Will Power, Self Control and Self Discipline

An interesting study reported in Sunday’s New York Times disputes a widely-accepted belief: that will power depends largely on chemical events in the body, especially in connection with glucose, and that it’s more or less beyond our conscious control, a question of biology rather than self-discipline. This new study found that people who believe willpower actually is limited perform significantly worse on assigned tasks than people who believe it is not limited. In other words, will power and self-control are limited only if you believe they are. It’s an interesting piece, and not very long — you might want to read the whole thing.

As I was reading this article, it resonated with my familiar objections to the diagnostic labels contained in the DSM-IV, as well as to the theory holding that mental illness is the result of a chemical imbalance in the brain. The use and abuse of psychological diagnosis, to begin with, makes people believe they have a recognizable disorder, akin to a medical syndrome, and that it’s beyond their control to do anything about it. If you are told and believe you suffer from borderline personality disorder, that it’s a lifelong malady you can do little to modify, then you have no reason to struggle with it and try to gain insight. If you are told and believe you suffer from Asperger’s Syndrome, you won’t try to understand the particular nature of your defense mechanisms and to confront what lies beyond them. In my experience, providing a psychological diagnosis to people essentially deprives their suffering of its meaning, discourages them from self-exploration and encourages a sort of passivity. “I have Asperger’s Syndrome — what can I do?” I don’t mean this as a criticism. When the medical establishment, the media and just about everything in our culture supports this view, why should anyone believe otherwise?

The chemical imbalance theory is even worse. Because people are told and believe that their symptoms of depression, their panic attacks or their bipolar disorder symptoms all result from chemical irregularities in their brain chemistry, they have no reason to dig in and do the hard work of self-exploration. It’s a chemical imbalance; I was born that way and I need to take a pill to rectify it, like my doctor said. One of the beneficial side-effects of the medicalization of mental health is removing much of the stigma from mental illness, especially as celebrities such as Catherine Zeta-Jones have publicly acknowledged their struggles with bipolar disorder and other issues. But in the face of the relentless public relations push for psychiatric medication as the answer to all forms of mental illness, few people have the will power and self-control to struggle with their inner conflicts. They have been told that will power and self-control are irrelevant — it’s all about your biology — and so they believe they can do nothing to help themselves get better.

There are some bright spots in the mental health profession. Cognitive Behavioral Therapy provides depressed clients with some useful techniques for coping with their negative self-talk and self-defeating behaviors — in other words, it assumes that you can make a difference in your state of mind by exerting effort. Will power and self discipline are necessary parts of the work. Dialectical Behavioral Therapy appears to be effective in reducing suicidality, substance abuse and hospitalizations with borderline personality disorder, using a highly structured program to help clients develop a degree of self-control where impulsive behavior is concerned. Neither treatment modality explores the meaning of the client’s symptoms, however, or helps them access their unconscious dynamics. Both reduce people to a recognizable syndrome that can be treated with a uniform approach, in the process accepting severe limitations on what is possible to achieve through psychotherapy.

Assumptions by the therapist as to what is possible for any given client will naturally have a profound impact on the treatment. If therapists believe they can do little to help a borderline client, they will communicate such a conviction to that client, who will then come to believe it as well. If a therapist believes that his or her client’s depression is the result of a chemical imbalance, both therapist and client will come to share limited expectations for what their work together can accomplish. Everywhere I look within my profession, I see evidence of this acceptance of limitations, a kind of widespread learned helplessness in the face of mental illness, a rejection of the long hard work involved in psychodynamic psychotherapy. I’m not advocating a return to the era when we blamed people for their difficulties, when our culture viewed mental illness as a weakness, a lack of will power, the failure of self-discipline; but the pendulum has swung too far in the opposite direction, so that we no longer expect anyone to take responsibility for their struggles.

It’s a medically-recognized syndrome, a chemical imbalance — you can’t help it. When you accept such a belief, you’re like the subject in that study from the NYT article, who did significantly worse on assigned tasks when they believed their own will power and self control were limited.

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

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42 comments

    I do agree with you that it is sometimes long hard work and dedication for a person to reach healing and wellness, but I wanted to add that this doesn’t always explain how sometimes women have depression after giving birth. Maybe acknowledging that hormones do play a part can give a more valid and realistic picture of what it takes for someone to get better.

