Don’t Say That Depression Is Caused by a Chemical Imbalance

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Researchers at the University of Melbourne conducted a meta-analysis of 25 different studies that looked at the impact of the “brain disease” framing of mental illness. They concluded that this framing is a mixed blessing: While some studies showed that this way of framing mental illness leads to a decreased sense of blame, many also showed that it leads to a stronger desire for social distance and an increased perception that people with mental illness are dangerous.

What are some better ways to talk about mental illness? One study found that talking about how genes and biology are malleable and interact with the environment led those with mental illness to have less pessimism about recovery. Another study found that talking about how there is a continuum between mental health and mental illness, rather than a strict dichotomy, decreases perceptions that people with mental illness are different and leads to greater social acceptance. And a meta-analysis of several studies found that some of the best tactics to reduce stigma against those with mental illness involve increasing contact with those who are suffering from mental illness and dispelling common misconceptions about having a mental illness.

Yet, the “brain disease” frame is still central to the way we talk about mental illness. Even the term “mental illness” evokes notions of physical illness, which raises the question: is even the word “illness” an issue when we talk about mental illness? Can we re-think the way we talk about mental illness, avoiding terms like “illness” and “disorder?”

Some people think we can. It has become increasingly common to refer to mental illnesses, as well as developmental disorders such as autism spectrum disorder and ADHD, as instances of “neurodiversity.” The term neurodiversity initially rose to prominence in online groups of autistic individuals, and is often strongly associated with autism spectrum disorder. However, it has since grown to become a way of describing a range of mental illnesses and developmental disorders, such as dyslexia, ADHD, depression, bipolar disorder, schizophrenia, and more.

The basic tenets of neurodiversity are that there is no “normal” human brain, that there are differences, not disorders, and that there are, in many cases, positive aspects to having a variety of brains that function differently. Advocates for neurodiversity commonly draw parallels with homosexuality, which was previously described as a disorder by the American Psychological Association until 1973, but is now viewed by many as an instance of normal human variation.

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