I don't think that's entirely fair. There does seem to be something distinct about mental disorders - namely, they are defined by the symptoms.
With physical ailments, symptoms are surface manifestations of an underlying physical cause. For example, fever and fatigue in flu are the result of the influenza virus. Crucially, you can have the physical cause without symptoms (such as in the presymptomatic period), so the two are dissociable. Even where the physical cause is unknown, there's still this symptom-cause distinction.
In the case of mental disorders, they're essentially defined by the symptoms. To have depression is to be depressed. To have anxiety is to be anxious. What would it even mean to have depression without being depressed?
While on some level these are physical in a sense (insofar as they result from brain activity), I don't necessarily think we should think about their cause in the same way as a physical ailment.
More to the point, there's a much more obvious sociocultral element to mental disorders. There's no 'objective' line between being sad and being depressed so while we clearly can and should treat depression, it seems to be very different from other diseases.
None of this is to take away from the real suffering people undergo with these disorders. I just don't think that treating them through a strict biological-pathological lens is as useful as people think it is.
This is what we see historically, in the 19th and early 20th centuries, in "body medicine". We're just at an earlier stage of understanding and treating psychiatric disorders. I assume in a couple hundred years we'll look back at the current state of the art as hopelessly outmoded.
> In the case of mental disorders, they're essentially defined by the symptoms. To have depression is to be depressed. To have anxiety is to be anxious. What would it even mean to have depression without being depressed?
What would it mean to have typhoid without an actual fever? The disease is something else, some causative factor that is not the actual symptom itself, but is no less real for that.
> I just don't think that treating them through a strict biological-pathological lens is as useful as people think it is.
Agreed, but that's with the current state of the art. I would be surprised indeed if by 2080 we didn't have a different lens to view these things through.
I think the mind and body are fundamentally different. Like with diabetes you might have a genetic deficiency that interferes with producing insulin so you have diabetes. You inject insulin and now you don't, more or less.
The mind is much more of a complex system than that.
Well, there are also slower/faster acting insulins so that system is also more complex than that, but yeah you are generally right.
I like to think of it with an analogy like you have a very intricate 3D maze and have to get a tiny ball into a hole, but you can only ever move the maze in one direction, and it resets between tries. Something like SSRI just pushes everything one way in a big swipe, and sure it might just solve a particular puzzle, but there are endless others where such low-precision method has no way of succeeding. Of course that’s why psychotherapy is a must have for any sort of medication.
> There does seem to be something distinct about mental disorders - namely, they are defined by the symptoms.
There a pretty long list of idiopathic physical ailments, and there are some mental disorders that have specific mechanisms. I get the generalization, but the reality is more jumbled.
With physical ailments, symptoms are surface manifestations of an underlying physical cause. For example, fever and fatigue in flu are the result of the influenza virus. Crucially, you can have the physical cause without symptoms (such as in the presymptomatic period), so the two are dissociable. Even where the physical cause is unknown, there's still this symptom-cause distinction.
In the case of mental disorders, they're essentially defined by the symptoms. To have depression is to be depressed. To have anxiety is to be anxious. What would it even mean to have depression without being depressed?
While on some level these are physical in a sense (insofar as they result from brain activity), I don't necessarily think we should think about their cause in the same way as a physical ailment.
More to the point, there's a much more obvious sociocultral element to mental disorders. There's no 'objective' line between being sad and being depressed so while we clearly can and should treat depression, it seems to be very different from other diseases.
None of this is to take away from the real suffering people undergo with these disorders. I just don't think that treating them through a strict biological-pathological lens is as useful as people think it is.