Most Mental Disorders Are Not Mental Diseases

We are seeing suffering arising from maladaptive patterns in a troubled society.

Posted Nov 13, 2020

Although some mental disorders are also mental diseases, many are not. To see what I mean, we can start with a good example of a mental disorder that is also a mental disease. A disease is best thought of as “broken biology” that results in harm. Given this, mental diseases are conditions that involve impaired mental processes that can be understood in terms of harmful breakdowns in neurobiology. Alzheimer’s disease is an obvious and good example. The neurobiological functioning of the memory system and other neurocognitive processes break down in a way that impairs the person’s mental behavioral patterns. However, most common mental disorders treated in psychotherapy are not mental diseases.

Why does our society think about so many mental problems in terms of a “chemical imbalance” that needs to be treated by professionals, often with medication? Because traditional modern, empirical, natural science—let’s call it “traditional MENS knowledge” has tended to be reductionistic at the level of mechanism, and it has not yet developed a good, consensual model of human mental processes. As a consequence, health is often too strongly framed in terms of biological medicine, and the medical fields are grounded in traditional MENS knowledge (i.e., STEM), and we have institutionalized the idea that health is treated by physicians and that “real” sicknesses are a function of broken biology.

The vast majority of mental disorders are “neurotic conditions” that cannot be reduced to broken biological mechanisms. Rather, they are caused by entrenched maladaptive patterns of thinking, feeling, doing, and relating that are associated with suffering and lack of fulfillment.

Because modern society is quite ill, it is no surprise that we are seeing a massive mental health crisis. We are almost certainly not seeing an epidemic of broken brains. Rather, we are seeing large numbers of people who have no idea how to deal with negative emotions, no idea what authentic fulfillment looks like, massive stress in trying to mimic some notion of consumptive success that is constantly being advertised to us, a chaotic information environment, confusing and tense relationships between polarized identities, and a society that employs a “disease-pill model” of mental health that stems from the fact that traditional MENS knowledge never developed a good resolution to the mind-body problem.

To be sure, the basic model of human mental health is pretty straight forward. Psychosocial well-being is achieved when humans (a) feel known and valued by important others; (b) develop and grow in a secure environment that knows how to generate a safe haven for exploration and challenge; (c) have clear identities regarding who they are and have good relations between the head and heart; (d) are able to learn and adapt with meaning and purpose; and (d) feel connected to a healthy society that has a healthy relationship with the natural world.

Modern society does not achieve this alignment very well. It is atomized, so that individuals are likely not part of a healthy community (hence the loneliness epidemic). It is anchored to capital-labor relations whereby much of human exchange is commoditized and instrumentalized, so that social influence and control for external reinforcement (i.e., money) is the norm, rather than authentic connection that engenders a sense of people being known and valued. Its knowledge systems are fragmented and, because of the Enlightenment Gap, overly reductionistic and mechanistic.

As a consequence, we literally do not know how to talk about the human soul, and we have yet to build an effective philosophy/religion for the 21st Century that allows for the growth of a wisdom orientation that is consistent with MENS knowledge. And because we have lost contact with wisdom and the virtues it cultivates, we instead try to bubble wrap our kids in safetyism, which only serves to make them more vulnerable. The bottom line is that we are facing a mental health crisis because modern society is broken in terms of its capacity to help the human soul find nourishment and orient toward the good.

Framed as such, it hardly is surprising that so many people are suffering and trapped in maladaptive patterns. To be sure, the solution to this sad state of affairs is not going to be found in therapy for all. Rather, we must come together, with ourselves, with important others, our communities, our nations, and Mother Earth to start the process of finding ways of being that enable us to collectively cultivate wisdom energy for systems at every level of analysis in the decades to come.