    If one ignores the health and hormonal aspects but only works on the mental and thoughts that possibly they are selling themselves short and not giving themselves everything that they need to fully recover. :-)

    I’m ok with the long hard work concept, but when someone is hurting or suffering the first thing you want to do for someone is relieve the pain. You don’t want to keep them in their pain because you believe they haven’t worked or suffered hard enough for it.

    The only reason I comment on this is that I have seen people who may judge a person in their suffering and assume that they haven’t worked hard enough for it and I think that’s a bit cruel and judgmental on the part of the therapist.

    Relieve the pain… Then help them to be better individuals. Kindness with discipline.

    Also when a person is depressed they can’t properly see their way out of it, all they know is that they are stuck and not sure of how to get out. The only way we can do our best work is to be in a state of balance health and wellness.

    Of course you’re right. In my anti-medical establishment zeal, I sometimes overlook things like post-partum depression, where surely hormones play a major role. I would add, though, that in the cases I’ve seen, those depressions still had psychological meaning that could be understood. They weren’t ONLY hormonal.

    Also things such as hypothyroidism or adrenal fatigue.

    I’ve also spoken to people that say once they changed their diet over to a organic health oriented diet that their symptoms of depression were completely reversed.

    I even spoke with a guy that said once his naturopath got his spleen working right the depression symptoms feel away.

    Here is a link on Hypothyroidism and Depression:

    http://www.m.webmd.com/depression/hypothyroidism-and-depression

    You are right in that not everyone’s case is the same and for a lot of people it is a combo of things. 😉

    Gotta hit it at all angles till you find the right solution… Which reminds me that I wanna change my diet back and focus on all aspects of health and wellness… Including my physical health along with mental and emotional.

    Thank you! 😉

    I would agree with your comment here Joseph. Post partum depression is a terrible thing to live through, you lose all your energy and can’t function, but you do for your child, and if you have older children, then God helps you.

    As for hormones, that is an excuse. Nobody has ever given me a hormone test. Just let them try!!

    Anne Brocklesby (Mrs)

    I think your arguments around Aspergers are a little weak. Those with a DX of aspergers who are at the excessively-logical end are well set up to explore possibilities while accepting some constraints from a very rational, experimental standpoint.

    Neuro-typical folk, on the other hand, are a veritable sponge for illogical cultural beliefs, and frequently engage in magical thinking and attachment of meaning to coincidences.

    On the whole, people who accept a diagnosis of autism are at least willing to recognise that they are in some areas experiencing difficulties, where the collective-insanity that the rest of the population exhibit (nail polish, really, what on earth is that about?) is comfortably ‘normal’ and ‘healthy’.

    My brain is demonstrably different – little tricks like being able to read and write in mirror and / or upside down make that pretty clear. I don’t expect the rest of you to work daily on acquiring these skills, and I don’t want you to hate yourself for not having them.

    I’m an advocate of therapy (our brain is a product of our experiences as well as our biological seeding), and I’m definitely against the prescription of meds for cognitive and perception differences, but in stating that CBT is useful for people with depression you ignore the experiences of the many for whom it was simply another stick to beat themselves with. Like us Aspies, presumably it’s *their* fault for having the wrong kind of depression, or simply lacking the magical self-motivation? Maybe they didn’t ‘believe’ enough in the treatment?

    I’m a recovered/ing alcoholic, and there can be no self-control or motivation until there is self-worth. Real self-worth. Which comes from people around you valuing you, and having a space to explore the things that led to you becoming an addict. But it’s also absolutely crucial to accept that on a chemical level, your reaction to alcohol is different to a non-addict. Until you also accept the brain chemistry part, you’re doomed to repeat the attempt-control/fail cycle that Bateson wrote so brilliantly about.

    You also ignore the role of hormones – we know that middle aged women begin to produce adrenaline as their female hormone levels drop off. Long before the hot flushes, many women experience frequent feelings of anxiety, or even panic. Underneath our nail polish we are animals after all.

    So… don’t throw the baby out with the bath water here. Where there is a chemical or neurological difference then it’s important to accept that as well as working with what might be possible. Otherwise you inevitably invite the client to attempt the impossible, so attachment to the idea that there are more possibilities than are actually viable is just as likely to be damaging to your client – doing actual harm as opposed to simply failing to do good.

