Tomorrow promises to bring advancements in psychological wellbeing care, with notable progress in this vital area of human health.
In 2023, the United States National Institutes of Health undertook a comprehensive investigation to elucidate the neural mechanisms underlying mental illness manifestations in the brain. Today, people are more open than ever before, as discussing depression, anxiety, and ADHD openly is gradually losing its stigma – at least online.
Despite record-breaking numbers of new entries into the US, with the highest quantity ever recorded? Despite the US Surgeon General describing psychological wellbeing as “the defining public health crisis of our time”, we remain no closer to grasping the neuroscience behind mental health than we were 50 years ago.
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Despite prevailing notions that mental health issues are solely the result of internal cognitive processes, A lingering myth in neuroscience – psychiatric medications often fall short of expectations.
If medications capable of modulating brain chemistry can effectively silence auditory hallucinations and alleviate suicidal ideations, it logically follows that mental chemistry must shed some light on the etiology of psychological disorders, if not entirely clarify their underlying mechanisms. While medications like antidepressants and antipsychotics can significantly improve mental health for some people, they also have the potential to exacerbate problems for just as many – if not more. Prescribing the correct medication for the appropriate condition often involves a degree of uncertainty, and an unfortunate mismatch can unexpectedly trigger severe consequences, such as inadvertently inducing a manic episode.
The human brain is a complex and intricate organ, comprising approximately 86 billion interconnected neurons that form the foundation of our cognitive abilities. To put into perspective just how challenging it is, neuroscientists spent over four years mapping the brain region known as the Drosophila melanogaster, which accounts for a mere 0.00003% of the neurons in a human mind – and even this significant scientific achievement falls woefully short of fully comprehending a fly’s behavior. Scaling the endeavour upwards by several orders of magnitude, the idea of comprehending human mind chemistry in its entirety seems utterly inconceivable.
Perhaps neuroscience simply needs more time and research to refine its approach to developing effective psychological wellness treatments for various scenarios. While still an emerging field, neuroscientists have only recently gained insight into the intricacies of human brain activity through the study of living minds over the past few decades. The potential breakthrough in psychiatry might just be around the corner?
But it’s also possible that some of the greatest psychological health care lies outside traditional Western psychiatry altogether?
Two potential problems may arise immediately.
For millennia, psychological illness was largely understood as a product of demonic possession, evil spirits, or curses. During the Enlightenment era in Europe and its colonial territories, individuals struggling with mental health issues were often confined to institutions that would later be labelled as “psychiatric hospitals”, effectively siloed from society.
In the early 20th century, Sigmund Freud and his contemporaries popularised psychoanalysis, a groundbreaking approach that empowered individuals to confront and overcome challenges such as melancholy and nervousness by exploring their unconscious thoughts and emotions. Initially, physicians at asylums favored a somatic approach to mental healthcare, focusing on physically stimulating the body and nervous system to positively impact thought processes.
It was widely accepted that issues like schizophrenia were thought to have been triggered by an imbalance in the primitive brain regions responsible for governing essential bodily functions such as digestion, respiration, and other automatic processes. Early psychiatric treatments aimed to deliver a sufficient jolt to the brain – using methods such as electroconvulsive therapy, insulin coma therapy, or lobotomy – to stimulate allegedly sluggish neural processes. Psychiatrists who pioneered malaria therapy, exploiting the malaria virus to provoke a high fever, thereby targeting and potentially eliminating neurosyphilis-inducing bacteria, did so during an era when asylums remained prevalent in Europe, amidst which they also developed prefrontal lobotomies.
As the years passed, however, physicians gradually came to realize that their physical treatments were falling short of expectations. As mental afflictions seemingly went unmarked by visible anomalies upon autopsy, the notion of physical treatments began to wane in popularity.
In 1952, Henri Laborit, a French surgeon based in Paris, made a groundbreaking discovery that revolutionized the field of medicine. While experimenting with antihistamines, he found that a particular compound could not only reduce the harm caused by anesthesia but also exhibit powerful antipsychotic properties? When chlorpromazine was introduced to the market in 1954, its impact resembled a significant modification of the treatment landscape for diabetes. Sudden liberation allowed patients previously confined to psychiatric institutions to engage in tranquil discussions with their treating physicians. Within a year, policymakers anticipated that new medicines would render institutionalization obsolete.
