Prof. Dr. Kemal Arıkan

What are Mental Disorders?

Ruhsal Bozukluklar Nelerdir?

The question of what mental disorders actually are, is an extremely controversial question. Classification systems, such as DSM-V and ICD-11, consider mental disorders to be thoughts, feelings and behaviors causing distress (symptoms). Therefore, mental disorders are diagnosed through an evaluation at the clinic, based on the symptoms included in the diagnostic criteria. Treatments, however, aim to alleviate these symptoms through various means.

From Symptoms to Brain…

Brain is the source of thoughts, feelings and behaviors. Thus, in terms of mental disorders, the first thing to come to mind is that a dysfunction in the brain might cause pathology. Nevertheless, in a similar manner to the way the symptoms of neurological and physical diseases show themselves, whether a dysfunction in the brain shows mental disorder symptoms is under discussion.

In order to understand this, underlying biological changes may be revealed by measuring what’s wrong through a comparison of the patients to healthy individuals. It may be possible to develop new treatment interventions diminishing such changes.

Yet at the same time, it is hard to understand it. This is because a symptom of a disease occurring in our body, such as fever or headache, could have different underlying etiologies, while the complementary psychological indications provided by the patient in mental disorders cannot easily match neuroscientific frameworks.

Additionally, the person experiencing the symptoms has a unique background, thoughts, feelings and behaviors, a genetic and developmental structure varying substantially from person to person. Accordingly, individuals, who apply to the clinic with the same symptoms, may show significant differences. Consequently, biological variables related to the same “symptoms” and disorder may vary to an extent where such individual differences are reflected.

From Brain to Environment…

Brain is an organ that is continuously developing; it recreates itself based on experiences. Therefore, it is important to be aware of the fact that the person experiencing these psychological symptoms is not fully independent. The elements of the stimulating medium may affect the severity of the mental health symptoms, just like the exacerbation of asthma symptoms to unbearable levels due to bad air quality or the exacerbation of diabetic symptoms by dietary elements.

Each and every individual is interacting with their surroundings and lives a life that is full of experiences that cause the brain to be reshaped continuously. Therefore, each human being is a unique entity that has different thoughts, feelings and behaviors.

A Multi-directional Approach

Mental disorders are in fact multi-directional deteriorations that have various complicated etiologies. Thus, it is not surprising to have a great number of different (and mostly contradictory) perspectives on the issue of what mental disorders really are, how they should be classified, how they should be evaluated, and how they should be treated.

The fact that all mental health disorders are considered to be brain disorders is still quite controversial for disorders that can be substantially affected particularly by social and environmental factors (e.g. Depression). Accordingly, to define mental health disorders at a personal level is another approach. Individuals have feelings, thoughts and behaviors. They also have a social and environmental context, as well as a genetic, developmental and experiential background. Each one is associated with one another. In other words, instead of arguing for an approach against another, it is required to have an approach that embraces the multilayer, multi-directional and heterogeneous nature of mental health disorders.

Researchers and clinicians evaluate and classify the questions on what the mental disorder is and how to diagnose it, which in turn leads the way to the answer that yields the best results for the patient. For humans, a biopsychosocial-cultural creature, the best answer comes from the merger of a biological approach that facilitates the development of new pharmacological treatments, a psychological approach that allows the development of new behavioral therapies, and a social and environmental approach that supports the development of life interventions.


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