Posted by Carol on May 24, 2004 at 12:12:45
Brain disease is the preferred term used by the National Alliance for the Mentally Ill (NAMI) for the schizophrenias, bipolar disorders, major depressive disorders, impulse control and anxiety disorders. When a medication radically alters symptoms like hallucinations, extreme mood swings, and obsessive-compulsive behaviors like pulling out your hair or handwashing 25 times day, the implication is that there is a neurochemical basis to the problem, i.e., a disease.
Violence, poverty, and emotional, sexual & physical abuse are mental health issues. So is recreational drug use. Some forms of brain disease (post-traumatic stress disorder, which is an anxiety disorder) are the direct consequence of traumatic injuries to the central nervous and limbic systems. It's similar to having a heart attack (a disease) as a consequence of environmental stressors like obesity, smoking, lack of exercise, etc. Nevertheless, the brain is "diseased" inasmuch as the bioneurochemistry of the brain is "not balanced." Some forms of brain disease--particularly with those like bipolar & schizophrenia that have a strong hereditary influence--are aggravated and made worse by mental health issues like violence, poverty & abuse, including substance abuse.
All of us experience imbalances in our neurobiology in varying forms. For example, with Pre Menstrual Syndrome, the endocrine system goes into a hormonal flux that prompts symptoms such as extreme irritability, crying, etc. Neurobiologists are only just beginning to understand the relationship of the endocrine system to brain functioning, but there is a large body of evidence that points to these factors as significant components of mental health. Since there is a wide variation in what is a "normal" amount of imbalance, we can evaluate whether serious disease processes are taking place by looking at the impact that symptoms have on behavioral functioning.
Irrational beliefs and unrealistic attitudes often attend brain diseases like major depressive disorder. These are mental health issues. We create intrapsychic stress on brain functioning through the impact of certain mental constructs (the mind). For example, if I believe I have to always sacrifice myself and my needs for the sake of others, I can and do create a lot of stress on my neurochemical functioning. That stress often leads to symptoms recognized as defining major depressive disorder.
The best analogy for what occurs to the neurons and synapses of the brain is like that of a long-distance runner on a hot day. If the runner doesn't replenish the body fluids lost by the sweat of exercise or respond to the approximation of internal body heat with external heat temperatures, that person will go into heat exhaustion and/or shock.
The brain does the same type of thing when we persistently deny the physiological needs of the nervous system. If you persisently deny yourself simple pleasures (reading a book, listening to music, writing a letter, going for a walk, planting a garden) because you believe you must meet the needs of other people first or obey some external authority and "die to self" or that the salvation of humanity depends on your heroic self-sacrifice, your brain will become diseased.
What happens (in the simplest terms) is that your seratonin and dopamin neurotransmitters go "dry." These are chemicals that make us feel good and keep our mood states and perceptive processes balanced. So maybe I decide to smoke some weed and "chill out." That's called self-medication, and it is one of the major reasons people abuse recreational drugs. Good health care for the human brain calls for the same things the rest of the body requires: sufficient & proper food, adequate rest & exercise, mediation of stress, and a rational approach to living & problem-solving.
Health is maintained and supported by social conditions. If I do not have social support, it is a lot harder to recover from hip surgery. If people are telling me "it's all in your head" (i.e., not real, doesn't exist) or "just get over it" or "examine your life for disobedience and sin and rebuke Satan," then I will have a very hard time healing and recovering from hip replacement surgery. In fact, if I think it's all in my head, and I decide to run the Boston marathon instead of going to physical therapy, I'm likely to do so much damage to my hip that I permanently loose a leg. These same things hold true with recovery from brain disease.
One other point: alcoholism and other drug addictions are also disease processes. There is a HUGE body of scientific literature on this subject, and it's no longer considered debatable whether alcoholism and addiction should be treated as diseases. When we consider the complexity of neurochemistry and how psychoactive substances like alcohol, crack & marijuana affect neural processes, it is easy to understand how we put our brains at risk for disease through irresponsible recreational drug use.
Some of us are more prone to weight gain than others, just as some are more prone to brain disorders than others. Nevertheless, sustained abuse of drugs and alcohol will cause permanent, irreversible changes in the neural structures and chemical processes of the brain the same way eating a diet of nothing but Big Macs, fries, and soft drinks will cause permanent, irreversible changes in our physical metabolism.