    As a parting thought – I have amazing will power in most folk’s eyes. I have inherited early-onset heart disease and since diagnosis I have completely cut out all ‘bad’ foods for that condition. I haven’t found it particularly difficult to be honest – compared to dealing with aspergers and some severe mental health problems I had in my 20s, never eating cheese or ice cream again is a breeze. I think your link between the NYT article and mental health / neurological difference doesn’t really hold up, and belittles the experience of living with those conditions. The article is solid, but your extrapolations overshoot the point at which their cantilever collapses.

    Very interesting topic! I had severe post natal depression/anxiety/ocd after the birth of our first child and have been in therapy since then…I attributed, for a long time, a lot of my symptoms with biochemistry, family history, hormonal shifts, sleep deprivation, lack of support etc etc
    Fast forward 7 years, another child later, trial and error with medication, better support etc and finally, a lightbulb moment in therapy where I finally confronted an extremely dysfunctional relationship with my own mother (who has narcissistic personality disorder), the processing of a lot of trauma that I had intellectualized but not felt emotionally (my doctor agrees that a large component of what I’ve experienced is in fact post traumatic stress and in some ways I think it was a normal human reaction to extremely abnormal and prolonged abuse and it all came to the fore after I had my own child and re-visited my own childhood and family of origin issues) and I feel much closer to the core of my depression and what I need to do to work towards healing rather than just accepting that I needed a pill for the rest of my life (I am still on medication though – as I need to function for our 2 young children)…but it has all been a process influenced by many factors…

    Your experience fits very much with mine: I’ve found that for many women, giving birth revives a lot of family-of-origin issues and can be highly traumatic. Thanks for adding to the conversation.

    Good on you. Much the same for me, except it was not my mother. Went to CBT and then psychotherapy, and confronted the situation, adequately.

    Moving on, Have a lovely life. And enjoy family life and the support of your husband. Mine is superb.

    Anne Brocklesby (Mrs)

    Hi Joseph,

    First off, thanks for a generally very interesting blog, keep up the good work! I agree with you to an extent with regards to the importance of subconscious defense mechanisms and underlying trauma in mental health. But I also know, both from my own experience and from numerous studies, that the physiological aspect is at least equally important. Omega-3 to -6 balance, vitamin D deficiency, hyper/hypo-glycemia, food intolerance (additives, coloring agents, gluten etc.) and many more aspects depending on nutrition, (with individual genetic differences rendering some more sensitive to nutritional imbalances than others) as well as exercise have all been shown to have a great effect on mental well being and functioning. The way I see it, these are things that should be looked into before therapy or drugs (which should be the last resort) enter the picture.

    If a person feels depressed, unfocused and anxious because they are deficient in Vitamin D and Omega-3 and eat snacks and drink soft drinks every day causing their blood sugar to fluctuate with resulting mood and energy swings, attributing these problems to some unresolved childhood trauma, without first correcting the nutritional deficiencies, is at least as irresponsible as blaming it all on genetics and prescribing drugs. It is likely that a person who feels depressed, due to chemical imbalances brought on by an unhealthy diet/lifestyle, will try to find things – be it memories from childhood, perceived relationship issues or anything in between – that can explain (because they relate to) the mood he or she is in. It is natural for one in a low mood to have thoughts or relate to memories that are connected to that particular emotion. That does not necessarily mean that these previous experiences, or these negative thought patterns, are the CAUSE of the mood. It may in fact be the other way round.

    My point is that the most responsible approach to therapy must be a holistic one. (without all the new agey connotations). When you know that your client/patient is not suffering from any nutrient deficiency-related chemical imbalances, you are much more likely to be able to address and successfully deal with the psychological issues that remain.

    Just my five cents :-)
    If you’re interested in the connection between nutrition and mental well-being I recommend this blog: http://evolutionarypsychiatry.blogspot.com

    All the best
    Henrik

    Holistic therapy is great. And look after yourself Henrik and thanks so much for your contribution. Keep getting better.

