Harvard Article: Messaging in Biological Psychiatry
A new Harvard Review of Psychiatry article entitled, “Messaging in Biological Psychiatry: Misrepresentations, Their Causes, and Potential Consequences”, (Vol.28, Issue 6, Nov/Dec 2020), discusses the media and policy skew to biological causes of mental distress, and away from the other, psychosocial aspects, such as environmental factors. In my “Evidence” tab, I provide a multitude of direct quotes from this article that I found particularly impactful, and I also include the link to the full article. In summary my understanding is that they describe that:
It’s not that psychiatric medications don’t alleviate “symptoms”, but the question of if they are “correcting deficits” is still a question.
While most of the studies that show positive effects of antidepressants are published, there are also studies that do not show these effects, and these are mostly either not published or mis-published.
Regarding a part of the brain called the “hippocampus”, a 1.2% volume difference was shown between “depressed patients” and “healthy controls” but the literature does not mention that this difference “is not observed in patients diagnosed with a first depressive episode” and therefore that “this minimal atrophy of the hippocampus might be the consequence of chronic depression rather than its cause”.
Sometimes initial studies that the media publishes are later disconfirmed by subsequent studies, but often journalists do not follow up with another article informing the public of this; for example, many studies reporting genetic risks of psychiatric disorders are not confirmed by later studies. (And, “Actually, [while] some rare genetic variants appear to be strongly associated with intellectual disability, autism, and schizophrenia… they explain only a small percentage of cases. Recent genetic and epidemiologic studies have softened the view that genetic defects play a major role in the etiology of mental disorders.”)
The media often publishes what is provided in press releases, but it’s the prestigious journals that tend to produce these, not the less prestigious journals.
While this skew might have come about to benevolently lessen blame on people for their mental distress, some unintended consequences of it could be that people suffering can then be stigmatized and/or perceived as less likely to recover; and, it can overshadow “psychotherapeutic and social approaches that have been found effective in alleviating mental suffering”.
Evidence is mounting that at least for some types of mental distress, psychosocial (environmental) conditions are a meaningful factor.
In Belgium, Canada, and Israel, politicians are more likely to pay attention to information provided by the media than by an individual. (In my anecdotal experience, this has been my experience.)
Also the article states, “national newspapers preferentially cover biomedical publications whose authors are working in that country”. I am not sure if I am interpreting this correctly, but I have anecdotally gotten the sense that there is a more open view towards the multifactorial nature of mental distress in Europe vs. in North America. But my view here is just an impression, subject to further analysis. If I am wrong I am wrong and am amenable to informative disconfirmation.
If you find it odd that in a democracy this skew could happen, maybe a reason for it could be that it shifts some attention away from the conclusion of another, cited study (Hackman et al., 2010). This cited study mentions that “prenatal factors, parent-child interactions and cognitive stimulation in the home environment” are factors “in the effects of SES on neural development”. As mentioned in the Harvard article, if these are factors, this might be “contradictory to “the democratic idea of equal opportunity”. (I add, for more information about these above factors, consider reading about the work of “ACEs Connection” where ACEs = Adverse Childhood Experiences: https://www.acesconnection.com/blog/aces-101-faqs)
This page is for information only, and is not advice of any kind (e.g., it is not medical advice — please consult with your physician if you require medical advice such as regarding any medication you are taking, as it can be dangerous to make any changes to these without medical supervision). It is neither counselling nor psychotherapy and implies neither an intent to provide professional services to readers nor that a professional relationship has been established with readers. If you need these services, please contact me or another professional. If urgent support is needed, calling Toronto Distress Centre at 416.408.4357 is an option. For emergencies, consider calling 911 or going to your local Emergency Room. Current adult residents of the Canadian province of Ontario are the only intended audience of this page.