What’s wrong with my brain? The Neurobiology of Mental Illness.
Alex Dranovsky, Columbia University
Recent advances in the neurosciences have generated a sense of excitement, but also of frustration amongst the clinical psychiatric community. Why has it been so difficult to translate exciting groundbreaking research into advances in clinical care? Why have we been unable to move our pharmacological strategies beyond the mid 20th century discoveries of modulating dopamine, norepinephrine, and serotonin to treat our illnesses? Some have argued that our strictly phenomenological approach to diagnosis is interfering with attempts to link neurobiology to psychopathology. In attempts to better grasp the etiology of mental illness, the NIMH rolled out an initiative to develop Research Domain Criteria (RDoC), as an alternative approach, to diagnosis. RDoC challenges investigators to re-conceptualize psychopathology within the context of dimensions of normal mental functioning requiring its classifications to be validated by empiric neurobiology. In its most simplistic terms this re-classification suggests that if the biology doesn’t fit the disease then make the disease fit the biology.
In this session we will argue that psychiatry’s struggles with pathophysiology stem from the delayed maturation and development of the central nervous system. The brain has evolved to be remarkably immature at birth enabling only the most primitive of its many functions. The brain’s immaturity allows for customized development, accommodating a diverse and an ever-changing environment. Maturation of basic functional systems or circuits is greatly impacted by the developmental milieu, at times succumbing to adversity. Functional redundancy in the contribution of basic circuits to complex mental phenomena like thoughts and feelings offers protection from defects in any one circuit becoming catastrophic. Consequently, impairments in complex mental phenomena could be viewed as the result of any number of environmental insults affecting any number of constituent circuits all presenting as a similar disease: Many paths to arrive at one destination with each road contributing to multiple paths. We hypothesize that the secret to unraveling the neurobiology of mental illness lies in revealing how the tempest of environmental caprice shapes the development of basic functional circuits.
Background Review Article:
Caspi, Avshalom, and Terrie E. Moffitt. "Gene–environment interactions in psychiatry: joining forces with neuroscience." Nature Reviews Neuroscience 7.7 (2006): 583-590.