Banner by: Matt Stoss

Mind Within Matter

by Madeline Kehl

Defining the relationship between the mental and physical is one of the oldest philosophical problems in human history. Humans have believed in the intangibility of the mind for thousands of years. The most famous modern iteration of that philosophy is Rene Descartes’s Cartesian dualism, which, in essence, states that a person’s physical existence, manifested in the brain and body, is separable from mental existence, which lies in an intangible mind.

But for the last 200 years, scientific discoveries have challenged that belief. While there is no way to prove that there is not some metaphysical cloud storing all the iterations of who we were and could have been in some multiverse daydream of immortal stability, we now know that if we were to take out a person’s frontal lobe and change half their DNA, they would be a different person. For all practical purposes, our minds are physical.

People struggle with this. When people say “love is just a chemical reaction,” it is not romantic. Nor is “we’re bags of biochemistry” optimistic.  The comfort of the intangible soul-like vision of the mind entraps us. But when discussing psychiatric disorders, it betrays us. If the mind is ephemeral, and the brain is riddled with structural and chemical abnormalities, what can a person do except wait for external salvation?

Luckily, the mind is not just a ghost in a neuron cage. Its thoughts, intentional and automatic, are physically real. Even in adulthood, conscious brain training can lead to measurable brain change. This is not to say that you can think away psychiatric disorders, but that even with the handicap of a psychiatric disorder, a person’s thoughts and decisions are still critical.

And acknowledging a physical mind also acknowledges that “mental” illness is not “just thinking about things the wrong way” – it is physical, genes contribute to it, issues show physically. Four years ago my BMI was 16, a year ago it was 25, now it’s 22, my heartbeat wakes me up at night. I don’t have an average response to anything. Ambien makes me sleep-eat, alcohol has essentially no effect until I start hallucinating, I have scars from tearing through skin with fingernails – why? I don’t actually remember now.

These issues haven’t just put me in the mental hospital; they have put me in the “medical” hospital as well. And there’s no way I got here without my genome. My first life-threatening suicide attempt was when I was 14. Looking at my grandfather who slashed thousands of dollars of art in a depressive fit and listening to my grandmother hatch conspiracy theories on bribery and vocabulary quizzes in a community college French class – I think it might be a little genetic.

However, with a physical mind, life experience can and does interact with that. My current diagnosis is “developmental trauma plus what I was born with,” which is the equivalent of diagnosing a person with “rat-born illness,” but that’s a different issue. This takes it up to my genes plus my life. Then add how I decided to handle that combination and reinforce it a billion times. That takes it up to today. Yes, it is physical. But in a complex way, where I can self-evaluate and can have a say in where I’ll be tomorrow.

And it’s not just me. For simplicity’s sake let’s consider depression. Is it just a chemical imbalance from losing the genetic lottery?

Based on the evidence-- partially. For the last 15 years studies have pointed to gene-environment interaction. When compared to people with one version of a serotonin-related gene, people with a different version are more likely to develop depression when exposed to stressors, especially childhood maltreatment and medical conditions.

This is wildly different from the idea that genes dictate fate. Genetics are part of an equation. Dozens of studies also support distinct worldview differences on average in people with depression. People with depression are more likely to blame something within themselves, something that seems impossible to change, and generalize the belief across many aspects of life-- for example, upon snapping at a friend thinking “I’m evil, I was born this way, so no one will ever care about me.” Like other maladaptive ways of thinking, these patterns can be targeted with cognitive therapy, which can have positive outcomes applied to depression. I’m not saying to ditch your meds, but it’s a multifront war. Especially since, to a person who does make those attributions, the “it’s just my genes” explanation can cement the destructive thought process with “science”. It’s not science. There is a medium between “just will it away” and “you have no free will.” In the vast majority of cases, the predetermined is a factor, not a fate.

It matters because, there are many people that the current psychiatric system cannot save long-term. No two SSRIs or antipsychotics are guaranteed to work the same way across patients or within one patient; people get caught in revolving doors, are misdiagnosed, and can’t afford the treatment that matches their disorder because of bureaucratic nonsense. Medications stop working, there are comorbidities, there’s societal stigma. As a patient, choosing a passive stance can be a death sentence or a life sentence.

What makes the difference between me being six feet under and me being a full-time student with a job? Aside from a lot of therapy convincing me to operate on the assumption that this is reality, it’s learning how to actively recognize and work with my disorder. For most of my life I just hated it, ignored it, imploded, repeated, accepting the consequences by rejecting the problem. But if I’m drawn to the open window, I can leave the tenth floor. When I catch myself obsessing over how a turkey sandwich is a disgusting combination of letters and phonetics, as well as a diluted dinosaur carcass with wet leaves, creepy spongy pillows of sugar, fruit ovaries, and rotted solid milk which is all conspiring with saliva and bacteria to feed the parasite that is physical existence-- I can force myself to think about something else under the threat of sacrificing an hour to choking on my own blood over a trashcan full of vomit. If it’s too late, and the thoughts are already looping louder and louder, I know enough now to not torture myself, do something else, and just try later.

It’s not ideal. It’s not a permanent solution. But while solutions take their time, it lets me function. I can’t say it’s possible for everyone; I have no way of knowing. But I learned. Just because you have a diagnosis or ten doesn’t mean your thought processes are not valuable. The perception that the choice is between mind and agency and genes and predetermined fate is a false dichotomy.

We have to get comfortable with being tangible. And we have to get comfortable with being complex. And we have to remember we are still people.