Riding the mental health pendulum: mixed messages in the era of neurobiology and self-help movements.

Abstract

Whereas professional disagreement about optimum mental health treatment is commonly understood, recognized, and discussed, the influence of opposing philosophies on patients is less often addressed. This article examines the long-term distress created for the author, battling severe, recurrent depression, as she received advice from practitioners who offered widely varying treatment theories as the basis for differing recommendations. Medical knowledge based on advancing research in neurobiology has led to greater understanding of brain chemistry, more reliance on the use of pharmaceuticals, and an emphasis on other "physical" approaches to mental illness. At the same time, growing "self-help" recovery initiatives, with underlying theories analogous to cognitive therapy, continue a focus on emotional and behavioral self-direction. These messages can appear dramatically opposed in terms of expectations on the patient, when presented from separate perspectives that are not described in a context of the whole. The resulting confusion is an unfair imposition of the personal differences of philosophy among practitioners on patients in crisis seeking help.