Brain Developmental Disorders vs Illnesses

Is it possible that bipolar disorder and schizophrenia have  more in common with autism and other brain developmental disorders than they do with what we traditionally think of as illnesses? 

That’s what Dr. Thomas Insel, director of the National Institute of Mental Health, suggested Wednesday night at the National Alliance on Mental Illness national convention in Chicago.

I’ve just returned to my hotel room after hearing his thought provoking talk, which I hope NAMI will reprint. Insel said that we need to stop thinking about bipolar disorder, schizophrenia, and major depression as ILLNESSES and recognize them as disorders that appear to be tied to developmental problems that happen when a child’s brain is being formed. By the time that the acute symptoms of the disorder actually appear (often in the early and mid-20s), doctors are seeing the disorder in its final stages and treating its symptoms — not the cause. Some studies suggest that by the time a person has their first manic attack or schizophrenic breakdown, the disorder itself might have been festering for a dozen or more years.  

He specificially mentioned how some studies suggest that ADHD is now thought to begin forming in children as early as age five when specific parts of the brain are being developed. However, the symptoms do not appear until the teenage years.

The problem today, he said,  is that we are diagnosing and treating symptoms. We don’t have the scientific knowledge yet that will allow us to pinpoint actual causes. Without knowing that, we can’t fix the impairment — possibly damaged brain cells. We can only try to find ways to alleviate the symptoms. 

In his wide ranging talk, he also discussed suicide, stating that  in the U.S., suicide claims twice as many lives as homicides and more than all traffic accidents in a year.  He added that most suicides in the military happen before someone is deployed to war, not after. And that suicides cause more deaths than the current deaths caused by combat.   

That’s sobering stuff.

Tomorrow (Thursday), I will appear with NAMI Executive Director Michael Fitzpatrick at the convention’s official opening session. I will interview him on stage about NAMI and the issues that it is facing in the coming months with massive federal budget cuts. We’ll also discuss the ongoing problem of the criminalization of persons with mental disorders as well as stigma.

Television newsman Bill Curtis will speak too.  More than 2,000 NAMI members are attending the convention and it has been great for me to see so many familiar faces and friends.

Insel ended his talk by optimistically predicting that in the next twenty years, we should make significant progress in identifying what actually causes mental disorders and finding ways to better treat — if not eventually — cure them.

Those are hopeful words. I pray he’s right.

About the author:

Pete Earley is the bestselling author of such books as The Hot House and Crazy. When he is not spending time with his family, he tours the globe advocating for mental health reform.

Learn more about Pete.


  1. What an important speech and one that gives hope for all of us who have family members and children with mental disorders. Thank you for sharing this information Pete.

  2. I’ve actually felt bipolar disorder seemed to be more in line with a developmental disorder for sometime now, it’s refreshing to know that exploration will deepen on this topic and hopefully research will open a new door to help treat the disorder(s) themselves.  Thank you for sharing Pete.

  3. Mary Atkinson says

    And, how do we help our loved ones now?  Right now!!!!  Where is the help?  What should we do?  How long before it reaches the Psychologists/Psychiatrists to do any good.  How long do we have to wait for our loved ones to get any help through the jail/prison system?  My son has had the symptoms since he was 16 months old.  Many years wasted taking him to doctors, Psychologists, Psychiatrists, Therapists, etc.  Lot a talk about nothing.  What is it going to take to get the help now?  Until then, the revolving door to jail / prison continues.

  4. I’ve heard Dr. Insel speak on this topic before. My strong impression is that he is simply softening us up for more expensive pharmaceuticals. Luckily for him, the public has a short memory span. Twenty years from now (way too late for most people today) there will be a new generation of parents who believe the promise that twenty years from then, “mental illness” will be understood.

  5. I was very impressed with Dr. Insel’s speech and it was one of the highlights of the convention for me.  Thanks for summing it up so nicely.

  6. i found this article extremely interesting. I myself, am bi-polar and my son was diagnosed with Autism 7 years ago.  Over the years I have discovered that i understand his thought process and actions more than anyone else who knows him.  I often wonder if this is because I know him so well or if this is also the way my mind works and makes connections.  I have never had a learning disability or delays of any kind, although 3 of my 5 other siblings do.  I do share a bit of his compulsive behaviors though.  Thank you for this article.  I will definitely be doing more research