Mental health is biological health: Why tackling “diseases of the mind” is an imperative for biological anthropology in the 21st century

Kristen L. SymeEdward H. Hagen

First published: 24 November 2019 https://doi.org/10.1002/ajpa.23965Citations: 2

Funding information: National Science Foundation, Grant/Award Number: BCS 1355469

Abstract

The germ theory of disease and the attendant public health initiatives, including sanitation, vaccination, and antibiotic treatment, led to dramatic increases in global life expectancy. As the prevalence of infectious disease declines, mental disorders are emerging as major contributors to the global burden of disease. Scientists understand little about the etiology of mental disorders, however, and many of the most popular psychopharmacological treatments, such as antidepressants and antipsychotics, have only moderate‐to‐weak efficacy in treating symptoms and fail to target biological systems that correspond to discrete psychiatric syndromes. Consequently, despite dramatic increases in the treatment of some mental disorders, there has been no decrease in the prevalence of most mental disorders since accurate record keeping began. Many researchers and theorists are therefore endeavoring to rethink psychiatry from the ground‐up. Anthropology, especially biological anthropology, can offer critical theoretical and empirical insights to combat mental illness globally. Biological anthropologists are unique in that we take a panhuman approach to human health and behavior and are trained to address each of Tinbergen’s four levels of analysis as well as culture. The field is thus exceptionally well‐situated to help resolve the mysteries of mental illness by integrating biological, evolutionary, and sociocultural perspectives.

1 INTRODUCTION

During the 20th century, the biomedical sciences rapidly reduced the global burden of infectious disease, leading to dramatic increases in life expectancy (Murray et al., 2015). In the 21st century, chronic, non‐infectious diseases have emerged as major contributors to global disease burden (Benziger, Roth, & Moran, 2016), with mental disorders playing a substantial role (Whiteford et al., 2013). The causes of most mental disorders, however, remain a mystery, and there has been little progress in reducing the prevalence of any of them.

Here we provide a comprehensive critique of mainstream research on mental disorders (see Figure 1). First, we review the contribution of mental disorders to the global burden of disease. Second, we explore the successes and failures of biological psychiatry, including psychopharmacology, imaging and other biomarker research, and genetic and epigenetic approaches. Third, we critique the theoretical foundations of psychiatric classification, reviewing different concepts of disorder and disease. Our goal in the first half of our article is to convince biological anthropologists that there is a genuine and widely‐recognized theoretical crisis in mental health research.

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Figure 1Open in figure viewerPowerPointSymptoms of mental disorders as defined in the Diagnostic and Statistical Manual IV (DSM‐IV). Each dot is one DSM‐IV symptom. Symptoms are colored by the DSM chapter in which they occur most often. Symptoms that occur in the same disorder are connected by an edge. Source: Figure from Borsboom and Cramer (2013). An interactive version of this figure that identifies each symptom (node) is available in the supplementary material of Borsboom and Cramer (2013)

In the second half of our article, we sketch new approaches to mental health research from within mainstream psychiatry and clinical psychology, some of which are driven by the National Institute of Mental Health (NIMH). We then offer a provisional evolutionary schema for conceptualizing mental disorders that identifies one group as relatively rare disorders of development that are probably caused by genetic variants, one widespread group that comprises aversive but probably adaptive responses to adversity and therefore are likely not disorders at all, one group that is probably due to senescence, and one group that might be caused by mismatches between ancestral and modern environments. For each group, we review biocultural studies of mental health that provide fresh insights. Biological anthropologists are unique among the health‐related researchers in that we take a panhuman approach to human health and behavior and are trained to address each of Tinbergen’s four levels analysis (mechanistic, ontogenetic, phylogenetic, and function; for historical overview, see Beer, 2019) as well as culture. Thus, our field is exceptionally well‐situated to help resolve the mysteries of mental disorders by integrating biological, evolutionary, and sociocultural perspectives.

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About S. R. Zelenz 119 Articles
S.R. Zelenz has worked in education for 20 years. Working with students from all walks of life, cultures, races, and social diversity, Zelenz’s research in Educational Leadership led to finding a better way to approach learning for students with trauma histories. Many were juvenile offenders, gang members, diagnosed with varying behavioral disorders, or had family histories of violence, murder, or narcissistic parenting. This research could not be effectively accomplished without further understanding: how epigenetic trauma inheritance may be impacting these students; how brain development from trauma may be impacting their behavioral and emotional development; as well as deep understanding of psychology and its varying classifications for behavioral and personality disorders. The goal is to find solutions for changing the conversation and making a real difference for these students. She has also worked with nonprofits of varying focus areas for the last 25 years. Her undergraduate degree in Arts Administration and Music prepared her for managing nonprofits of any size as well as procuring funding so that they can achieve their goals. Pairing her nonprofit background with her education background, she has been able to make a difference for over 200 nonprofits worldwide, written curriculum for schools across the globe, and assisted many arts organizations through performance and management.