‘Let’s stop constructing illnesses’

A letter from our July edition.

I felt compelled to write to express how refreshing and stimulating I’ve found a lot of the content in The Psychologist’s last couple of issues. Many of the pieces have resonated with me, as themes have arisen acknowledging the social roots of human experience and challenging its pathologisation.

A couple of years back I submitted an article to be considered for the ‘New voices’ feature of this magazine, and was disappointed that the piece wasn’t accepted for publication. It addressed the issue of the overmedicalisation of low mood, noting trends in prescribing of antidepressants and social explanation for this. The Editor noted that the arguments I presented were well rehearsed and didn’t contribute enough innovative thinking.

I agreed that a substantial proportion of what I said had already been said elsewhere, but was frustrated because in several years of subscription to The Psychologist I hadn’t yet seen any such material in its pages.

It’s not until recent months that this has changed, and there seems to have been something of an explosion of BPS content and activity that resonates with my values! In March I attended History of Mental Health, a joint conference between the BPS History & Philosophy of Psychology Section and the Critical Psychiatry Network. It was great to connect with so many people who hold similar values to me when it comes to mental health (you can read a report at www.thepsychologist.org.uk/critical-and-historical-accounts). One of the keynote speakers was Joanna Moncrieff, who gave an intriguing, informative and critical overview of the history of psychiatric drugs. I was very happy to see a written account of this – ‘Opium and the people’ – in April’s issue of this publication. I also find it very heartening and refreshing to see our new President Peter Kinderman’s Mental Health Manifesto, which calls for understanding people’s difficulties in the context of their lives and society, rather than throwing them into diagnostic categories and ‘treating’ them coercively and relentlessly with medication that, as raised in Moncrieff’s account, is often likely to be doing more harm than good.

To illustrate my point, I refer to an intriguing article I read recently about the link between depression and inflammation. The piece first notes that inflammation is caused by lifestyle factors such as poor diet and inactivity, and goes on to relay some evidence that depression could be the result of an allergic reaction to inflammation. Given that we know that both depression and the lifestyle factors associated with inflammation are on the up, and that eating well and exercising are known to have positive effects on mood as well as reducing inflammation, this intuitively makes some sense. The logical conclusion, to me at least, is that depression can be prevented and treated, at least in part, by living a healthy lifestyle – amazing! – I already knew this, but it was interesting and refreshing to see a biological explanation for depression converging with this belief! However, the authors fail to acknowledge this implication, instead highlighting the argument that depression could therefore be ‘rebranded as an infection disease’. I find it beyond frustrating that where a plainly obvious way of tackling the root causes of depression is presented, people are still hell-bent on finding a way to medicalise the experience and mask the ‘symptoms’ with drugs.

In May’s issue of The Psychologist, Ella Rhodes called for readers’ opinions on what impact looks like in psychology. My personal take is that psychology will only make its impact when critical, non-medical, psychological and sociological accounts of mental distress begin to be taken seriously and become embedded in practice and culture. Psychology has the power to provide insight into how society, relationships and lifestyle impact on our physical and mental wellbeing, which in turn unlocks knowledge about how best to cultivate wellness on individual and societal levels. However, this knowledge cannot possibly have any real impact until we start to let go of the pathologisation of human experience. Let’s stop constructing illnesses and start constructing a culture conducive to wellness.

Lauren Bishop
Poole, Dorset

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