Mental illness and brain deficit

There are brain deficits 'caused' by many mental illnesses and there are
brain abnormalities and physical illnesses that can cause psychiatric
symptoms.

The brain deficits, by which I mean reduction in grey or white matter
associated with the course of the condition, are well evidenced.

This information can and usually is interpreted to show that mental
illness is brain illness and therefore an illness like any other
illness. This provides a biological basis for the description of these
experiences as illness in the fundamental or Kraeplinian rationalisation
of medicalisation. The psychosocial model has an alternative
understanding and this is becoming more acceptable.

An alternative explanation could be that the experience of life rather
than the condition itself causes the change in the brain. I am limited
in my capability to evidence this however it is a possibility. I can
guess at the mechanisms. The lives of people who suffer severe mental
illness and receive psychiatric care are generally different from those
who don't receive psychiatric care. In the UK people who had received
secondary mental healthcare are highly unlikely to be employed. Of those
that are employed may be doing menial tasks or manual labour. They may
be limited in other ways such as through poverty or isolation.

It is psychosocial factors that could cause the change in the brain. The
difference in what people do with their daily life is the cause of the
changes in the brain shown in MRI studies. That's what I'm trying to
say. Someone who watches TV all day and may use certain areas of the
brain less than someone who reads research all day. When someone watches
TV they can be engaging with it in different ways (just as with reading
research), for example they could use it to trigger their creativity or
they could watch critically analysing the quality of the production or
they can disengage (or allow the TV to occupy one bit of their mind)
while they withdraw into an internal world.

I think I need to look at some adopted twin studies.

Medication may also be a cause of the changes in the brain however I
wonder if it's a direct causal effect or an effect caused indirectly
(i.e. the effect on the mind causes a change in behaviour or lifestyle
that changes the brain rather than the chemicals directly working to
damage the brain).

What that means for treatment, in my opinion, is that if people who get
a diagnosis of a mental illness can be assured of a society that won't
allow the illness to change their outcomes. This is what the antistigma
movement is all about but perhaps without the understanding that it may
directly contribute to better neurological outcomes.