We distinguish between mental and physical illness. Why? Many illnesses we consider physical have a mental component, including ulcers, asthma, hypertension, irritable bowel syndrome, heart disease, urticaria (hives), and sexual dysfunction. And the illnesses we consider mental all have a physical aspect to them, namely the brain. Yes, the brain is physical. It’s not just some nebulous collection of emotions, thoughts, and brain waves concentrated in a person’s head. In addition, some so-called mental illnesses – anorexia, for instance – have readily observable physical symptoms.

Whenever we use the phrase “mental illness,” regardless of whether we intend to do so, we reinforce the false dichotomy of mental vs. physical, mind vs. body. This leads many people to question whether brain dysfunctions such as depression and bipolar disorder are truly illnesses, even when they have no trouble recognizing that that certain so-called mental illnesses, such as autism, epilepsy, and Alzheimer’s are physical.

R. E. Kendell, FRCPsych published an interesting editorial addressing this topic in the British Journal of Psychiatry back in 2001. The editorial is entitled “The distinction between mental and physical illness.” In it, Kendell explains the history of when and how the distinction arose, argues effectively that the distinction has little evidence to support it, and explains the negative ramifications of drawing a linguistic distinction between mental and physical illnesses.

Unfortunately, the linguistic distinction between mental and physical illnesses, and the mind/body distinction from which this was originally derived, still encourages many lay people, and some doctors and other health professionals, to assume that the two are fundamentally different. Both are apt to assume that developing a ‘mental illness’ is evidence of a certain lack of moral fibre and that, if they really tried, people with illnesses of this kind ought to be able to control their anxieties, their despondency and their strange preoccupations and ‘snap out of it’.

R. E. Kendell

Of course, we need a term to collectively refer to these illnesses of the brain. Kendell recommends referring to them as psychiatric illnesses or disorders or, if we must “refer to ‘mental’ and ‘physical’ illnesses we should preface both with ‘so-called’, to remind ourselves and our audience that these are archaic and deeply misleading terms.”

I think “psychiatric illnesses” and “psychiatric disorders” fall short of the goal, because many people consider psychiatry to be the treatment of mental illness. I prefer the terms brain disorders or brain dysfunctions, just as we refer to a so-called physical ailment by the organ or system in which it’s rooted; for example, “heart condition,” “liver disease,” and “auto-immune disorders.”

Photo by Urban Data, available under a Creative Commons attribution license.

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