Friday, February 06, 2004


Here is an excerpt from an article by Ann Arbor's own Huda Akil.   I post this because I had been thinking about writing a follow-up to the post on Crooked Timber entitled Fooling the Shrinks.  This post generated a lot of comments.  Other blogs picked up on the story  in The Guardian.  It would be too tedious to catalog them all.  One thread that came up in several comments was the notion that there is no known biological basis for mental illness.  I thought about how best to respond to that, and realized that it would take quite a bit of time to write a good article about it.  When I found Dr. Akil's article, I realized that I didn't have to write it; she already has.  See the Society for Neuroscience's booklet, Brain Facts, for background information that is presented in an understandable manner. 

Neuroscience Quarterly
Huda Akil, SfN President

Message From the President

Toward a Neurobiology of Mental Disorders: Scientific and Societal Implications

The neurobiology of mental disorders is at a crossroads. And the neuroscience community can play a pivotal role in the next few years to transform this fascinating field scientifically and to communicate this transformation to other biomedical specialties and to the public. [emphasis mine]

Studying mental illness from a neurobiological perspective is fraught with challenges. Although many neuroscientists enter the field to understand how the brain sustains complex functions like perception, emotion and cognition, they rapidly come to the conclusion that we lack the conceptual means to frame many of these questions especially if they come close to the idea of "consciousness." For example, how does one capture the concept of a "mood" scientifically and search for its molecular and neural underpinnings?

However, without having solved such philosophical questions, neuroscience has done remarkably well in terms of defining many key features of complex behaviors and brain disorders and beginning to understand their underlying neural mechanisms. Animal models, even if they do not fully mimic human behavior, can capture critical elements of higher order processes. As discussed by National Institute of Mental Health Director Thomas Insel in this issue, sometimes we overestimate the degree of complexity underlying a given behavior. But even for truly complex functions, advances in scientific tools now available have begun to fuel exciting progress.

More importantly, studying the neurobiology of mental illness is not a luxury that neuroscientists can engage in after they have handled more accessible problems. The need is urgent...

You may encounter numerous criticisms of mental health practice.  Many of these criticisms are based upon the observation that we really don't know much about how the brain works.  Others will point out how primitive some of the treatment methods are.  I would like to ask the critics to stop, make some observations, and think for a bit.

If you think that mental illnesses are not serious problem, try spending a week in a psychiatric hospital. You will be impressed by two things.  One is the astonishing frequency of humans' inhumanity to other humans; often, it is inhumane treatment that has resulted in a person's being hospitalized.  The second is that these people really are suffering.  The common misperception that the patients are lazy or [insert pejorative adjective here] tends to be based upon nothing more than unexamined narcissism: "I am a [insert complimentary adjective here] person, because a least I am not like that [insert pejorative adjective here] person over there..."

It is true that the treatment of mental illness is a young science, but that does not make it unworthy.  Remember: the alternative to trying to help, is to do nothing at all.