Frequently Asked Questions

 
1. WHAT IS A NEURO-BIOLOGICAL DISORDER? 
 
A neuro-biological disorder, a term not universally used, refers to those mental disorders that have, as their origin, some sort of brain anomaly or aberration. Simply put, there is a "brain glitch." These glitches occur in one of two primary ways.  
 
First there are imbalances of chemicals that regulate the transmission of messages. Brain chemicals such as serotonin, dopamine, acetylcholine, epinephrine and norepinephrine are responsible for regulating neuronal transmission for anything from bodily movements to mood to impulse control.  
 
The second major glitch has to do with actual physical/structural abnormalities in the brain. We are all quite aware of traumatic brain injuries that result from, for example, automobile accidents where one is left with thought disruptions or speech impediments. Actual differences in how the brain's message pathways develop or in how a specific region of the brain fails to fully develop result in neurological or mental health disabilities. 
 
2. WHAT ARE SOME EXAMPLES OF A NEURO-BIOLOGICAL DISORDER? 
 
Two of the more common conditions are Depression, a chemical imbalance and Attention Deficit Disorder (ADD), a structural difference.  
 
To simplify, clinical depression results from difficulties with serotonin. While chemical transmission is rather complex, suffice to say, that Depression, in a manner of speaking, results from being a couple quarts low. Much like an automobile engine that requires oil for the engine to run smoothly and at a proper temperature, so does one's mood require an effective and efficient use of it's "lubricant," namely serotonin. If one runs low on serotonin, one's mood suffers and one "gets hot" (irritable and angry in clinical terms), resulting in depression. 
 
ADD, it is widely accepted, has a lot to do with difficulties with what is known as Executive Function. These functions consist of planning, problem solving, decision making, organizational abilities and impulse control. Brain-wise, these functions are involved with the frontal lobes of the brain. While chemical imbalances may also be a factor, it is the structural differences in this area that generate ADD symptoms. 
 
3. ARE THESE CONDITIONS GENETIC AND THEREFORE HEREDITARY? 
 
There is increasing evidence to support the hypothesis that many of these disorders are genetic in nature. For instance, the Tourette Syndrome Association regularly supports research to isolate and identify the "TS Gene." They also support efforts to acquire brains of deceased individuals with TS for tissue studies.  
 
With Bi-Polar Disorder (BPD), it has been fairly well documented that a child with only one parent with BPD stands about a 50% chance of having BPD as well. Those chances increase to over 70% if both biological parents have BPD. Clearly, this signifies hereditary connections. 
 
4. ARE ALL PSYCHIATRIC CONDITIONS THE RESULT OF CHEMICAL IMBALANCES OR STRUCTURAL ABNORMALITIES? 
 
The short answer here is no. There are many mental health diagnoses delineated in the DSM-IV Manual that have, at least as of yet, no known basis in these two areas of concern. There are various Adjustment Disorders outlined in the DSM-IV that are more situational than anything. For instance, depression resulting from the loss of employment, the death of a loved one, separation or divorce or bullying, is more "environmental" rather than an organic, neurological condition. Such predicaments are not chronic (i.e. life-long), biological conditions. Another diagnostic category has to do with trauma, the most well-known being Post-Traumatic Stress Disorder (PTSD) which can result from being in combat, the sudden, unexpected death due to an automobile accident or plane crash, or more current, the PTSD suffered by the survivors and the helpers of 9/11. Again, while conditions such as these have no known organic basis, that does not mean that treatment in the form of medication and psychotherapy is not warranted in order to ameliorate any long term effects.  
 
5. WHAT IS CO-MORBIDITY? 
 
While there are numerous neuro-biological disorders such as AD/HD, OCD, TS, ODD, etc., that have been delineated (with probably more on the way), rarely, if ever, does one specific disorder exist in a vacuum. Rather it seems that at least two, if not more disorders, tend to congregate and hang out together. Unfortunately, these first cousins make themselves at home, wreaking havoc on the family member they inhabit. In that "hanging out/habitation process," the individual disorders lose their separate and distinct characteristics as they mesh together to form a constellation unique to that individual. It is this gathering together and melding of disorders which results in the overlapping of a myriad of characteristics and symptoms to the point of making any individual disorder almost indistinguishable from any other that is known as co-morbidity. No longer just TS or just ADD, it is as if an entirely new disorder has evolved from this synergy.  
 
6. HOW PREVALENT IS CO-MORBIDITY WITH NEURO-BIOLOGICAL DISORDERS? 
 
In a word, extremely. In my experience I have yet to encounter an individual with just a single neuro-biological disorder. Frankly, I don't believe that's possible. While one may not have a full-blown version of any additional disorders beyond their primary diagnosis, that does not imply that they have not been tainted by others. I believe that there is, for example, always some degree of anxiety that is present in every one of these disorders. To me, it goes with the turf. As such, it requires attention and treatment. 
 
When it comes to high rates of co-morbidity, one need only consider Tourette Syndrome (TS). Often referred to as the "Terrible Triad," TS is commonly associated with AD/HD (about 70-80% of the time) and OCD (about 60-65% of the time). To make the co-morbidity case even stronger, those with TS have about a 50% chance of also having BPD.

All material on this website ©2009 by Bridging the Chasm and Garry L. Earles, L.I.C.S.W.