Although scientists have learned a lot about the brain in the last few decades, approaches to treating mental illnesses have not kept up. As neuroscientists learn more about brain circuits, a Stanford psychiatrist foresees a time when diagnoses will be based on brain scans rather than symptoms. It was really not until about 10 years ago that mental health professionals started realizing how little difference we have made. There are a few fundamental issues and mistakes we’ve made. One is that in the absence of knowing what the causes of the illnesses that we treat are, we focus on the symptoms, and that has already led us down the wrong path.
Realizing that errors has coincided with the era of imaging, and even more recently with the really exciting focus on individual subject analyses. We understand behavior is essentially underpinned by brain circuits. That is, there are circuits in the brain that determine certain types of behaviors and certain types of thoughts and feelings. That’s probably the most useful way of organizing brain function. If you can start characterizing circuit disruptions for compensatory symptoms at an individual subject level and then link that to how you can provide interventions, then you can get away completely from diagnoses and can intervene with brain function in a directed way.