Post No.: 0108
At what point does a ‘crazy’ thought or feeling of sadness (that we all feel at least every once in a while in our lives) become a mental health problem? Depression, for instance, tends to come in bouts too – some weeks or months are better or worse than others. Depression is also typically undramatic – it’s typically quiet, mundane and easily disguisable unless an observer understands and actively seeks to look for the signs. So where’s the line drawn between ‘normal’ and ‘abnormal’ behaviour?
Clinically, according to DSM-5 (the current Diagnostic and Statistical Manual of Mental Disorders, as of writing), it’s deemed as depression if you’ve had five or more of the following related symptoms for longer than two weeks – a depressed or hopeless mood for most of the day (particularly in the mornings), fatigue or a loss of energy almost every day, feelings of worthlessness or guilt almost every day, an impaired concentration or indecisiveness, either insomnia or hypersomnia (difficulty sleeping or excessive sleepiness), a markedly diminished interest or pleasure in almost all activities nearly every day (key signs are a loss of interest in the activities one used to enjoy, withdrawing oneself socially from others and a loss of pleasure in life overall), recurring thoughts of death or suicide, a sense of either restlessness or being slowed down, significant weight loss or weight gain, plus the fact these symptoms cause significant impairment or distress in one’s life.
Do note that the Diagnostic and Statistical Manual of Mental Disorders is useful for guiding diagnoses and communicating on the same page with other professionals regarding these somewhat ‘intangible’ diseases or conditions (at least compared to something like scoliosis or atherosclerosis, for instance), but it can lead to over-diagnoses and therefore the over-medication of patients if people take the guidelines too over-simplistically and don’t consider possible alternative solutions to the labels and medications first. It’s a manual that is still very much evolving (it’s currently on version 5) because we hardly know everything about the human brain and mental disorders yet. But we are collectively gradually learning more and more, and will do so faster with more investment put into mental health research. Woof!
Although with the current level of understanding and ability to investigate and decipher the finer detailed workings of brains being more advanced than ever before, we have yet to clearly identify the causes or symptoms of depression based on visually looking at a sufferer’s brain (e.g. via a scan or by cutting open a brain of a deceased person who suffered from depression during their lifetime), yet we know they must be there within the noise. It’s analogously just like if your computer is suddenly or gradually slowing down but you’ve yet to pinpoint exactly the reason(s) why, you’ll still know that there must be ultimately physical causes and symptoms (e.g. somewhere within the noise of whatever’s on your hard drive, BIOS, registry or wherever). Of course there might sometimes be visibly obvious signs of damage on a hard drive, just like with a brain, but this isn’t always the case (e.g. you won’t always be able to identify a ‘bad sector’ on your hard drive just by opening it up and looking at it with your eyes). We may never actually be able to diagnose certain mental health conditions via a visual inspection of the brain alone because they may be way more complicated than that.
Understand that computer software, or ‘0s and 1s’ or ‘high voltages and low voltages’ (in digital computing), is ultimately physical too – no one can store, transfer or utilise software without a physical medium such as a disk or optical fibres, even though if you were to stare at a hard drive with your naked eyes, or even with a microscope, you highly likely won’t be able to discern the difference between e.g. a virus-infected or clean hard drive, a bad sector or a good sector. And telling your computer to, “Snap out of it” is as similarly ineffective as telling a human to do so too(!)
And it could arguably be said that ‘(the input, processing and output of) software is to hardware’ is like ‘mind is to brain’ – the mind is ultimately the workings and result of physical processes and matter too. You cannot have a mind without a physical brain of some sort, just like you cannot have software without a physical medium or method to store, transmit or make use of it. No one is saying that a living organic brain is the same kind of machine as existing human-made computer technologies, but they’re machines of a sort, with moving electrons (electricity), nonetheless. And please note that wireless radio transmission, such as Wi-Fi or Bluetooth, is a physical process too and not some kind of magic that uses sorcery summoned from an immaterial realm! Without the help of tools, humans hardly naturally possess all the senses or ranges of sensitivity to sense all physical phenomena that exist around them. The bottom line is that mental health problems are ultimately physical problems, but of the sort that involve the most complex organ in the body (please read Post No.: 0101 too), which therefore strongly arguably makes them the least trivial health problems of them all.
Humans designed computers and their programs from scratch though so at least someone or a group of people expert in the field of computer science can identify deviations from the intended designs and so can identify what’s wrong with any computer – but humans didn’t design organic brains to fully know how one works and how to always fix one, and a human brain is one of the, if not possibly the, most complex machines ever encountered anywhere so far too, with about a currently estimated 80+ billion neurons and trillions of neuronal connections that can go ‘right’ or ‘wrong’. Evolution hasn’t stopped either.
Stress, anxiety, depression, etc. are therefore all fundamentally physical conditions with physical causes and physical mechanisms from a biological and biochemical perspective. And just like over-training a limb correlates with very real and very physical problems – chronic stress correlates with fatigue, distress, hypertension, nerve cell and organ tissue damage, hippocampal (brain) damage, maladaptations of homeostasis and other very real and very physical problems too.
And although external physical injuries or disabilities are more visually obvious, would you rather have a mental or a physical problem? Would you rather lose a leg or lose your very identity, personality, source of your self and joy? (Do note, however, that physical and mental health conditions are frequently co-morbid e.g. someone suffering from depression after losing their hearing, if they didn’t receive the right support at the right time.) No one who suffers on the inside is making it up just because you cannot see it on the superficial outside.