Beyond Brain Chemistry: Exploring the Wider Context of Mental Illness

by Hilary Smith

When I wrote the first edition of Welcome to the Jungle: Everything You Ever Wanted to Know About Bipolar But Were Too Freaked Out To Ask, my mission was to provide positive, engaging companionship for young people being diagnosed with bipolar disorder. My goal with the second edition, Welcome to the Jungle: Facing Bipolar Without Freaking Out, was a little bit different: to help people understand the wider context of their diagnosis, and encourage them to think about bipolar as not only a matter of biochemistry, but as a complex interplay between a person and his or her cultural, social, economic, geographic, political and environmental contexts.

Why is it important to see bipolar disorder in a wider context? Didn’t that public service announcement I saw last week explain that bipolar disorder was a chemical imbalance, best managed by taking lifelong medication? While the biochemical model has been useful for some, it has had the unexpected consequence of blinding us to the other factors feeding into mental distress, and to the many free, healthy and safe ways that people experiencing mental distress can help themselves.

For example, the destruction of the natural world and lack of access to nature are both factors that increase a person’s stress levels, yet people diagnosed with bipolar are rarely encouraged to reconnect with nature. Homelessness and economic pressure can give people symptoms resembling mental illness, yet most books about bipolar disorder do not consider housing status or economic security. Social isolation, not brain chemistry, is one of the greatest predictors of suicide, yet the biochemical model of mental illness makes no allowance for this or other crucial facts.

My hope is that Welcome to the Jungle: Facing Bipolar Without Freaking Out will help individuals, their families and friends, and their doctors make wiser decisions about dealing with depression and mania—decisions that go beyond the limited “brain chemistry” model to take the whole person, and their whole environment, in mind.


The subject of mental health has fascinated Hilary Smith since being diagnosed with bipolar disorder in college. She is the author of the novels Wild Awake and A Sense of the Infinite, both of which explore the themes of mental health and illness. She lives in Portland, OR. Visit her at www.hilarytsmith.com.

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