    Anne C Brocklesby (Mrs)

    Having seen this “learned helplessness” regarding the patient’s role in recovery, and having worked extensively w/clients using Cognitive Behavioral Therapy, I totally agree that outcomes are highly reflective of the therapist’s skills and belief in patient empowerment. Additionally, the more a clinician gives empowerment and responsibility for improvement to the client, the outcomes will reflect both patient improvement and clinician alliance in working together to find treatment solutions that transfer the “work” to the client. I always knew when I was was working harder than the client, an imbalance in the relationship indicated lack of treatment perspective.

    However, despite advances in treatment that allow for transferring much of the “work” of healing to the patient, there are many clinicians and psychiatrists that maintain the belief that a “medicinal cure” is the primary treatment foundation. The patient accepts that psychotherapy is only an “adjunct” treatment, thus presenting difficulties when therapists address treatment alternatives by joining with patients as “co-healers’….the end result frequently being clients with elevated levels of hope and self insight will work harder towards building skills that will ultimately help them feel better.

    The latter group, those that feel “chemically or situationally predisposed” to be suffering, have little motivation for looking inward for solutions. It is very difficult to engage this type of client, used to externalizing their condition to “factors out of the control.” These clients will often never try to use the tools presented or respond minimally to self-directed treatment modalities.

    Ultimately, I do agree that the therapist plays a very important role in setting the stage for client success by establishing a foundation of joint “responsibility” for favorable outcomes. When the client understands that they have the tools to build a healthier and happier future, they are more likely to develop and use them to gain insight into their underlying issues.

    Thanks so much for contributing your informed perspective. You said it so well, and I think that others will appreciate what you have to say.

    Hi Serenity, you may feel you are giving more than the client at that stage, and so that is fantastic, because you can, and the client cannot. So all thanks to you Serenity.

    Serenity, sometimes when one looks inward, as you put it, there are no solutions, as we are not members of the professions and the therapists, we are often individuals struggling alone, sometimes in relationships, and sometimes with children, and some of us are even professionals too, but the profession does not reach out to us.

    Anne C Brocklesby (Mrs)

    Joseph,
    As M. shared, I do believe there can be underlying physical reasons that need to be attended to.
    At the same time, I value your insight and agree that the two can be mixed with each other –
    after all we are “whole system”.

    The challenge your zeal faces, I think, is that unless one has already done his/her own deep and rigorous internal psychological work your point of view actually cannot be understood. It seems to me that what you propose (and I agree with) cannot be grasped intellectually but only through the actual living experience of it.

    Yes, it’s true. At the same time, I find that even most inexperienced clients feel an immediate sense of relief when I start to talk about the meaning of their depression/anxiety, etc. On some level, my approach makes intuitive sense to them.

    Do you think this sense of relief is based on your words to them or based on an new experience of intimacy with another? In other words, maybe it is a combination of your words providing hope and the experience of intimate caring from another more than an intuitive sense of their understanding. Possibly different ways for different people.

    I think Serenity has put it so well.
    I feel that I have done a lot of the hard work myself in therapy – in fact my husband asked me recently “why are you paying a therapist money to work this all out yourself? Why didn’t she just tell you your mum was abusive and narcissistic in the first place?” but I think that is probably the outcome of a good therapeutic relationship – she has helped me be empowered to work things out in a time frame that was right for me, bearing in mind the severity of the depression and the need to function for the rest of my family.
    I also think that it was only once I had reached a certain point in my life that I was able to confront the issues at the core of the depression. Prior to this, I knew that I had difficulties in my family of origin but I preferred, for a variety of reasons, to not really “go there” and focus more on symptoms and other factors.
    I should note that I also take vitamin D, omega fish oils, magnesium and other supplements under the advice of a naturopath and try to exercise regularly and maintain good eating and sleep habits. In other words I have taken a holistic approach to treatment however ultimately I now believe that it is was the underlying issues that made me physically and mentally more vulnerable to stress (including the stress of having a newborn) and that these issues needed to be addressed in order to move towards true healing.

    Thanks, Marianne. I’m all in favor of vitamins and fish oil (take them both) but they’re no substitute for doing the inner work.

    It’s difficult being diagnosed with bipolar, or manic depression. I experience two severe manic breaks in my early 20’s. The second break I attribute to not taking the prescribed lithium. Now the theory that it may not all be chemical imbalance, which I can understand to some extent, does it make more complicated for the diagnosed bipolar. People will always be researching causes for this disease, but regardless of the cause, the condition is no less valid or disabling.

