Why we stay stuck: Part 2

The question in this series of post is why we stay stuck. Why is changing or feeling better or whatever sooooooo very difficult. As I previously wrote, there are many, many reasons why. One way to organize those reasons in into different levels, starting with the biological level.

The biological level of a person, as it relates to mental health, is the functional and anatomical nature of the brain and the consequent somatic effects. It is the genetic propensity towards or resistance too any given mental illness. In many instances, like depression or eating disorders, there are actual functional and anatomical brain changes that occur over the onset, course, and remission of a mental disorder 1. These changes appear to impact how a person views the self, the world, and her place in it 2.

Let me add the caveat that the timing of the onset of brain changes and the onset of any given disorder are difficult to tease out. We do not know who will develop an eating disorder, so scientists are unable to scan a person’s brain BEFORE it happens. They can only look at what differences between those who do and those who do not meet diagnostic criteria. Once identified, study participants can be followed during recovery or relapse; That said, when there are brain differences between people who do and do not have a given disorder, recovering brains start to look like the brains of those who never had the disorder in the first place. Powerful, powerful stuff!

So, I am not going to go into details of all the changes of that happen in people with eating disorders or any other type of mental health issues. The changes are just too varied but I will bring us back around to the point that the brain contributes to why people stay stuck.

It’s like trying to walk on a broken leg. You will be able heal, to walk again. However, you will have a period where you cannot walk and there are things you will have to do in order to heal, like go to the emergency room. You cannot just “decide” to walk; nor can you expect to walk instantly. There are very real, biologically based events that have happened and they must be addressed.

Because the brain takes time to heal, people may continue to engage in behaviors that are not good for them or they might be only able to make small changes at a time. Healing may have started but it might not be immediately obvious.

**Stay tuned for the next post, as we move up to the cognitive level of “staying stuck.”

1 Adams, H.E., & Sutker, P.B. (Eds.) (2004). Comprehensive handbook of psychopathology 3rd Edition. New York: Springer Science + Business Media, L.L.C.

2 Drevets, W.C. (2003). Neuroimaging abnormalities in the amygdala in mood disorders. Annals of the New York Academy of Sciences, 985, 420-444.

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