The best answer to this question may be “either and both”.
Most of us here have been diagnosed as having a major mental illness. Mental illnesses are not mental weaknesses. The diagnoses that we are most familiar with include:
All of these illnesses have one thing in common. They are not our fault. Each disorder has both biological and psychological components. We all begin our lives with a brain that is built using the blueprints contained within the genes we inherit from our parents. Later, hormones change the brain to prepare it for adulthood. It is continually being changed by the things we experience. The brain determines the mind as the mind sculpts the brain. Unfortunately, the brain can also be changed in negative ways by things such as drugs, alcohol, injury, trauma, and chronic stress.
How we think and feel are influenced by our environment. Probably the most important environment during our development is that of the family, with the most important time being our childhood. We all have both positive and negative experiences as we travel through life. How we are as adults is in large part determined by these positive and negative experiences. They affect our psychology, our emotions, and our behaviors. All of us can be hurt by unhealthy negative experiences.
Some of us are also hurt by unhealthy brains. Medical science has long recognized that many mental illnesses are actually biological disorders. Even Sigmund Freud, who we know for his development of psychoanalysis, proposed a role for biology in mental illness. He was, after all, a neurologist. The first solid evidence for this concept in modern times came with the discovery of lithium in 1947. Lithium was found to reduce the symptoms of bipolar disorder (manic-depression) or cause them to disappear completely, allowing previously disabled people to lead normal lives. Lithium helps to correct for the abnormal neurotransmission in the brain that is the cause of bipolar disorder. Subsequent medical discoveries included the observations that the drug, Thorazine (an antipsychotic), successfully treated schizophrenia, and that Tofranil (an antidepressant) successfully treated depression. Again, these drugs help to correct for the abnormal biology of the brain that accompanies these disorders. Since then, a great many drugs have been added to the arsenal of doctors to treat mental illness. In addition, there are some newer brain stimulation techniques that work without the need for medication.
What about psychology? What role does it play in mental illness? This can be a two-way street. The abnormal biology that occurs with some mental illnesses affects our psychology – how we think, feel, and behave. On the other hand, our psychology can also affect our biology. As we now know, the emotional stresses and traumas we experience change the way our brains operate. This is especially true of things we experience during childhood. These stresses can trigger the induction of abnormal brain function that leads to major depression, bipolar disorder, schizophrenia, and other major mental illnesses. In order for this to happen, however, there must be a genetic or some other biological vulnerability to begin with.
It is important to remember that not all psychological and emotional difficulties are biological in origin. Again, we are all products of our environments – family, friends, enemies, school, work, culture, climate, love, war, etc. Environments that are unhealthy often produce unhealthy people. However, this, too, is not our fault.
In conclusion, regardless of the cause of our mental illnesses, it is important that we treat both the biological and the psychological. We will all benefit most if we do.
Blog posts are written by Shore House members and staff.