I struggle with mental health issues. Card-carrying, diagnosably legit issues. This is a frustrating but large part of my life, so you can bet that I’ve spent years looking for answers and explanations. And in that long and unending search for answers, I’ve journeyed through the most common answers our society offers, some conventional and some alternative.
That journey has taken me through an obsessive deep-dive into many mental health diagnoses, from obsessive-compulsive disorder to depression to anxiety to phobias to the many variations of bipolar disorder and beyond. I showed up as a psychology undergrad already knowing way too much about the DSM, psychiatry’s diagnostic manual, and which types of therapies were believed to work best for which disorders.
Sometimes my quest for answers was calm and strategic, other times desperate. I threw myself at conventional psychiatry in a week-long hospitalization when I couldn’t escape my deepening depression and growing preoccupation with suicide. I unquestioningly went on a cocktail of meds. I went to therapy.
When that didn’t work, I threw myself at alternative methods, taking herbs in an attempt to relieve various symptoms. I embraced functional medicine wholeheartedly, believing that my mental health issues were symptoms of physiological imbalances, longing for some unreached perfection when my mind would be well.
As a student of psychology and biology, and as a student of my own chaotic life, I’ve learned that the answers often aren’t as easy or as black-and-white as we want them to be. Psychiatry has sure as hell let me down, but I’d be lying if I said functional medicine is its perfect alternative antidote.
Psychiatry, Help Us
Psychiatry does its best to match pharmaceuticals to symptoms, but the matching is a messy game of trial-and-error, a game that usually comes with at least a couple of unwanted side effects. If you’re lucky enough to finally find a good match, you sign on to those side effects, and hope to God the drug continues to work. It often doesn’t.
In the early days of psychiatry, it was seen as desirable for each patient to qualify for one diagnosis. Multiple overlapping diagnoses were seen as a weakness of the diagnostic system. Today, multiple diagnoses are common and research has found diagnosis to be incredibly inconsistent from one practitioner to the next. It turns out that, to some degree, this grouping of symptoms is more an ambitious practice in classification than a scientific way of determining concrete illnesses.
People on psychiatry’s side of the fence depend on repetitive explanations of neurotransmitter deficiencies. It’s an illness like any other illness, we’re told, and that’s why we need the meds. This explanation is rampant in direct-to-consumer advertisements for psych meds (which aren’t legal in most developed countries) and has made its way to advocacy organizations. Because if we’re sick, our struggles are justified and we can finally defeat stigma, right?
I find myself in this messy middle ground, because of course I hate stigma. Of course I think my experience is real, and that I’m not just some massive fuck-up. But I can’t embrace explanations that aren’t scientifically supported in an attempt to gain some ground. The causes of mental illness are complex and not particularly well-understood, but what we do know is that research does not support the idea that mental illness is caused by neurotransmitter deficiencies.
Functional Medicine, Maybe?
When I pushed back against psychiatry, deciding to go off meds and deal with these problems in other ways, I was drawn to the world of holistic health and functional medicine. Functional medicine is a perspective on healthcare that focuses on identifying the underlying causes of symptoms instead of simply trying to suppress those symptoms without diving into where they came from.
I love this field and think it has a huge impact to make on our broken healthcare system, but I think it falls a little short when it comes to mental health. Because of the field’s emphasis on resolving underlying biological issues, these practitioners usually focus exclusively on the fact that mental health symptoms could very well be a result of this or that or that other biological issue.
This leaves us believing that if we just get well, finally, if we just find the quality of healthcare we deserve, and eat as well as we should, that we shouldn’t struggle with this anymore. And sometimes this is true, sometimes mental health symptoms are an issue of damage done by lifestyle choices or a thyroid issue or something else. But this isn’t the whole story.
Because it’s entirely possible that we could eat perfectly, heal our gut, and restore optimal thyroid function and still find ourselves dealing with the same old shit. And what then? Do we give up? Assume there are no answers to be had?
I don’t think so.
I think we find answers where we can in what is available to us, but that we push ourselves to experiment. To become painfully self-aware, students of ourselves. That we share our thoughts about these experiences, and we listen to other people’s, and come to whatever synthesis we can. That we stay open, questioning, and allow our perceptions to grow with us.
That we push for change, for compassion and awareness, but that we never depend on dogma to achieve it. That we find meaning in the DSM when it’s helpful, that we use meds as an educated choice if we want to, that we grow through therapy if that works for us. That we heal our bodies to feel our best, use herbs that can work for us, and depend on extreme self-care to stay well.
We want easy, concrete answers, but life is messy. My experience, your experience, is messy.
That usually means the answers are a little messy, too.