Dave's Progress. Chapter 23: Society and Environment or Biology and Chemistry.

Echoing the concerns of many, me included and perhaps others who read this blog, I have decided to share some of what I have learnt in researching mental ill health, particularly of my own diagnosis, schizophrenia. God, how I loathe "that word", but for the time being it will have to do as a description of what I have experienced over almost the last twenty or so years.
It would appear to me that, according to research I have done, there is something of a split, a division, amongst the opinions of psychiatrists as to what actually causes mental ill health, in particular schizophrenia. While some would appear to see it as a purely bio-chemical condition, others, like the (something of a celebrity) psychiatrist Oliver James, for example, emphasise the impact of our society and environment on mental ill health. On the one hand, then, many would view depression as a simple chemical imbalance of levels of serotonin in the brain, and similarly with schizophrenia, levels of dopamine, hence one of the many touted "new names" for schizophrenia being "dopamine dysregulation disorder".
Indeed, it would seem that since Eugen Bleuler (forgive me if I have the name wrong) coined the phrase "schizophrenia", or more precisely, "the schizophrenias", notions of causality have been hotly contested. For example, while some still argue that there is a genetic link to the cause of schizophrenia, others play this down dramatically, some even arguing that there is no genetic or inherited basis of the disease at all and that the research done to prove this argument, for example studies done on sets of twins, was inherently flawed. Also, many used to view schizophrenia as a chronic, biological brain condition which involved an inevitable demise into more severe ill health. Still today, studies are made by comparing the "schizophrenic" brain to the "normal" one, suggesting somehow that there are organic, biological "differences" between the two. But, it seems, for every argument put forward there is someone there to rebut it, and it is no different here, many suggesting that there is no apparent organic or biological difference between a schizophrenic and a normal brain.
Moreover, many on the social/environmental side of the argument put forward the notion that those on the biological/chemical side are merely cow-towing to the massively influential and financially powerful pharmaceutical companies. After all, it is in these companies' interests to promote a bio-chemical view of mental ill health as their products directly deal with this aspect of disease. This is, however, a somewhat conspiratorial argument which, like all conspiracies, is probably prone to over-simplification and lacks factual proof. However, it still seems to be a hotly contested debate.
Indeed, those who have called for a change in the name of schizophrenia have also called for a paradigm shift in how the illness is viewed, moving away from the bio-chemical model to a more social/environmental view of stress and vulnerability. One of the new names for schizophrenia being proposed by people such as Marius Romme is "post-traumatic psychosis", emphasising that the illness is caused by some traumatic event in the patients life. Such new ways of thinking I find valuable because they get away from the notion that simply throwing pills at people is the answer to all their ills. Rather, it encourages a more sympathetic approach where other methods can be used in treatment. As I have often described in these pages, medication is not the panacea it appears to be. Don't get me wrong, I am not against taking medication, it is just that, with its often ghastly side-effects, I don't believe it is providing all the answers. If it did, and social and environmental causes were not important, then I doubt that recovery rates from schizophrenia would be better in the non-industrialised as opposed to the industrialised world, which, surprisingly, they are.
Being something of a leftist in my thinking, I also have a great deal of time for Oliver James' arguments which he sets out in his books, "Affluenza" and "The Selfish Capitalist", where he sees advanced capitalism as a large contributor to unhappiness and mental ill health.
Anyway, no doubt these arguments will rage on, but I have to say that, although I acknowledge the need for medication, I think it is a great disservice to undervalue social and environmental factors. No doubt, once again, you will have your own opinion, so feel free to comment. Any errors or mistakes I have made in this blog I'm afraid I alone am responsible for.
That's all for now from your normal, average, paranoid and delusional man.


dcrelief said…
Dear David,
For what I'm about to say, forgive me. I dislike "Big-Pharma" the med kings.
There's a audience in my head that applauds you! We've formed a committee to launch support your way. Together we agree that "left" thinking is the right thinking. Any errors we've made, well... we have a clean up crew standing by.
Thank you for your sharing.
Most kindly,
dcrelief said…
Dear David,
My earlier comment speaks volumes for me about me. "Society and Environmental or Biology and Chemistry"... neither were particularly involved. I had Fibromyalgia when mimics many illnesses of the maind and body. Therefore a "missed" diagnosis lead to a diagnosis of traumatic impact. (Something I have spoken of before here.)
Sometimes there are mistakes and hopefully some good can come of them. For example I do not regret sessions with a counselor.
My concerns involve the testing given impacted by the "exclusions" of other exhibited symptoms. Yet I have no answers that would have allowed avaiodance of what happened to me. So I know it could easliy happen again. And at this moment I am going "blank" due to the Fibro, so I will close.
I do enjoy reading your chapters; they offer hope.
Most sincerely
Dixie :)
David said…
Dear Dixie,
Thankyou for both your comments. I can only hope your own health will get better and if my blogs offer hope to you then I am truly glad.
Hope (which seems to be the operative word here) you keep on reading and writing.
Yours with Warmest Regards,
klahanie said…
Hi David,
Another highly informative blog and you certainly have done a considerable amount of research.
I know that the debates rage on. The 'nature, nurture' aspects to all of this, ofcourse can have a devastating consequence on our mental health wellbeing.
Look forward to 'Chapter 24'. Thanks for your ongoing comments on my blog. We are all in this together.
Warm wishes, Gary.
dcrelief said…
Dear David,
I apologise for my two other posts.

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