Yes, it’s true that mental illness is no-fault, in that you didn’t get to choose the genes you were born with. And hardly any of us know what hit us after a first-episode depression or mania or psychosis has hijacked our brains and left us in a hole that will take us years to dig our way out of.
The medical model tells us that mental illness is much like diabetes. Yet while no one tells a diabetic to just snap out of it, doctors and other health experts do tell individuals with diabetes and those at risk of diabetes a lot of the same things they tell us: Proper diet and exercise is a must. Cut down on the drinking and other bad habits.
At-risk individuals invite in trouble by refusing to change their behavior. Those who are already ill – whether physically or mentally – undermine their ability to work toward stability and recovery by failing to implement lifestyle changes.
But there is an added complication to mental illness. Our broken brains conspire to play tricks on us. If we’re not over-reacting and over-thinking, we’re under-reacting and under-thinking. On one hand, we drive away the very people who can help and support us, on the other we are afraid to seek them out. Either way, we risk finding ourselves alone, isolated.
Then there’s that little-understood chemical imbalance of the brain people keep talking about. The neurotransmitter dopamine, among other things, is involved in motivation. So if your dopamine levels happen to be low, there is a good chance you will not be motivated to improve your life. Researchers and clinicians are only just beginning to appreciate the role dopamine may play in helping us get well and stay well. Ironically, antipsychotics – a first option in treating mania, psychosis, and some depressions – block dopamine.
Glutamate is another neurotransmitter that can boost our mood, but too much of a good thing can flip us into mania or psychosis or affect our neurons in a way that may bring on depression. It can be difficult to change one’s behavior if one’s glutamate is imbalanced.
