On being mentally unwell - part 2

This is the second post in a two part series about mental health. For more context, see this post. For the first post, see here.

This is the less coherent post - each section could be the topic of an essay by itself.

Mental distress and disease

Mental distress comes in many flavours. In moderation these flavours have a certain piquancy that assist the organism in bringing its powers to bear to solve whatever problem has arisen that caused the distress.

When the mental distress is some combination of extreme, apparently immune to common palliatives like rest or a change of scenery, and impairs the ability of the organism to function, we may reasonably call it a disease. Likewise if the distress is caused by events or situations which, in themselves, pose no real threat to the welfare of the organism. From this perspective, mental disease is a maladaptation of the organism to its environment. The genesis of the maladaptation can be strongly organic, as in schizophrenia (in which case the flavour of the mental distress may appear to belong to an alien palate), or be based in more complex dynamics related to interactions with the environment (which may include other organisms, e.g. your mother).

To the extent that mental illnesses are both manifested in, and perpetuated by, mental states and the behaviours that follow from them, we may imagine them to be separate from more purely ‘physical’ diseases like cardiovascular diseases - but a moment of reflection makes it apparent that since these latter diseases are often, to varying extents, influenced by our behaviour, the distinction is not clear cut. On a more pedantic note, interpersonal relationships cannot exist without the medium of physical interaction, and likewise mental states cannot change without corresponding physical changes - in this sense, ‘everything is physics’, but a physics textbook is nonetheless unlikely to be of great help when dealing with mental illness (source: extensive self-experimentation). But in any case the set of diseases that are completely and unambiguously non-mental is likely smaller than you may naively expect, and everything is constrained by physics.

Beliefs and mental illness

Mental illness also appears to be encouraged or (more charitably) enabled by certain strains of religious belief - I have austere, strict forms of Calvinism in mind, because that is where I have observed it. Providing evidence to support this observation is not a simple matter; when talking about what effects specific belief systems may have on an organism’s mental activity it is difficult to imagine a way to test your hypothesis, because of the subtle way in which the belief may influence the development of the mind over an extended time, and the daunting prospect of controlling for confounding factors; but it is also difficult to believe that beliefs have absolutely no role in the etiology of some types of mental distress - in the case of scrupulosity it is the defining feature.

The situation is further complicated by the fact that some of the people I know who most strongly exhibit what I would term the Protestant work ethic are in fact nominally atheists, who happen to have grown up in a society of Protestants. This observation may prompt questions regarding the legitimacy of statements about sociological influences; the sceptical outsider may very well question whether it is not I that am mentally unwell, if I insist that a hard working atheist is driven by a work ethic that is tied up with being the opposite of an atheist - but some of the apparent awkwardness of the observation is surely due to semantics and what Russell called ‘the cult of common usage’.

By way of a clarifying analogy; as organisms we are immersed in a sea of social influences that we take for granted, even as we unconsciously navigate the currents to the best of our abilities. From this perspective it is not so strange to imagine an atheist internalising values whose prevalence are due to the influence of a dominant religious mode - they have simply adapted themselves to the environment as they found it, and their explicit beliefs about supernatural entities or unfalsifiable metaphysical positions are not strictly relevant to many (most?) aspects of their behaviour.

Natural selection and mental health

Continuing the analogy of mental illness as maladaptation: perfect adaptation to the environment is not possible; at least not in the sense of the word ‘perfection’ that seems to be in common usage. ‘Perfect’ adaptation, in the popular sense of the word, would imply, biologically, that the organism cannot possibly increase its reproductive fitness any further; and perhaps that it does not experience senescence (it is not clear that biological immortality must necessarily increase reproductive fitness; perhaps on average the opposite is true).

Similarly, I know of no reason to believe that natural selection, left to its own devices, would select for mental well-being beyond what is strictly required to maintain the organism in a state of health sufficient to reproduce (arguably this is the origin of the need for theodicy); of course, by definition, natural selection cannot select for phenotypes that lean towards suicide before reproductive age (unless perhaps if this benefits their genetic relatives, in a perverse form of kin selection, as is the case for certain species of social insects); so we should expect suicide, which is often perceived as the final stage of severe mental disease, to be relatively rare in nature; and this appears to be the case. When it is higher under certain conditions it is logical to conclude that there is something to those situations that is singularly distressing, and that resists the attempts of the organism to maintain its mental homeostasis.