On mental health

Last week I came across two articles on mental health that caught my attention.

One was from Axios Columbus which reported the most recent numbers from the nonprofit Mental Health America: Nearly 25% of adults in Ohio experience mental health issues.  The numbers are just coming out for 2019 so this is pre-pandemic.  The article notes, but does not give hypotheses toward why, Ohio had one of the largest negative changes from previous years.  In addition, 63.3% of Ohio youth with major depressive episodes received no treatment.

The other article was from 2020, published in Forbes magazine, with the provocative title “Researchers Doubt That Certain Mental Disorders Are Disorders At All.”  It points to a new paper by biological anthropologists calling on the scientific community to rethink its approach to anxiety, depression, and post-traumatic stress. 

In short, the authors propose these conditions are best thought of as “adaptive responses to adversity.”  They note that “medical science has never been able to prove (these)…are inherited conditions.”  They note that despite increasing uses of antidepressants rates of major anxiety and depressive disorders have held steady for the past 30 years, and that placebos perform similarly to these drugs.  They also note that while the global rate of these disorders is 1 in 14 people, it is 1 in 5 in high conflict areas. 

After positing that these are adaptive responses to adversity the paper continues:

“If that sounds unlikely, then consider that neuroscientists have increasingly mapped these three disorders to branches of the threat detection system. Anxiety may be due to chronic activation of the fight or flight system. PTSD may occur when trauma triggers the freeze response which helps animals disconnect from pain before they die, and depression may be a chronic activation of that same freeze response.”       

The article moves on to examining ADHD as an example of something that has been labeled a disorder, but might rather be “an evolutionary mismatch to the modern learning environment we have constructed.”

It proposes that the labels we give things impact how we relate to ourselves and the problem itself. 

None of this is intended to point the blame back to the person experiencing the episode, or to suggest ending medical treatments.  But, put bluntly, the paper states: “Research on depression, anxiety, and PTSD, should put greater emphasis on mitigating conflict and adversity and less on manipulating brain chemistry.”

I am not in a position to evaluate the research. On a gut level there is part of me that finds this argument empowering – the body is actually trying to protect itself.  And part of me that finds this a tremendous indictment of the world we have created.