The mind-body problem is the deepest mystery of existence. Narrowly speaking, it asks how a brain — a mere chunk of matter, a bundle of quarks and electrons — makes a mind. It also encompasses free will, morality, and the meaning of life. Simply put, the mind-body is about who we really are, can be, and should be.
Mental illness poses the mind-body problem in an especially stark manner. How should we see depression, schizophrenia, bipolar disorder, addiction, and other afflictions of the mind? Are they best understood as afflictions of the brain, the mind, or the soul? Do they spring from faulty genes, neurotransmitters, hormones? From abusive upbringings, traumatic events? Or from some combination of nature and nurture?
When I discuss these issues in my science-writing seminar here at Stevens, I note that modern psychiatry has embraced the physiological paradigm of mental illness. It stems from flawed genes or neurochemistry and is best treated with physiological remedies, such as antidepressants. This emphasis is good in some ways, because it reduces the stigma of insanity. It’s not your parents’ fault, or a failure of character or willpower. It’s a disease, like diabetes.
But this view can lead to despair, I point out, if you think that biology is destiny. Also, medications are far from a panacea. That’s why psychological and even spiritual therapies persist, from cognitive-behavioral therapy to mindfulness meditation. So what is the evidence for various theories and therapies for mental illness? And why do attitudes toward mental illness vary so widely across eras and cultures?
Years ago, I started encouraging students in my writing seminar to write about these issues — and, if they chose, to describe how mental illness has affected them or people they know. This personal approach, I said, can be a good way to hook readers emotionally and pull them into your story.
Some students report on mental illness in a conventional, objective way, as if they were writing about genetically-modified food or nuclear energy. But many take advantage of the personal, first-person option, and their papers invariably surprise and dismay me. Some students who seem calm and easy-going on the outside reveal that they are struggling to hold themselves together.
Here is a sampling of responses from one class, with students’ names changed. Tyler wrote about his brother’s depression, Karen about the suicide of a teenage friend, Trevor the heroin addiction of his girlfriend’s mother. Melanie admitted that she never felt much sympathy for people who were depressed until, out of the blue, “IT” struck her:
One minute I am a happy girl, I have had a perfectly good life so far, and I have never really pondered anything upsetting or had any major setbacks. The next minute IT happens… stress, anxiety, dietary changes, sleeping changes, moodiness, risky behavior, apathy, hopelessness. IT hit me like a bulldozer out of left field.
One drawback of this assignment is that papers are impossible to grade. If Tyler reveals his fear that he shares his brother’s tendency toward depression, I’m not going to complain that the ending of his essay needs tweaking. But the papers are for the most part almost too compelling. The authors seem to find disclosing their personal troubles cathartic. As Melanie wrote:
When I finally started talking about the problems I was having, it turned out that so many people around me were having or had had similar issues. Several of my close friends came out to me about their struggles with depression, and many of them are currently on treatment for depression.
One of the worst aspects of mental illness is that it isolates us from others precisely when we most need companionship and help. We feel strange and ashamed, so we keep our illness secret, which can make it worse. Sharing our suffering can relieve our pain and help others, by letting them know that they are not alone. That’s why I applaud the editors and writers of The Stute for devoting this issue to mental health. The more we talk to each other about this painful topic, the better.
John Horgan directs the Stevens Center for Science Writings. Some of the material in this column comes from his 2018 book Mind-Body Problems.
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