The Lack of Strong Links Between Mental Illness and Brain States

The recent paper "Examining the Long-Term Impacts of Psychotropic Drugs and Considerations for People Discontinuing Treatment" is by Timothy Wand, PhD and a registered nurse. It can be read here. Below is a quote:

"Multiple studies have now cast doubt over any clear or direct neurobiological or genetic cause or association with mental illness (Border et al., Citation2019; Borsboom et al., Citation2018; Curtis, Citation2021; Marsman et al., Citation2020; Nour et al., Citation2022; Winter et al., Citation2024). For example, Nour et al. (Citation2022) surmise that despite three decades of intense neuroimaging research, there is no neurobiological account for any psychiatric condition. Torrey (Citation2024) concludes that not one gene has been found that can be causally linked to ‘schizophrenia’, and despite many studies and variety of techniques used, Parlatini et al. (Citation2024) confirm that no promising biomarkers have been identified for ‘Attention Deficit Hyperactivity Disorder (ADHD)’. The chemical imbalance theory of mental illness and the serotonin hypothesis of depression have been refuted (Ang et al., Citation2022; Healy, Citation2015; Hengartner & Plöderl, Citation2023; Moncrieff et al., Citation2022, Citation2023).

While genetics and biology have a role to play in all aspects of the human condition, the degree to which genetics and biology influence mental health and well-being remains a matter of conjecture. What is known without question, is that mental health challenges are predominantly associated with socio-economic disadvantage, as well as trauma, adversity, violence, abuse, neglect, oppression and discrimination (World Health Organization & the United Nations [WHO & UN], Citation2023).

The fact is, there is no pathophysiology, disease process or one identifiable biomarker associated with any psychiatric diagnosis. They are highly heterogeneous labels of questionable scientific validity (Kajanoja & Valtonen, Citation2024)." 

Below are two relevant quotes by scientists:

• "In contrast, the major mental illnesses...bipolar disorder, anxiety disorders, anorexia nervosa and depression have proved remarkably resistant to similar developments. Unfortunately, it is still not possible to cite a single neuroscience or genetic finding that has been of use to the practicing psychiatrist in managing these illnesses despite attempts to suggest the contrary." -- David Kingdon, Emeritus Professor of Mental Health Care Delivery. "Why Hasn't Neuroscience Delivered for Psychiatry?"
• "Despite three decades of intense neuroimaging research, we still lack a neurobiological account for any psychiatric condition. Likewise, functional neuroimaging plays no role in clinical decision making....It remains difficult to refute a critique that psychiatry’s most fundamental characteristic is its ignorance. . . . Casting a cold eye on the psychiatric neuroimaging literature invites a conclusion that despite 30 years of intense research and considerable technological advances, this enterprise has not delivered a neurobiological account (i.e., a mechanistic explanation) for any psychiatric disorder, nor has it provided a credible imaging-based biomarker of clinical utility."  -- Neuroscientist Raymond Dolan and two other scientists (link). 

Erroneous "brains make minds" ideas can lead to bad psychiatry. A psychiatrist may see mind and mood and behavior problems as being all due to brain causes, ignoring economic causes and bad parenting  causes and social injustice causes and societal causes and poor education causes and life history causes and trauma causes.  And sometimes what is called a mental illness may be mainly an example of nonconformity or human mental diversity, something a healthy society should tolerate under a policy of "let a hundred types of flowers bloom." 

Undark.org has published some good articles questioning some of the legends and boasts of science professors. But it recently had a poor article trying to sell us on the idea of "psychiatric brain surgery." The principle evidence it provides for such a thing is very weak from a standpoint of decent evidence. We hear some testimony from an anonymous person who 16 months ago underwent tissue-destructive brain surgery to try to prevent him from thought patterns that had been classified as "obsessive compulsive disorder." The man seems pleased with the results, although we should suspect that what is going on is a mere placebo effect, something that would have achieved the same results if a mere sham surgery (with no real surgery) had been done. The man says he is "still aware of his repeating thoughts after surgery" and he may wonder whether his problem may recur. The author confesses, "Given the small number of operations performed each year, the field lacks large-scale trial data on its effectiveness."  So why has she written  some article trying to boost this dubious approach to mental health? 

During the 19th century there was endless testimony about the high medical effectiveness of hypnotism, which previously had names such as artificial somnambulism and mesmerism. But the medical mainstream refused to listen, largely because hypnotism was strongly associated with reports of mysterious psychic powers such as clairvoyance.  The promise of hypnotism was immense, as shown by the success of the physician James Esdaile in supervising many hundreds of tumor removal operations in India, in which patients undergoing severe surgeries with no anesthesia reported no pain, because they had been hypnotized to think they would feel no pain. This route was taken because anesthesia had not yet been invented. On pages 27-28 of a book by Dr. James Esdaile he lists a host of dramatic painless surgeries he performed without using anesthesia, but only hypnosis on patients. The list includes about 20 amputations, and 200 removals of scrotal tumors ranging from 10 pounds in weight to more than 100 pounds in weight. A book on this topic by Esdaile can be read here. 

Medicine has largely failed to take advantage of hypnotism, because of medical personnel being stuck on "brains make minds" errors. And so we had disasters such as the opioid epidemic, in which more than 700,000 Americans died from overdoses of opioid pills that were overprescribed by physicians looking for quick and easy ways to do profitable high-volume patient processing, rather than slower methods such as hypnotism.   Astonishingly, most people in the US still have blind faith in people in white coats, ignoring how the greed and haste of white coat guys led to 700,000 US deaths. Shouldn't a toll like that make you think: maybe these guys can sometimes be seriously wrong about things? 

And speaking of the fellows in white coats making very bad mistakes, a recent NBC News story suggested that more than 2% of all cancers are caused by CT scans suggested by people in white coats, which are used too frequently, and often with too high radiation. We read this:

"About 93 million CT scans are performed every year in the United States, according to IMV, a medical market research company that tracks imaging. More than half of those scans are for people 60 and older. Yet there is scant regulation of radiation levels as the machines scan organs and structures inside bodies. Dosages are erratic, varying widely from one clinic to another, and are too often unnecessarily high, Smith-Bindman and other critics say.

'It’s unfathomable,' Smith-Bindman said. 'We keep doing more and more CTs, and the doses keep going up.'

One CT scan can expose a patient to 10 or 15 times as much radiation as another, Smith-Bindman said. 'There is very large variation,' she said, 'and the doses vary by an order of magnitude — tenfold, not 10% different — for patients seen for the same clinical problem.'  In outlier institutions, the variation is even higher, according to research she and a team of international collaborators have published.

She and other researchers estimated in 2009 that high doses could be responsible for 2% of cancers. Ongoing research shows it’s probably higher, since far more scans are performed today."

There are about 600,000 US cancer deaths per year. If we assume 2% of these were caused by unnecessary or too-strong CT scans per year, then maybe 240,000 were killed by such scans over the past 20 years. That's in addition to huge amounts of unnecessary suffering caused by non-fatal cancers.  Then there is also the very large number of neuroscience research subjects who may have been needlessly imperiled by the use of gadolinium contrast agents (discussed here), a technique that may have seriously endangered a much larger number of people who took them after doctors suggested taking them to make the doctor's analysis of MRI scans easier and faster. 

Besides such examples of guys in white coats blundering, there is an additional reason for suspecting that millions of others may have died in this decade because of guys in white coats blundering.  It seems that those in white coats can often make big mistakes. 

 

Most of those in white coats are good people. But don't assume a claim is very probably true merely because it comes from someone in a white coat.