Modern psychiatry defines disorders by a checklist of symptoms (e.g., via the DSM), treating the syndrome itself as the disease. This is unlike the rest of medicine, which views symptoms like a cough as signals of various underlying causes. This flawed approach has stalled progress by focusing on labels instead of mechanisms.
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The Hierarchical Taxonomy of Psychopathology (HITOP) model reveals that symptoms of mental health problems cluster into five major dimensions that closely correspond to the Big Five personality traits. This suggests mental illness can be understood as an extreme expression of normal personality variation.
In its rush for the next breakthrough, the field of psychiatry often discards older, effective treatments due to historical stigma. For instance, MAO inhibitors and modern, safer Electroconvulsive Therapy (ECT) are highly effective for specific depression types but are underutilized because of past negative associations, a phenomenon driven more by politics than science.
The American medical system's emphasis on 15-minute visits and efficiency incentivizes prescribing medication to treat symptoms rather than unraveling root causes. This approach aims to "polish the hood when there's a problem in the engine."
A diagnosis like autism may function like the 19th-century term 'dropsy' (swelling). It accurately describes a collection of symptoms but doesn't necessarily identify a single, unified underlying cause. The label captures a surface-level phenomenon, not a fundamental 'thing' in the world.
Instead of a categorical disease model (virus present/absent), mental health should adopt a dimensional approach like internal medicine. Just as blood pressure exists on a spectrum, psychological traits do too. Treatment decisions can be based on evidence-backed cutoffs for risk, eliminating the need for arbitrary diagnostic boxes.
Dr. Bolsiewicz reframes major depression not as a purely psychological issue, but as a physiological condition rooted in inflammation. He states with "total clarity" that depression, along with neurodegenerative diseases like Alzheimer's and Parkinson's, is a manifestation of chronic inflammation affecting the brain.
Many common GI diagnoses, like Irritable Bowel Syndrome or gastroparesis, are simply labels for a collection of symptoms defined by criteria, not explanations of the underlying physiological cause. This limits effective, targeted treatment.
Contrary to the dominant medical model, mental health issues like depression and anxiety are not illnesses. They are normal, helpful responses that act as messengers, signaling an underlying problem or unresolved trauma that needs to be addressed rather than a chemical imbalance to be suppressed.
The term "depression" is a misleading catch-all. Two people diagnosed with it can have completely opposite symptoms, such as oversleeping versus insomnia or overeating versus appetite loss. These are not points on a spectrum but discrete experiences, and lumping them together hinders effective, personalized treatment.
The common thread in mental disorders is metabolic dysfunction at the cellular level, specifically within mitochondria. This reframes mental illness not as a purely psychological issue or simple chemical imbalance, but as a physical, metabolic problem in the brain that diet can influence.
