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“Just” a psychiatric problem

I am a keen reader of headlines about eating disorders. The headlines are often so badly off the mark, even of the content of the article, but recent news about eating disorders and genetics has been filled with *headdesk* moments.

“ANOREXIA NOT JUST A PSYCHIATRIC PROBLEM” is my favorite. It’s got all the myths rolled in together in one dangerous package.

“JUST” psychiatric can easily be read as “only.” As in, not as serious or real or worrying. “Just psychiatric “can, and will, sound to people as if the news is notable because a psychiatric problem isn’t as important, meaningful, or treatable. It is.

“JUST” also treats the brain as if it not part of the body, somehow. As if a problem can exist in society and not in the brain. No matter how mechanistic one may be, and I’m pretty reliably mechanistic when it comes to mental illness, the brain is not only in the body it is part of the body’s systems alongside metabolism. There is no brain function without metabolism and no metabolism without the brain.

“PSYCHIATRIC” is being used in these headlines the way we often use “psychological.” Incorrectly. Again, as if it has little to do with biology. Brains are biological. Thoughts and behaviors are biological. They’re also environmental: responding to and formed by experience. Those can’t be usefully separated.

“NOT JUST” implies that everyone thought it was “just” psychiatric. We didn’t. We all know that eating disorders are complex and involve a lot of systems and a lot of environmental and experiential and cultural factors. The public keeps being “shocked! shocked!” by the brain being an organ in constant interaction with the rest of the body and the environment, but no one in the eating disorder treatment or advocacy world is shocked.

It’s finally time to locate the brain in the body, the body in the picture of mental health, and see eating disorders as just as real and just as challenging and just as important a thing to study and treat as any other disorder. The world has been skeptical, indeed the eating disorder treatment community has been highly skeptical, that these disorders are not under the cognitive control of the person experiencing them. Yet we would not expect someone with diabetes to think their way out of and explain their pancreatic disorder, nor would we expect the pancreas to operate in isolation from other systems of the body.

Time to put aside the myths around eating disorders and study this new research. Let this research make us optimistic and motivated to do more in this direction for the full range of eating disorders and for all psychiatric and brain disorders.

Let’s please, also, stop using the word “just.”

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2 Comments

  1. Doreen Feeney

    I 100% agree with the above. My daughter has had an ED since she was 6 and today she is 36. It manifested itself when she was 15. Today is suffers from OSFED. She has had enough. She was only 300 hours away from her Bachelor of Science in Nursing, today she wants NOTHING to do with nursing. She has had over 20 ECT’s, multitude of meds and lost tract of hospital stays, therapy etc. She has lost all hope. I haven’t.

  2. Laura

    Having loving parents who hold the hope is so powerful. These disorders drain hope, motivation, and life direction from the sufferer, and try to alienate us as parents. How fortunate and loved your daughter remains, even when she can’t hold that for herself you are doing it for her until she can. That’s love.

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