For decades, the mechanism behind medicines like chlorpromazine remained unclear, aside from their observed effects – including unpleasant side effects such as drowsiness, weight gain, and uncontrollable muscle spasms. Researchers later discovered that antipsychotics such as chlorpromazine selectively bind to specific dopamine receptors in the brain, specifically an overabundance of these receptors being identified as a biological precursor to schizophrenia.
Chemical imbalances are believed to contribute significantly to the rapid shifts in thoughts, feelings, and actions that are characteristic of various psychiatric disorders. Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, work by blocking the reabsorption of leftover serotonin in neurons following the release of this neurotransmitter after a specific chemical signal has been transmitted. If a shortage of serotonin is thought to contribute to feelings of sadness and despair, then increasing the availability of this neurotransmitter could potentially lead to greater happiness and well-being.
Don’t you truly experience a sense of euphoria and accomplishment after a few months? Notwithstanding the widespread assumption, renowned antidepressant researcher Alan Frazer disputes the notion that depression is predominantly linked to serotonin deficiency, stating, “To my knowledge, there isn’t a compelling body of evidence suggesting that melancholy is significantly related to a lack of serotonin.”
Pinning schizophrenia solely to dopamine levels is an outdated and overly simplistic approach. Researchers believe that various neurotransmitters, in addition to multiple genetic, social, and environmental factors, significantly impact the likelihood of developing a psychological disorder.
Despite the continued popularity of self-help films on TikTok touting the benefits of dopamine and serotonin, many neuroscientists and psychiatrists have long rejected the notion of a “chemical imbalance” as the sole explanation for mental health issues. While significant progress has been made in elucidating electrochemical interactions, a comprehensive scientific grasp remains elusive, rendering it challenging to definitively explain or effectively manage psychological illnesses.
Considering psychological sickness as something that remedy can cure affords people “a means to frame their struggles as both tangible and authentic, and it provides a straightforward explanation and optimistic prognosis for their struggles,” a sociology professor noted in. When individuals acknowledge the debilitating impact of their psychological illnesses, such as mental health conditions or neurodiverse disorders, deserving equal respect and support as those living with physical illnesses like cancer.
Two decades ago, the US Food and Drug Administration approved an antidepressant that didn’t target dopamine receptors—the first such medication since chlorpromazine was initially introduced. The novel drug, Cobenfy, focuses on acetylcholine as an alternative to dopamine, a neurotransmitter with indirect effects on dopamine levels.
The revelation that Cobenfy represents a groundbreaking innovation of this magnitude over the past seven decades has garnered widespread media attention. Whether Cobenfy’s efficacy endures beyond current options remains uncertain: None of the drug’s three clinical trials ran sufficiently long to indicate whether it will trigger the same prolonged adverse reactions – substantial weight gain, compulsive bodily behaviors – characteristic of its predecessors?
The launch of Cobenfy effectively encapsulates the complex interplay between the challenges and opportunities presented by neuroscience’s role in addressing mental illness, revealing both the difficulties and the potential for improvement. A newly developed pharmaceutical therapy shows promise in alleviating the most debilitating symptoms of schizophrenia while minimizing adverse reactions compared to previous treatments. Introducing a novel medication cannot single-handedly eradicate the complexities surrounding psychosis or fundamentally alter how individuals cope with this condition.
The latter technique – revolutionizing community approaches by rethinking support for individuals with even the most severe mental health conditions – is. Across various cultures, mental health concerns often lead to a reluctance among individuals to seek help or therapy. Community-based mental wellness initiatives, where non-professionals provide support sessions within their local communities, have been shown to be an effective complement to traditional psychiatric care, whether treatment is involved or not.
While community-driven fashion trends are occasionally linked to non-psychotic mental health conditions such as depression, alternatives beyond traditional psychiatry can also be explored. Regardless of whether psychosis arises from ancestral spirits, childhood trauma, viral irritation, or neurochemical fluctuations, it’s crucial to provide individuals with multiple avenues to process and make sense of their experiences.
Currently, neuroscience serves as our primary gateway to understanding. As we venture into an uncertain future, it will become imperative that we transcend individual pursuits and cultivate a collective capacity for introspection.
