Posted by SLS on July 9, 2009, at 8:25:37
In reply to Re: ECT - Zeba, posted by morganpmiller on July 9, 2009, at 0:03:41
That was a great post.
I would agree with you in that there is often a psychosocial stress that creates a substrate upon which a biological potential is realized. This might even be true of the majority. Even homozygous twins are not necessarily concordant in their presentation of a mental illness. That leads me to believe that epigenetic factors are involved in the evolution of the resultant pathological phenotypes. Events in the womb might even come into play.
I think I understand the paradigm that you are suggesting. It has always been my belief that the majority of pathological presentations are the result of an interaction between biology and psychology (nature and nurture) Still, I would be careful when attempting to establish the presence of a trend by creating generalizations that are all-inclusive. You cannot know the experiential history of everyone who displays a major mental illness. When you search for imperfection in growth environments, you are likely to find it. It seems to me that your paradigm is really a thought experiment that can be bolstered by saying that "we all have issues" because none of us had a perfect growth environment. It might make sense to consider depression as a spectrum of the contributions of the biological and the psychological. I believe that there are cases that occupy one pole or other; either all psychogenic or all biogenic. Most will be found somewhere in the middle with various combinations of nature and nurture involved in the evolution of the illness.
All in all, I actually agree with you. I just do not think that every single case of MDD or BD occupies the center of the affective spectrum. In fact, I think that there are enough occupants at either end such that they need to be understood and treated very differently clinically. It is sabotage to tell someone at the biogenic end of the spectrum that they must have had psychological issues to become ill in the first place, and that they might have to resolve them through psychotherapy before they can become healthy. I would say that "we all have stress", rather than "we all have issues".
The affective spectrum is simply a thought experiment on my part. I have no data to present in order to support it.
- Scott
poster:SLS
thread:901064
URL: http://www.dr-bob.org/babble/20090709/msgs/905771.html