While it is true that it has been found that people with depression, for example, have lower levels of certain neurotransmitters like serotonin in their brains, correlation is not causation.
This article speaks a bit more to the neuroscience of depression. Note specifically the impact that *stress* has on certain areas of the brain. The capitalist dystopia that is the US in 2020 is the cause of considerable stress. Look at populations where depression is more likely to be diagnosed (women, LGBTQIA+ individuals, and this study which shows Hispanic and Black individuals reporting higher rates of depression than White individuals, etc.) and recognize the impact of minority stress on individuals holding these identities.
Rates of depression have grown over the last 20 years, and are increasing among Gen Z at a faster rate. When people do not have access to healthcare, are not paid a living wage, when parts of the world are literally on fire, when faced with an ongoing global pandemic, racial unrest and police brutality, climate change, the rise of fascism…. At some point we have to recognize when symptoms of depression are a realistic response to the environment. Members of marginalized communities are the most vulnerable to mental health conditions, and are also more likely to experience both developmental trauma and ongoing minority stressors.
Research in psychology and neuroscience has shown differences in production of certain neurotransmitters or the relative size of different areas of the brain in individuals experiencing mental health conditions like depression or anxiety. But scientists don’t know that a lack of serotonin is the *cause* of depression. It is just as likely the *effect* of living in a perpetual state of stress caused by the inequality of our society, compounded by higher incidences of trauma, and leading to a perfectly reasonable lack of hope for positive change in society and a more equitable future for everyone.
I’m not saying to not take medication. It can help alleviate symptoms and make it easier to cope with life and benefit from therapy. But antidepressants do not remove the necessity of also fighting to create a more equitable society. Recognize that we are living in a society that would rather give you a pill for depression, anxiety, high blood pressure, high cholesterol, etc. than make sure everyone has access to nutritious food, adequate healthcare, emotional support, time for recreation and exercise, rest, artistic creation and exploration, etc.
Health disparities exist across the lines of power and privilege, and genetic predisposition is influenced by systemic inequality and intergenerational stress and trauma. But if depression is a chemical imbalance then we can just treat individual people with “broken” brains and ignore that often, at least the initial depressive episode is triggered by stressful life event(s). The narrative of the broken brain reduces stigma towards the mentally “ill” while giving the powers that be the ability to maintain the status quo.
It is convenient for capitalism to locate the cause of mental illness within the individual. Capitalism turns systemic issues into individual problems ALL THE TIME. That is part of how capitalism perpetuates itself – by creating conflict between individuals to distract them from its systemic deficits. This narrative has also allowed mental health to be easily integrated into the way the rest of the current US healthcare system works, permitting the pharmaceutical industry to profit from mental illness.
I’ve been focusing on depression, but the same argument applies to mental health conditions which are over-diagnosed in BIPOC, like schizophrenia or ADHD. Mental healthcare is political. Women are more likely to be diagnosed with mood disorders because of the misogynistic legacy of “hysteria” and the view that women are more emotional than men. ADHD is diagnosed more frequently in Black boys because their behavior is more likely to be perceived as disruptive by (white) adults.
The answer to the nature/nurture debate is always both and, not either or. And what is considered normal or abnormal behavior is culturally bound.
Even if we had a cultural utopia, some people might still end up depressed. Accidents and natural disasters would still happen, and life will always have some element of suffering. But we can make society more supportive of a wider range of human experiences, whether physical or mental/emotional, and widen the scope of what we consider “normal” or acceptable. We have to recognize the impact capitalism and systemic inequality have on the brains of social mammals who depend on one another for survival. A trauma-informed lens does not ask, “What is wrong with you?” Instead, it asks, “What happened to you?” All behavior is adaptive, and makes sense in a larger context.
So still take your medicine.
And also understand that it isn’t your brain that is is broken – American society is.