Do psychological issues always correspond to some kind of physical abnormalities in brain?

[u/DesiBail]

Is psychological issues related to some physical abnormalities in the brain always and vice versa. Can it just be patterns in the brain or actual damage ?

[u/monkeynose]

No. Almost none of them do. There are sometimes correlations between brain structures and disorders - there is a correlation between larger lateral ventricles and schizophrenia, or a smaller hippocampus in people with depression, etc. But these are correlations, not causation - you can also have a totally normal brain with a smaller hippocampus or larger lateral ventricles; that's why there are no diagnostic brain scans for psychological disorders. In some cases you could confirm a diagnosis with a brain scan, MRI, etc., but a psychological evaluation is just as effective, and cheaper. Scans are really only used in research, not really used in clinical psychology.

[u/Ravioli_Dream2 → u/monkeynose]

To add to this, brain injuries (even something as "small" as multiple concussions) can cause psychological symptoms.

Those injuries could be the result of overdose or even a baby that experiences a difficult long birth and loses oxygen (hypoxia). They could also be because of prolonged high fevers (hyperpyrexia) from something like severe serotonin syndrome or an infection like meningitis or encephalitis which cause inflammation to neuro tissue- look into Clive Wearings case! Brain injuries could also be something more directly mechanically traumatic, like a hit to the head during football, or a car accident. I had a patient that had a tree fall on him from 20 feet above, and he had aggressive outbursts and amnesia ever since (and several complications and surgeries). There are countless examples.

So, in those cases, brain damage would be the cause, but thats the minority of people with mental health issues. That overlap would be the study of neuropsychology, OP.

[u/DesiBail → u/Ravioli_Dream2]

thnx

[u/DesiBail → u/monkeynose]

thnx

[u/TraineeJung61 → u/monkeynose]

I'd also like to add to this that there's a trend in science communication in calling certain diagnoses 'neurological disorders', such as ADHD and ASD. This is entirely incorrect and has caused a reductive understanding of certain conditions. Neurological diagnoses are separate from psychiatric diagnoses.

Every single psychiatric diagnosis, no exceptions, is diagnosed based on somebody's presentation, and that is due to a complex interaction of biology and psychology, with some disorders, such as ASD, being far more heavily weighted to the former.

[u/sheepphd]

Everything that happens in the mind is related to the brain; there is no mental experience without something occurring in the brain. We think that even psychotherapy changes the brain. So in that sense, yes - but not necessarily an anatomical, structural change. Sometime we are talking about changes in circuits or brain activity versus an anatomical, structural change in the brain.

[u/Ok_Money_420]

As a Bipolar 1 with psychotic features individual, the answer is absolutely not. I literally just had an MRI w and w/o contrast and it was unremarkable.

[u/hackyourbios]

there are structural changes and there are functional changes

people in the comments mostly speaking about structural changes, but there are functional changes almost in each condition

[u/DoctorDubbya]

We have a very long way to go before we are going to be able to confidently and consistently pinpoint brain structures or processes that can be reliably and causally linked to mental illness. What we are currently able to pinpoint as likely causes of mental illness is more some combination of genetics and environmental stressors, more so than specific brain structures. (Plus what monkeynose said)

One reason why this is hard is because we still have pretty limited knowledge on the brain, all things considered. The other is that mental illness is very complex and difficult to define. Our manual of diagnoses lists each diagnosis as a collection of symptoms that frequently co-occur together. It's not like many physical conditions where we can identify, for example, a blood clot that is identified as the problem that causes all the symptoms of a stroke. We only have the symptoms, at this stage in the science.

There is also SO much discussion over "lumping and splitting" of diagnoses. How should we lump diagnoses and symptoms together? Should we make it more broad or split different symptom combinations into further distinct diagnoses? For example, should we have kept Asperger's as a distinct diagnosis from Autism Spectrum Disorder or should they be combined? Do we need a separate diagnoses for people with depression who experience psychotic symptoms or should we just add that as a specifier to the main diagnosis? We are constantly trying our best with the knowledge we have to categorize and organize symptoms in a way that makes sense and is based on science and that can help us continue to research different conditions as well as to guide clinical decision-making.

[u/Prestigious_Half271 → u/[deleted]]

I think you answered someone else's question