    Gary, it’s true — regardless of the cause, it’s painful and disabling. But wouldn’t you rather know that you might be able to effect change yourself, instead of taking a pill that doesn’t live up to its reputation and has some very severe side effects? Besides, bipolar is a label applied to many many people, all of whom are unique and express their “bipolar-ness” in different ways. The label erases all that and groups you together with a bunch of people who theoretically have the same “syndrome” as you, just as if it were diabetes.

    I have been able to see and appreciate your videos. I think they are great and you do a wonderful job. Part of the problem I see is that bipolar has been overdiagnosed. Seems anyone with a “mood” can get the diagnosis. I feel unless someone has had an actual psychotic break, they are not “manic-depressive’ – more appropriate name for the condition. All my lithium blood checks have been fine since 1977. Why fight this pill that works without debilitating side effects. I’m certainly not proud of my condition, but I feel it is different, due to the severity of my breaks. I lived that and never forget it. It went beyond syndrome.

    I’m not trying to talk you out of taking your meds. There are certainly cases where they’re very useful, and yours may be one of them. I’d be concerned about the long-term side effects, though. You may not see debilitating side effects now, but many of these drugs do lasting damage that isn’t visible until much later.

    On the other hand, I have a good friend who suffers from OCD that has been crippling during her life; psychiatric meds have been enormously useful to her and she told me that, even if she knew they were doing lasting damage, they’ve given her the last 10 years of life free from the grip of her OCD. Having those years was worth any price she might have to pay.

    Medicines are prescribed. Years later we are told that they may have bad or unknown side effects.So we might consider self discipline and willpower and self control to get off of these drugs. Major University Hospital, 3rd best in US. When I see doctors it’s all about pills. I am given information about where to get therapy. Medical theories change with the decade it seems. The latest wind seems to be blowing.

    Thank you, thank you, thank you for writing about this. Finally someone dares to speak about such a hot subject within the medical and psychiatric profession.
    I couldn’t disagree more with M.
    Especially post-partum depression, i do not believe that it has something to do with hormones. Which hormones and why?. as you say, if we say that is all down to hormones then there is nothing to find out or do. It makes much more sense to me the confrontation with the fear, anxiety of separation from whom we were, to become a parent. Not an easy transition. Becoming a parent means from now on, I am responsible for everything that happens in my family. Before that we could always blame somebody else, namely our parents.
    Of course that if someone can’t even sit down to talk, a medicine will help, for a while, but i can’t stand the abuse and the disempowerment that comes with the idea of just biological illnesses. The idea that there is nothing one can do about it is what gets us even more sick.
    Thank you Joseph. Love your blog!

    I agree it’s hard work with lots of tumbling of the beam. But one just has to keep at it and steer the middle way between “it’s not my fault” and “all of it’s’s my fault”

    I think a diagnosis can be useful to people – “I’m not alone, it’s not just me”. It depends on how it is presented I guess.

    I think most of the time our experience is a mix of the chemical, personal, perceptual and so on.

    One other comment. If it is fun we don’t need to be disciplined. I’d like to see much more concern with how to make therapy enjoyable. So much of it comes across as ‘thou shalt be healthy’.

    I don’t know about “enjoyable”, Evan. How about “deeply meaningful” or “personally satisfying”? I don’t think my clients “enjoy” their sessions but they sure value them.

    This article explains well how the medical model as related to mental illness is incorrect. By assigning labels to individuals you inherently prevent them for seeing the potential of a positive future. New research shows that it is not genetics necessarily that creates situations of disease, but rather the environment that activates potential gene types. Like nature, when we alter the environment positively we manifest growth. This concept is akin to that of self-actualization which seems to be missing from the current mental health model.

    Whilst labeling may be useful for insurance and other professional reasons, it ultimately does not serve the individual. Give them hope that their current circumstance does not condemn them to a life of stagnation and the results will be revolutionary.

    Carl Rogers was a great example of someone who understood this. Through attentive nonjudgmental listening he provided a platform for clients to navigate their inner-world, allowing them to gain insight, and thus find their Way as the Taoist would say.

    I am glad to see many people viewing the profession this way now. In the end, it is from small discussions like these that we can collectively change the system for the better.

