Since When Is the Brain Not Part of the Body?

I have a suggestion. To some it may sound outright “crazy,” but speaking of “crazy…”

Please, for the love of Pete, let’s make the choice today to stop differentiating between “physical” and “mental” illness.

Why? Because when it comes down to it, I believe mental illnesses are physical illnesses.

Mental illnesses are diseases of the brain. And when, may I ask, did the brain stop being part of the body?

Let’s look at an example. If I’m a patient with viral encephalitis, I have what is medically classified as a “physical illness,” even though encephalitis is a disease of the brain. Even if viral encephalitis produces psychiatric symptoms, it’s still a physical illness. Why? Because the brain is part of the body.

A person with multiple sclerosis (MS) also has what’s medically classified as a “physical illness” even though it’s a condition that affects the brain. And even if MS produces psychiatric symptoms, it’s still a physical illness. Why? Because the brain is part of the body.

Yet, in society today, we make the distinction between “medical” and “mental” like the first should be taken more seriously. While neurological disorders are viewed as medical, or illnesses of the brain, psychological conditions are viewed as mental, or disorders of the mind.

So what’s the hang up? Why do we act like “physical” illnesses are more medical than “mental” illnesses?

I would argue this distinction exists because we’re still learning about the causes of mental illness. Neurological illnesses, like dementia and epilepsy, are often classified as physical illnesses largely because science has been able to determine and document a physical cause, one that is detectable through blood work, imaging or other diagnostic testing.

But just because the cause of a condition remains elusive to science, doesn’t mean it’s any less “real,” “medical” or physical than the myriad of conditions for which science has provided concrete information. A sick person is sick, regardless of whether a microscope, x-ray or genetic test can show the reason why. It’s time for us to focus more on skilled healing than skeptical hesitation.

Furthermore, there are several psychological illnesses for which science is beginning to determine a cause. And that cause, it would appear, is physical.

A common illness worldwide is major depressive disorder. Advancements in science over the last few decades have allowed us to gain some insight into the chemical imbalances, faulty neurotransmission and genetic predispositions that combine to create the not-so-perfect storm we know as depression.

According to the International Bipolar Foundation, there is no single cause for bipolar disorder. It appears to be a combination of genes and the environment. The organization also says, “There is evidence from imaging studies that the brains of people with bipolar disorder may differ from the brains of healthy individuals. As the differences are more clearly identified and defined through research, scientists will gain a better understanding of the underlying causes of the illness.” It would appear there’s more to this “mental” illness that meets the eye.

So among all the confusion surrounding mental illness, what can be done? To start, I think we should simply do away with the distinction that makes people take “physical” and “psychological” illnesses more seriously than “medical” and “mental” illnesses. By continuing to distinguish between “physical illness” and “mental illness,” we’re reinforcing the already too strong stigma that surrounds these true disorders of the brain. We’re promoting and strengthening the belief that mental illness is “all in a person’s head” — or in other words, the patient’s fault — and not a real illness or disease.

What is mental illness really? It’s a medical, physical illness of the brain. The fact that mental illness — just like medical conditions — can be triggered by environmental factors doesn’t make it a choice, any more than Parkinson’s disease or any other neurological condition is chosen by those afflicted by it. It’s no more the person’s fault than a recurring malignant tumor is the fault of a cancer survivor. And it’s time we started acting like it.