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Why should I believe that mental illness is a "brain disease" when, in fact, there is no proof that it is? Please quote for me the studies to prove this theory is true. Medications fail in the long run for most people with anywhere from bothersome side effects to devastating side effects such as tardive dyskinesia or akathesia, heart problems, and weight gain that can lead to diabetes. If it wasn't a "disease" from the beginning, it will be when the meds are done working on the mind and body.

Ruth Ehrenberg
Longmeadow, Massachusetts

Answered by John Hsiao, M.D.:
When it comes to pharmacological treatment of mental illness, the glass is very much more than half full. The antipsychotic drugs may not have helped you or someone you loved as much as you (or I) would have liked. They are far from perfect. They work better in some than in others, and you are correct to point out that their side effects can range from merely bothersome to devastatingly life threatening. That is why they are used only under a doctor's supervision. However, when used properly -- when they are given to appropriate patients, at appropriate doses, with appropriate laboratory and clinical monitoring -- antipsychotic drugs can be life-saving.

Mental illnesses are not just "problems of living." An illness like schizophrenia can destroy a young person's future just as effectively as cancer or AIDS, and this is no less a tragedy for being an illness of the brain rather than the body. While many studies document measurable brain abnormalities associated with schizophrenia, as well as brain changes associated with treatment, the proof you ask for is not in some dry scientific study, but in the day to day lives of the millions of people and their families who have benefited from mental health care and medications.

John Hsiao, M.D.

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