    As always, here was food for thought.
    Willpower, one can`t do much without it.
    After reading the article in New York Times which Burgo mentioned, I came to think of Arthur Schopenhaur who stated that “Man can do what he wills, but he cannot will what he wills.” (“Der Mensch kann tun was er will; er kann aber nicht wollen was er will”). And that remains a fact even for the well nourished .

    Interesting quote from Schopenhaur. Is that like Woody Allen saying, “The heart wants what it wants”? I’m not sure I entirely agree. Sometimes change means behaving “as if” you willed something, because you know it will help, until such time as you really do want it.

    JB, it appears to me that Woody Allen is more akin to Blaise Pascal`s “The heart has its reasons which reason knows nothing of.” And I have a notion that Schopenhaur is somewhat lost in translation. (Anyone interested may find an elaboration in The Philosophy of Freeom by Rudolf Steiner.)However, neither I nor Schopenhaur`s statement disagree with what you say about change and “as if”-behaving. By no means.

    great article and comments,

    fake it till you make it! isnt that what they say? convince your brain cos it can be fooled thats how it works.

    and i do believe that its so healthy for me to “take responsibility for how i am” i dont mean blame , but if i take responsibility then it gives me the power just like you say,

    i struggle daily with mental ill health and i have had it in me to blame others etc etc, but im working on taking responsibility and it is GIVING me something, its giving me hope,

    to just believe its genetic, or biological takes that away from me , so i choose to believe i have some say and effect in this,

    its still really hard, like moving through a field filled with barbed wire, but id rather look at it the way of me having a responsibility and a say.

    i really belive that things even like post partum are events that crack open deeply held inner pain that was already there, unresolved trauma that has been locked away, if the core had been stable than the massive event of having a child would have nothing to expose, or less anyway,

    i had an opening up into an illness after several close horrific bereavements in quick succession – traumatic events opened up the locked away pain?

    could it be that with some other “escaping into your head” type conditions like asperges and autism that there has been a fleeing from emotional pain and shutting down on emotions completely into the brain?

    i use medicine too, but as a support to healing, not as the main thing that takes charge of it,

    In a post about autism symptoms in other psychological disorders, I take up the issue of early traumatic awareness of separateness. I think that people who suffer from the autistic spectrum disorders have their own characteristic defense mechanisms but struggle with the same issues as the rest of us. Thanks for contributing to the discussion.

    Hello there. I am new to this site. I’ve read your blog and all I have to say is WOW. I NEVER thought I’d see the day when someone told me I didn’t have to take pills. I was on medications since I was 11. Very dangerous ones, I might add. I have had 3 allergic reactions to medications, two resulting in tardive dyskinesia (thank goodness not permanent), and one was a really freakish reaction that was apparently “rare”. Each time, the said psychiatrist at the time thought I was somehow making up the symptoms. I probably saved my life by stopping them myself. So, for about 2 years now I have been medicine free. I have BPD, Bipolar, OCD, and an anxiety disorder. While I do agree that to an extent for some will power may help most if not all of their issues, I don’t think that is for every single person. Now, it’s not to say that people cannot help themselves. It’s just that…I have been in therapy for a long time. I have found that by self acceptance, rather than changing everything (for depression, anxiety, so on) actually allows me to get through my current emotions easier. I once heard a great analogy. If someone is on a diet, and they think of not eating ice cream all of the time, they will want to eat ice cream even more. For a long time, I was told to “think positive” or “use will power”. As a result, I became suicidal. Why? Because it lead to I am thinking positive=not working=I must not be trying hard enough=I am the cause of my own problems=It is my fault I am the way I am, and I just have to try harder. You can see how that leads to a downward spiral. I’ve also had this stuff shoved in my face about there is always someone worse off than you, and there is always a positive trait in a negative situation. That kind of stuff would be said in groups I went to whenever we talked about a bad part of our lives, and how it was just a pity party and to feel positive. And lastly, the biggie, happiness is a choice. And it takes a long time, and work. But if you aren’t happy, you aren’t trying hard enough. It was extremely invalidating. There was no acceptance of depression or anxiety. It was all about being normal. (Not joking. The word normal was used, and one therapist even said we had to pretend to be normal to gain friends. Because no one wants a depressed friend or negative nancy.) I’ve seen people who believed in this stuff our group leader was saying, but they have been there for years with NO improvement except for their relief in some depression from the support they got. Of course, in those groups, there were no “alternative” views. It’s not that I think willpower can’t work for some people (and I don’t mean willpower without insight and hard work), but for some, I think they can improve in some areas and have self acceptance in other non destructive areas of their life. Then again, the people in my group all believed it was a chemical imbalance, never focused on past issues that have caused current ones, invalided feelings with a “but…that’s not what you SHOULD feel like”, and urged to take your meds. I was the only one not on meds. Actually, now that I write it all out, that group was probably the crappiest, most invalidating group ever. I have tried willpower on my own in combination with personal responsibility and other things. It has helped, but I guess I am saying I just accepted I may, to some degree, have depression, anxiety, and emptiness. And that is OK with me because I am trying my hardest and some things are beyond my control. I’m kind of on the line of the chemical issue. I don’t believe it’s an imbalance, but before I even KNEW what a mental disorder was, I can feel my emotions change. Like…I can physically feel myself get manic and then depressive from my Bipolar. Setting in habits does help, but only 50%. I would argue that even though some disorders are over diagnosed, there is some merit to chemicals at play, just not the supposed balance and easy fix that is currently presented. I don’t understand why such complex issues are often muddled down to…it’s always this, so take this pill. In those commercials for meds, they even say things like “Depression is THOUGHT to be caused by” or “It is now believed that bipolar is a an imbalance between this and this, so take this.” My, how clever wording leads on a lot of individuals. But, I guess I just wanted to end things with I really, really love your blogs. I hope I can find a therapist who understands me someday so I can go back. By the way, I am very sorry if this is a bit all over the place. I am experiencing some mania right now.

