It’s striking that many mental health disorders are named after their symptoms rather than their causes.

That’s not accidental, it’s because, in most cases, we don’t actually know the underlying cause. So instead of explaining why something happens, we describe what it looks like.

There was once a strong belief in the “chemical imbalance” theory. The idea that mental disorders are mainly caused by faulty brain chemistry. But this hasn’t really held up. We haven’t been able to consistently identify clear imbalances, and medication doesn’t reliably fix every condition.

That forced a shift in how we think about mental health.

Today, mental disorders are mostly defined based on observable experience.

A condition is typically considered a disorder if it’s unusual compared to the general population, causes distress, and interferes with daily functioning.

The difficulty is that the brain is incredibly complex. Unlike other organs, we can’t fully map thoughts, emotions, or consciousness in a clear, mechanical way.

So the field has a certain “fuzziness” we’re often working with patterns and interpretations rather than definitive causes.

There’s also a two way relationship to consider: biology can influence thoughts and behaviour, but thoughts and behaviour can also shape the brain.

For example, chronic stress or repeated negative thinking patterns can physically affect the body over time.

Some conditions, like schizophrenia, appear to have stronger biological roots. Others, like anxiety, PTSD, or personality disorders seem to arise from a mix of experience, memory, and behaviour, not just chemistry.

This leads to a deeper issue: the field isn’t unified.

Diagnosis often leans toward biological explanations.

Therapy focuses on lived experience.

And psychiatry adds medication into the mix.

These approaches don’t always align, which makes the whole system feel inconsistent.

Dr.Francesca Bocca-Aldaqre & Shaykh Shadee Elmasry