Obsessing over observation and why understanding mental illness is so complicated
Human science is obsessed with observation, and rightfully so. Observations summarize what we see, what we hear, what we smell, and what truly exists. When we look around us, each individual cursory glance reveals a wealth of knowledge that ultimately contributes to our understanding of our world. Without observation, science amounts to nothing more than conjecture and consideration – an argument with no proof.
Both Eastern and Western science has greatly benefited from the combined total of the sum of all human observation. Where once we only had philosophy to provide us with a mere glimpse of a possibility of an understanding of the universe, we now have science to illuminate the darkness, and bring human intelligence into the light. Admittedly, that’s left us with a few hang ups that have only served to hinder our collective pursuit of knowledge. Humanity now has an obsession with proof and evidence, which has made educating people about the mind an especially harrowing endeavour.
As far as scientists and doctors and surgeons and patients – the people at the frontlines of medical study – are concerned, mental illness is a thing. For most people in the world, mental illness – depression, schizophrenia, anxiety, OCD, ADHD – is not a debatable issue. However, a surprisingly vocal minority still insists on challenging the notion that mental illness exists, not only because they don’t understand it, but because they can’t see it.
Heart disease is impossible to deny because we can plainly see its manifestation. A broken leg can’t be argued, and no one will ever tell a person missing a limb that they should “get over it.” Mental illness, as a purely physical construct, cannot be directly observed without the assistance of intermediary interpretive devices.
Furthermore, it’s easier to visualize other illnesses that do require the use of MRIs and CT Scans to diagnose, simply because we can imagine what cholesterol building up in an arterial wall looks like. Excluding the rare cases where a patient’s brain contains physical abnormalities, like fissures or lesions, mental illness is almost impossible to imagine as a physical concept.
Much of this visual difficulty comes from the public’s misunderstanding of the cerebral structure, as well as a lack of knowledge as to how the brain communicates with itself and the rest of the body. Furthermore, almost all of the misunderstanding comes from the assumption that the brain works like the rest of the body – almost entirely physically.
The brain itself works through a process of electric and chemical signals. The nervous system’s pathway is almost purely electrical, but nerves communicate with one another using chemical neurotransmitters. Unlike blood in the circulatory system, which is a cellular collection of molecules, nerve cells rely on electricity to communicate. Even more unlike cells, the neurotransmitters that allow nerve cells to communicate with each other aren’t “living.”
Treating mental illness requires an understanding of the body’s neurotransmitters, as well as how they function within the brain, and talking about mental illness requires forgetting almost everything known about treating physical illness. It requires looking at the body from an almost purely objective perspective, disregarding the concept of emotion as a physical property and thinking about it as a collection of responses produced by little more than a series of chemical reactions.
Once we look at the brain as chemical, we begin to understand why it’s so difficult to diagnose, treat, and cure mental illness. Living things can be killed – chemical processes can only be manipulated. Bacteria can be eradicated, dopamine bonding to a dopaminergic receptor cannot. This significantly changes the way that medicine can be administered. Due to the chemical and electrical nature of the brain, directly injecting chemicals into the brain is not a solution to chemical inadequacies.
The blood-brain barrier is an incredibly selective barrier that separates circulating blood from extracellular fluid in the brain. Simply put, the blood-brain barrier is the reason we can’t directly inject neurotransmitters and hormones into a person – the barrier prevents the entrance of certain foreign substances, even if those particular substances are produced and circulated by a healthy brain.
For example, current research indicates a relationship between low amounts of dopamine and incidences of Parkinson’s disease. The question first-year psychology students ask is, “Why don’t we just inject more dopamine into the brain?” The answer is simple: The blood-brain barrier blocks dopamine from entering the brain, even though dopamine is a significant, necessary, and essential neurotransmitter.
An entire subset of neuropsychiatry is dedicated to understanding how to circumvent the protective nature of the blood-brain barrier. For almost a decade, scientists have been experimenting with the idea of using ultrasound waves to induce permeability in the blood-brain barrier. Incredibly fascinating is the fact that these studies work. While this is fantastic news for patients, imagine explaining that sound is being used to open a chemical barrier in the brain that prevents us from injecting more of the chemicals already found in the brain to a group of people who already don’t understand mental illness.