    CeeCee

    Not to worry — everything you say is very interesting and apt. The invalidating group sounds pretty awful, but unfortunately not so uncommon. I especially like what you have to say about accepting that you’ll always struggle with certain issues. That’s not a recipe for discouragement; it’s facing the truth and doing the best you can with what’s possible.

    There’s a flipside to this argument as well. If someone is suffering from depression, and they are led to believe that hard work can get them out of it, it may increase their hopelessness if their hard work doesn’t pay off. “If only I was better at this, if only I could try harder… if only I wasn’t so lazy I could feel better and live my life… I am such a failure”. etc. I think the “hard work” route assumes that you have a competent guide… and from my personal experience, there aren’t a lot of them out there – and boy are they expensive. I think this is why pills are so popular. A pill can give you a leg up to a place where you can start to do the hard work with help from the people you have available to you, and you can get it done without necessarily having to pay the world’s expert in behavioral therapy. I’ve dealt with this most of my life, I took medication for 13 years. I’m not on it anymore, and I’m starting to figure a lot of this out on my own – but the medication gave me a critical leg up. I’m not saying it couldn’t have been done without the pills, but I didn’t have access to that level of expertise, and I think most people don’t.

    I felt compelled to write a post in agreement with your blog article despite the fact that it’s not current.
    My thinking concurs with your reasoning, particularly with some of the treatments used to manage some psychiatric conditions. In fact, I am equally bothered by the facile with which diagnoses are dispensed, particularly “bipolar disorder.” I think the diagnosis should be recognized and treated accordingly when the symptoms and etiology correspond with the classic diagnostic criteria. To that end, it is undeniable that some people do suffer from bipolar disorder in the traditional sense, so to speak, and in some of them the illness may have a genetic origin. However, I suspect at one time or another many, if not most, people suffer from “bipolar symptoms,” the key word being symptoms.
    As you point out in your article, the possible root causes behind such symptoms of “bipolar disorder” are myriad. You’ve mentioned several triggers and I’ve thought of some myself. Here’s a partial list: Excessive sugar, drug use or drug withdrawal, sleep deprivation, allergies, chemical exposure/ingestion, learned behaviors leaving a person stress intolerant, prone to outbursts, etc., personality disorders, and poor self discipline (also often resulting from flawed “nurturing” rather than from nature) which frequently engenders a less-than-healthy lifestyle.
    Because a patient exhibits symptoms of bipolar disorder does not necessarily call for the classic medical definition of “bipolar disorder” (prev. manic depressive illness).

    Even though the post is old, I’m glad you commented. I couldn’t agree with you more. The whole problem is the “disease model” of mental illness. I hope we’ll get beyond this perspective some day.

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