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> (along with the idea that all mental illnesses are neurostructural in nature) I agree with everything you said except I'm having trouble with this bit. Neur

> (along with the idea that all mental illnesses are neurostructural in nature) I agree with everything you said except I'm having trouble with this bit. Neurostructural as opposed to what? All thoughts are physical things happening in the head. The brain changes. Sometimes it changes to a state that creates problems for a person (perhaps long term depression spurred by grieving a loved one.) Sometimes talk or time can change it back. Or change it to another state that isn't impaired by ticks or grief or anger. But it is a physical process. I understand that sometimes working at the granular level of neurons or chemistry isn't as productive as working at the psychological level. i.e. sometimes talking about emotions can get the brain to start to encourage different pathways that will eventually become the norm and take one away from the problematic ones. But this is still a neurostructural change in the brain. It is just mediated by the brain itself. Perhaps I am missing some subtle point or misinterpreting you?

ojnabieoot 6y ago
No, I was being vague and you are basically correct: I really meant "occurring due to a static abberation in the brain present since birth / puberty / adulthood", like schizophrenia, bipolar disorder, many forms of depression, versus something that can be induced by circumstances or upbringing. Making it more vague is, for instance, that PTSD is obviously "induced by circumstances" but is also thought to be due to a brain injury caused by emotional trauma. Scientifically there isn't a boundary, and I am speaking very loosely here and probably should have said something more specific. But "all thoughts are physical things happening in the head" is perhaps too reductive, similar to saying "all physics is quantum mechanics" - just because it's true doesn't mean it's a useful way to think about a specific problem. There's a distinct medical difference between someone with chronic depression without a specific life event ("neurostructural"), and someone who started out being "legitimately" depressed after being laid off, but spiralled downwards. Both can be described as a "deficit in the structure of the brain" but in the former case that structural deficit likely cannot be fixed by the brain itself (even with the guidance of a therapist) and drugs are probably necessary. In the latter case, perhaps only CBT and general wellness habits are enough - the brain can fix its own "structural problem."
- DubiousPusher 6y ago
  Thanks for the thoughtful reply. I grew up with a parent with severe mental illness and a person now in my immediate family has a similar condition. So while I've never formally studied psychiatry, psychology and neurology, I've been submerged in the lingo, treatments, concepts and philosophies for most of my life. I lean heavily on the mechanisms of thought and mind because even now there is a tremendous amount of stigma and mysticism surrounding mental illness. I've encountered even mental health providers who still speak or act as if patients have a failure of character or personal weakness. I've encountered specialists who aren't really even familiar with CBT or who still think digging up trauma repeatedly a la Freud is useful. I encounter a kind of dualism all the time, as if the mind is some kind of sick spirit inhabiting the brain. I agree though. Treatments can function at a more macro level. I think this is demonstrated by something as simple as venting about a problem or person. A resentment or regret that is stopping one up finally falls to the side when one talks to a friend about it. These high level concepts we have about objects and people and concepts clearly have some power to drive the lower level. Attempting to resolve some issue a person might have with their spouse at the neuronal level would be a bit like building a house up from atoms rather than timber.

ojnabieoot 6y ago

No, I was being vague and you are basically correct: I really meant "occurring due to a static abberation in the brain present since birth / puberty / adulthood", like schizophrenia, bipolar disorder, many forms of depression, versus something that can be induced by circumstances or upbringing. Making it more vague is, for instance, that PTSD is obviously "induced by circumstances" but is also thought to be due to a brain injury caused by emotional trauma. Scientifically there isn't a boundary, and I am speaking very loosely here and probably should have said something more specific. But "all thoughts are physical things happening in the head" is perhaps too reductive, similar to saying "all physics is quantum mechanics" - just because it's true doesn't mean it's a useful way to think about a specific problem. There's a distinct medical difference between someone with chronic depression without a specific life event ("neurostructural"), and someone who started out being "legitimately" depressed after being laid off, but spiralled downwards. Both can be described as a "deficit in the structure of the brain" but in the former case that structural deficit likely cannot be fixed by the brain itself (even with the guidance of a therapist) and drugs are probably necessary. In the latter case, perhaps only CBT and general wellness habits are enough - the brain can fix its own "structural problem."

DubiousPusher 6y ago
Thanks for the thoughtful reply. I grew up with a parent with severe mental illness and a person now in my immediate family has a similar condition. So while I've never formally studied psychiatry, psychology and neurology, I've been submerged in the lingo, treatments, concepts and philosophies for most of my life. I lean heavily on the mechanisms of thought and mind because even now there is a tremendous amount of stigma and mysticism surrounding mental illness. I've encountered even mental health providers who still speak or act as if patients have a failure of character or personal weakness. I've encountered specialists who aren't really even familiar with CBT or who still think digging up trauma repeatedly a la Freud is useful. I encounter a kind of dualism all the time, as if the mind is some kind of sick spirit inhabiting the brain. I agree though. Treatments can function at a more macro level. I think this is demonstrated by something as simple as venting about a problem or person. A resentment or regret that is stopping one up finally falls to the side when one talks to a friend about it. These high level concepts we have about objects and people and concepts clearly have some power to drive the lower level. Attempting to resolve some issue a person might have with their spouse at the neuronal level would be a bit like building a house up from atoms rather than timber.