bioethicists:

transmutationisms:

1. the specific ‘chemical imbalance’ myth i was talking about in this post is the idea that depression is caused by low serotonin, and that therefore SSRIs—serotonin re-uptake inhibitors, ie drugs that cause a higher level of serotonin in the brain—ought to cure or at least ameliorate depression. this conjecture is belied by the fact that SSRIs don’t, at a population level, reliably perform better than placebo.
2. although a neurobiological cause of 'mental illness’ has long been the holy grail of psychiatry, the serotonin imbalance myth is far from the only hypothesis that psychiatrists and neuroscientists have proposed. so, a critique of the serotonin myth is not synonymous with, or generalisable to, a critique of every neurobiological mechanism purported to explain psychiatric diagnoses. you may be interested to know, though, that genomics and neuroscience have not identified a biological cause of any psychiatric diagnosis (p. 851).
3. all human experiences are biologically instantiated, including in the brain and wider nervous system. we are embodied beings. however, it is a leap to assume that such instantiation is automatically equivalent to a causal explanation or disease etiology. in other words, to deny that psychiatric diagnoses are known to be biologically caused does not mean we deny that thoughts and thought patterns express in the physical matter of neuroanatomy. this is a major philosophical sticking point to keep in mind whenever you’re looking at something like, eg, a study that purports to show 'brain differences’ in those assigned a certain psychiatric diagnosis. another thing to consider is whether these papers are plagued with methodological issues or financial conflicts of interest.
4. i can’t possibly tell you why you exhibit agoraphobia. however, when i talk about social, economic, and environmental factors that may contribute to the patterns of behaviour labelled as 'mental illness’, i’m talking about much more than the individual choice to leave your house. since phobias are 'anxiety disorders’, i might start by probing into questions like: is the world you live in safe? do you perceive it as safe? do you or your community face existential threats that may confront you more obviously when you go outside? are you nervous around other people, and if so, might that be connected to fears (well-founded or not) about interpersonal violence and harm? do you think any of these anxieties may be connected to the hostility and inaccessible design of the social environment and economic conditions?
5. human behaviour and thought varies. some of those variations may be totally benign; others may be helpful or harmful to the person living with them. it would be weird if every single of the 8 billion people on earth experienced precisely the same amount of anxiety about any situation, no? all of this is to say: yeah, it’s entirely possible you have been, for one reason or another (genetic, neuroanatomical, social, &c) predisposed to experience high, even debilitating levels of anxiety when leaving your home. most human characteristics develop from a tangle of social, environmental, material causes—ie, from a combination of 'nature’ and 'nurture’. what doesn’t follow, though, is the claim that there is therefore a discrete, 'diseased’ element of your brain or brain functioning that can simply be cured or eliminated through psychiatric intervention.
6. however, it is a critical point of anti-psychiatry to challenge psychiatric and neuroscientific claims to neurobiological determinism where psychiatric diagnoses are concerned. this is for many reasons, including: a) that these claims have not been demonstrated to actually be true [see above]; b) that they rob pathologised people of agency and self-determination [see: you’re too sick to know you’re sick, and the doctor will fix you now]; c) that they are often pushed by pharmaceutical companies with financial interests, or grant-funded researchers with… financial interests; d) that they are politically seductive in various eugenic, hereditarian discourses that seek to eliminate the biologically 'unfit’ element from society.

this is implied but i just wanted to add- absolutely none of this means that emotional suffering is the fault of the individual or something unimportant. many ppl chafe against the idea that “mental illness” is not biologically caused because they think that biological causation is the only thing that could validate or legitimize their suffering. part of psych abolition is abandoning the dichotomy of “biologically ingrained inevitability VS things that are stupid + your fault”. anatomical fault/genetics/hormones/biology are not the sole reasons why things happen + sometimes things do happen that are unexplainable!

it’s okay to not know why you are agoraphobic because u don’t need to know why in order to heal or be validated in yr suffering. further, even if they did identify a specific biological mechanism mediating your agoraphobia, addressing that mechanism could not possibly address the trauma it has likely caused, the social shifts it has likely caused, the cultural context in which it occurred, the economic/lifestyle impacts, the ways in which it has shaped your life history, etc. this idea that everything happens because of the body therefore shifting the body can change everything gives almost no thought to the millions of things outside the body which shape who we are + what we feel + why we do the things we do.