ABSTRACT
To best understand our quest to feel good, it is useful to first appreciate the role of emotions and emotional reactions in the human experience. Psychologists have studied emotions for years, and before them, philosophers and theologians debated the role and substance of emotions. As a result, there is a great deal of information available to help understand this critical aspect of the human condition. Unfortunately, it may be the case that there is not enough cross-referencing between those who treat emotional disorders and those who research emotions. As a result, emotions discussed in the clinical literature are too often presented as states of disorder, which are seemingly unrelated to normal emotional reactions discussed by those who research emotions. As an example, we know that bipolar disorder, whether type I or type II, is characterized by emotional instability. The person is thought to be plagued by an inability to regulate emotions, and that this emotional disregulation is the outcome of some poorly understood medical condition. While the point is not to argue the validity of the diagnosis, I would hope to challenge the assumption that anyone diagnosed with emotional instability suffers from a medical condition known as bipolar disorder or cyclothymia. I will underscore this challenge by suggesting that when people receive the diagnosis of bipolar disorder, as an example, they then come to identify with the disorder and come to perceive it as a condition that essentially exists inside them that is prone to erupt at any moment. I can remind the reader that if one experiences frequently changing emotions and goes to a physician for help, that physician, whether a psychiatrist or other medical professional, is invested in helping to remedy the discomfort—a justifiable intention. What that physician has to offer is medicine, and to give the medicine, he or she must give a diagnosis. We should recall that a diagnosis implies the presence of a problem; it does not by default imply a medical disease. To be sure, some are more impacted by their physiologies than are others, but emotions serve a purpose, and for many, apparently an increasing number of others, those emotions are not working well in an optimal sense. I think we will consistently find that they are working in the immediate sense to drive the behaviors necessary to deal with an immediate challenge. Even for those with a temperamentally based emotional sensitivity, the emotions are purposeful—albeit expressed with excessive intensity. Medicines can certainly help and are often necessary, but we need to be careful to not confuse symptoms (emotional lability) with clinical disorders. The clinical disorder could be a purely medical condition. We should not rule it out; however, there is not a reliable medical account of that condition. The ability to show active areas of the brain in emotionally labile people does not validate the presence of brain pathology, only brain activity. If one is emotional, we should see predictably active areas of the brain. Further, that medicines help does not support a medical disorder, just the role of physiology, which we know to be necessary for any human experience. The disorder may be in one’s orientation to life as reflected in one’s lifestyle. Altering lifestyle may require the help of medicines to regulate the emotions that interfere with therapy, but the medicines do not typically treat the disorder itself.
