The smoking of psychiatry

The debate about whether psychological problems are caused by trauma/abuse OR by our chemistry OR by our genes has been going on for as long as I can remember.

Here Simon Hatcher reminds us that childhood abuse is a major reason in causing psychiatric problems. He likens this abuse to smoking that beyond doubt causes disease.

http://www.thementalelf.net/populations-and-settings/child-and-adolescent/childhood-trauma-and-abuse-is-the-smoking-of-psychiatry/

In a very different article Ken McLaughlin says “This social preoccupation with abuse, and the way people are encouraged to interpret their current problems through the prism of past sufferings, should be of greater concern than anything DSM-5 might come up with.” – This is from a longish article which left me feeling that Ken has not met as many people as I have who have never doubted that abuse in childhood was the main reason leading to psychiatric difficulties. If you have time his article is here…

http://www.spiked-online.com/site/article/13621/

Or read what Judith Haire has to say in response to Ken McLaughlin’s “Our brains aren’t moulded by abuse”

http://dawnwillis.wordpress.com/2013/05/21/judithhaire-comments-on-ken-mclaughlin-our-brains-arent-moulded-by-abuse-mentalhealth-ukmh/

Different groups have different things to gain from convincing us that their preferred explanations are the most valid.

My own experience and what I have learned by listening to hundreds of people and reading widely is:

Genetics pretty much have nothing to do with causing us to come in front of psychiatrists. No one is immune and the trend is towards every family being affected by poor mental health. As discussed before at Rethinking Bipolar the claims of links between genes and emotional distress have never been backed up by any other group doing similar research anywhere in the world. There is however no single cause of mental distress and often there are multiple triggers.

Trauma/abuse sets millions of people up for struggling with their emotional health for decades after the event(s). Sometimes it is recognized as Post Traumatic Stress but usually it is not so clear-cut.

Our biochemistry is a huge factor in determining our mental health. Our mental health also affects our biochemistry. DSM-5 is essentially the drug company’s brochure and main marketing tool. The problems we have with our body’s chemistry rarely need the high-tech, complex solutions the drug companies would have us believe. Next time you are sitting with someone who is keen to talk about their emotional difficulties take a look at them. Chances are they will not be looking particularly physically fit. Trauma and abuse makes us more susceptible to less healthy life-styles and then life-style drives both our physical and emotional health – in the wrong direction.

I think all our authors and just about everyone involved with sorting out emotional health problems know that both trauma/abuse and chemistry are involved. The debate as to which is more significant will continue. What I am hoping can be accepted is that both are always involved in some way. Even in the cases cited by Ken McLaughlin where people say they were abused but will not or cannot talk about what happened, I feel sure things did happen that influence them towards the troubles they end up in.  The fact that some or even a great many people suffer extreme trauma/abuse and have never had to see a psychiatrist is perhaps a testament to healthy life-style, good relationships  etc being protective factors.

What I have consistently noticed is that those who feel they were traumatized/abused who then went on to make poor lifestyle choices and without the right support things got worse for them.

Poor lifestyle choices? I read an article this morning about some mental health issues causing sufferers to die 25 years earlier and the likelihood that this is largely as a result of psychiatric drugs and not just a direct result from poor mental health and poor lifestyle choices.

Summary: Trauma/abuse with insufficient support > poor lifestyle choices > poor chemistry > stress > diagnosis > a need to discuss earlier problems which may be to do with past events OR maybe what I help people with, which is in addressing current lifestyle to correct biochemistry without the need for DSM-5.

*Biochemistry:  http://en.wikipedia.org/wiki/Biochemistry