The Mental Health Place Blog - A Mental Health Blog

Philip Brown, LCSW, challenges us to rethink our views on the Affective Disorder spectrum (Depression and Anxiety) which in turn would categorize more people as NORMAL than "sick."

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Current research suggests at a least 1 out of 3 people (some 33%) will end up sitting on a couch talking to one of us about their Affective Disorder. I look at the Affective Disorder spectrum from Major Depression to Generalized Anxiety as one animal with many different heads. We have all seen mixed Affective Disorder, Depression with a side of Anxiety and Anxiety with a bit of Depression. Well the whole spectrum is treated psychopharmologoically with the same type of medications. Medications which reestablish a ratio of serotonin, norepinephrine and dopamine to some magic ratio to each other in the synaptic gap that gives symptom reduction and/or resolution. The Newest boys on the block are the SSRI's and SNRI's. We try modify mostly serotonin and norepherine levels to reestablish emotional harmony.

When I refer to the Affective Disorder I mean Major Depression, Dysthymia, OCD, Eating Disorders, Panic Attacks, Phobias, and Generalized Anxiety with all their NOS (Not Otherwise Specified) counterparts. They all seem to be modulated by the same electrochemical neuro pathway in the brain. Therefore, I look at them as all the same beast with different manifestations of itself at different times sometime within the same person.

Here is where it gets interesting. Remember the good old Normal Curve, the Bell Shaped One, with its three Standard Deviations above and below it's mean? We would measure the population of all college freshman, for height, weight, IQ (whatever that is) and so on and see a nice normal curve. Take IQ for example, mean at 100, SD=20, NORMAL RANGE=Mean+/- one SD (IQ's 80-120). I'll bet there is a Normal Curve for S/N/D ratio (serotonin/norepherine/dopamine). I'll also be if we measured it in the population today and had data from 100 or 150 years ago, it hasn't changed. Someone, dig up some 150 year-old tissue and then do a double tailed "T" test... I think that 68% of the population then and today would have a NORMAL S/N/D ratio. Just like height and weight I believe this level is passed on genetically.

Well if brain chemistry hasn't changed (evolved) in the past 100-150 years what has changed? Well, we had and Industrial Revolution and an Information/Technology Revolution. Thousands of metric tons of pollutants and chemicals have been added to our environment. We are now asked to multitask in 30 second bytes and have access to an almost unlimited amount of data. Could these revolutions have put an undue stress on our brains that make NORMAL people go "tilt"? Of the 68% of the population with NORMAL ratios, could it be the folks in the First Standard Deviation (34%) below the mean of the Bell Curve who are showing Affective Symptom? If we were bacteria, there would have been countless thousands of generations of us in the last 150 years, but how many Human generations have there been? Maybe our brain has not been able to evolve fast enough to keep up with the changes in our environment.

Perhaps we need to change the way we think, this would not be disease, abnormality or deficit. We would not label these NORMAL people as being "sick". Maybe they wouldn't label themselves as "sick" either

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Philip H Brown, LCSW has had over 25 years of experience in diagnosing Psychiatric and Neuropsychiatric conditions. His college education, at the University of Connecticut, included majors in both Psychology and Biochemistry. His Graduate Training was at the University of Connecticut's School of Social Work. He received his initial clinical training at Waterbury Hospital's Division of Psychiatry. While employed there for seven years he helped train Psychiatric Residents for Yale University School of Medicine and Yale University Post Doctoral Fellows in NeuroPsychology. For 10 years he instructed classes in both Psychology and Sociololgy at the University of Connecticut Regional Campus and Nortwaestern Connecticut Community College. He was a Field Instructor for the The University of Connecticut School of Social Work's Casework Program. He later became the Coordinator of Emergency Psychiatry for Day Kimball Hospital, training Clinicians to do after hours Psychiatric work-ups in the area's two Hospital Emergency Rooms. He has led training workshops for both Social Service and Emergency Medical responders.

Learn more about Philip at www.NEpsychotherapy.com.

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Lisa Brookes Kift is a psychotherapist in Marin County, California and the creator of The Mental Health Place - A Mental Health Blog.