Brian chemistry

Brian Lynch

It is certainly not uncommon for me to run across people who will express a desire to understand the “chemical” nature of their mental problems or likewise see the problem as being fixable purely or solely based on mediation.

This is a tragic situation.

Even as a doctor knowing what goes on inside the brain in terms of the chemical workings rarely helps me help you. We have to understand that we are nowhere near the sophistication in brain science that we are in other areas of medicine. We can, for example, test for a specific infection and give a specific drug for that infection. We are not so lucky to do much of any kind of tests on our brains.

For sure we know when someone has a seizure to give anti-seizure medication. But that is a “physical problem” that has to do with the physical brain. That has to do with the “physical” electrical network of the brain. And we have learned that anti-seizure medication often helps with more “mental” problems to calm people down yet exactly how and when to give them is not exact and certainly it is very individual how they affect an individual life.

My point is more with many a patient and doctor’s fascination with the thinking that knowing about serotonin, dopamine, and norepinephrine will somehow help them feel much better. I ask you, do you experience these chemicals directly? No, you don’t. Can you have any idea that you are affecting the levels of these chemicals? I say not by much. And I as a doctor cannot measure them. Again, I can give you medication that we believe alters these chemical levels and that we believe logically end in affecting certain pathways that end in making you feel different. There is an important point. You feel differently. 

If both doctor and patient would focus more on specific feelings I think we would make much more progress. And note I say feelings and not acting or behavior. Specific feelings like anger, fear, shame, disgust, interest, and joy and forgo the more diffuse and imprecise words such as “depression” and “anxiety” or “panic.” These are being called into question by more and more professionals. Just tell yourself how you are feeling today. Then, if you are taking a medication which of these specific bottoms did it push? Is the medication, making you less angry? Less afraid or is it making things worse?

We live in a world of “feeling”, we do not live inside our brain. We will never be able to experience our brains. We experience what those chemicals in our brains produce. They produce in some miraculous way our feelings. If we want to affect those chemicals the road is a direct one, but one that shifts focus to something right under our noses, something palpable and real, our feelings. Work on our feelings and there will be feedback to our chemicals that will then, in turn, feedback to our feelings and help us out.

Now a final thought. Focusing on the “chimerical” seems to presume, most of the time, that the reason we feel bad is due to an ad hoc imbalance in the chemicals. Something is wrong in my head. Fix it doc! Give me some medicine. I have a cold in my head. Well, we believe that the chemicals are being stimulated by something, by what? By the world. Anger, fear, distress, disgust, and shame have their chemical equivalents in the brain. We “get our buttons pushed!” We live in a world that can push our buttons. We need to work. We need to work with the environment and do also what we can to remove the button pushers and thus the stimulus that is causing the pain and causing, yes, that neuro-electrochemical imbalance. Not easy I know.