There is a common, popular narrative in mental health. That mental illness is caused by faulty brain chemicals.
People with depression have brains that cannot produce enough serotonin. Those with ADHD lack dopamine.
This narrative attempts to reduce cultural stigma associated with mental health issues. If someone’s brain is “broken,” a mental health issue is beyond their control. Therefore, they cannot be at fault for it. It doesn’t mean they are bad, lazy, selfish, etc. This can reduce shame and make it easier for someone to seek support.
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.). It asserts that like other diseases, mental health issues have a biological basis.
While the intentions may be good, this narrative is still founded in ableism. It perpetuates a false binary between “healthy” and “sick” brains. It reinforces the narrative that people with mental health issues are deficient in some way.
The blame is placed on the individual. With no regard for how the environment impacts mental health. Or how prevalence of mental health issues varies widely across culture and across time.
Instead, we can embrace a wide range of human experience as healthy and normal. What is considered “abnormal” behavior is culturally bound. Just like some people are taller than others, or some people are left-handed, there is diversity in how our brains develop.
Impact of Minority Stress on Mental Health
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+, Hispanic and Black individuals are all diagnosed more frequently. It is important to recognize the impact minority stress has on marginalized individuals. And how that could lead to depression.
Rates of depression have also grown over the last 20 years. They are increasing among Gen Z at a faster rate. When people do not have access to healthcare and are not paid a living wage. When parts of the world are literally on fire. 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. They are also more likely to experience both developmental trauma and ongoing minority stressors.
How Do We Interpret Research?
Research in psychology and neuroscience has shown differences in the level of production of certain neurotransmitters. In other cases, the brain is more efficient at the reuptake process. So neurotransmitters are available in the brain for a shorter length of time.
Other research has noted differences in the relative size of different areas of the brain in individuals experiencing mental health conditions.
It is important to remember, however, that correlation is not causation.
If you believe that mental illness must have a biological cause, that bias will lead you to interpret scientific data to reinforce that narrative.
Scientists don’t know that a lack of serotonin is actually 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 experiencing trauma.
This can lead to a perfectly reasonable lack of hope for positive change in society or belief in a more equitable future.
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 or other forms of support.
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. Genetic predisposition is influenced by systemic inequality and the impact of intergenerational stress and trauma.
Who Does this Narrative Benefit?
If depression is a chemical imbalance, then we can just treat individual people with “broken” brains. That narrative allows us to 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 rest of the current US healthcare system. Which permits the pharmaceutical industry to profit from mental illness.
Mental Health and Social Justice
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. This is 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. 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.
Even if we had a cultural utopia, some people might still end up depressed. Accidents and natural disasters would still happen. 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 we can 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.