OBSERVATIONSA New Way to
Think about
Mental Illness
Instead of looking for “the” cause of
schizophrenia, depression and other disorders,
we should consider whether there might be
a network of causesH
ave you ever heard of a condition known
as “general paresis of the insane”? Proba-
bly not. In the 19th century general paresis
was one of the most commonly diagnosed
mental disorders. Its symptoms included odd so-
cial behaviors, impaired judgment, depressed
mood and difficulty concentrating. Around the
turn of the 20th century, though, we figured what
it really was—a form of late-stage syphilis infect-
ing the brain and disrupting its function. A few
decades later we discovered a highly effective
treatment: penicillin.
Although general paresis is now very rare, its
example is still instructive. Any honest researcher
will tell you we don’t currently have good explana-
tions for most mental disorders. Depression, ob-
sessive-compulsive disorder, schizophrenia—wedon’t really know how these patterns of disrupted
thought, behavior and emotion develop or why
they stick around.
Yet the hope remains that, much like with gen-
eral paresis, we may soon discover the root caus-
es of these illnesses, and this knowledge may tellus how to treat them. An example of this hope can
be seen in the popular notion that a “chemical im-
balance” causes depression. This might turn out to
be true, but the truth is that we don’t know.
Some researchers are starting to think that for
many mental disorders, such hope might be basedKristopher Nielsen is a Ph.D. student in the
Explanation of Psychopathology and Crime lab at Victoria
University of Wellington in New Zealand/Te Whare
Wananga o te Upoko o te Ika a Maui.GETTY IMAGESOPINION