Yes and no. It all depends on what we mean by the term brain.
This article remains highly relevant because the statement “mental disorders are brain diseases” is widely used not only by psychiatrists but also by many other actors within the biomedical field, including the pharmaceutical industry and neuroscientists.
However, this assertion—that mental disorders are diseases of the brain—can be made with very different intentions and for different purposes. The most common include:
- Relieving patients of unnecessary guilt and encouraging them to seek help by conveying that their condition is treatable. This is often an attempt to reduce the stigma surrounding mental illness and challenge the notion that psychiatric disorders result from personal weakness or moral failure.
- Refuting simplistic or pre-scientific explanations that attribute mental illness to witchcraft, curses, demonic possession, or similar beliefs.
- Reinforcing the idea that psychiatry is a medical specialty whose primary organ of study is the brain, and is therefore fundamentally comparable to other branches of medicine.
- Convincing the public that pharmacological treatment is the primary—or only—solution.
- Offering a simplified explanation of an extraordinarily complex subject, thereby avoiding the deeper discussion that it truly deserves.
Some of these motivations are beneficial and ethically justified; others are far less so. For example, presenting medication as the only effective treatment often reflects commercial or ideological interests rather than scientific evidence.
Much More Than an Organ
So why does the answer depend on how we define the brain?
My answer is yes if we understand the brain as the entire encephalon—including the cerebrum, cerebellum, and brainstem—which serves as the primary biological substrate of mental activity, while remaining inseparably connected to the rest of the body and continuously interacting with the surrounding environment.
In fact, it is more accurate to say that the biological substrate of the mind is the human body as a whole, not the brain alone.
Under this broader conception, the brain is not merely an organ composed of neurons. It is also the structure that stores a person’s life history, preserving memories, experiences, narratives, beliefs, values, and judgments. It transforms lived experience into meaning and language, while simultaneously translating language, knowledge, and abstract thought into enduring neural connections.
From this perspective, I would answer yes to the title of this article if we define the brain approximately as follows:
Brain = encephalon + the rest of the body + personal biography + language + social and relational context + physical environment + morality + artistic capacity, and much more.
On the other hand, my answer would be no if the brain is viewed merely as an isolated organ whose function can be explained solely by neurotransmitters, neuronal electrical activity, and the biological state of nerve cells. That reductionist perspective overlooks much of what shapes mental life.
Two Illustrative Examples
Imagine someone who becomes anxious before giving a public presentation or taking an important examination. Their heart races, their stomach tightens, and they experience intense nervousness.
Is this a brain disorder?
Not at all.
The brain is functioning exactly as expected in anticipation of a stressful situation. The task for that individual is to gradually become accustomed to public speaking or examinations and develop confidence. If this proves difficult, psychotherapy may help uncover why these situations provoke such intense fear.
By exploring the person’s life history, important relationships, environmental demands, personal expectations, strengths, and vulnerabilities, it becomes possible to understand and eventually overcome those fears. In fact, most people never become completely free of anxiety in these situations—because we are human, not machines. A certain degree of social anxiety is entirely normal and physiologically appropriate.
Consider another example.
Imagine a woman who was sexually abused during childhood and, years later, enters an arranged marriage. During sexual intimacy with her husband, she begins experiencing flashbacks of the childhood trauma. Her mood changes, she becomes irritable, struggles to concentrate, and develops low self-esteem.
Is this a malfunction of the brain?
In one sense, yes.
Her symptoms are understandable responses to the reactivation of traumatic memories whose effects continue to shape her present experience. Traumatic life events leave lasting biological footprints, altering both the structure and function of the brain. At the same time, those symptoms cannot be understood without considering her personal history and lived experience.
