I'm also feeling a need to clarify
I've got no doubt that neurology underpins some disorders. Yet we know that, even in cases of clinical depression, schizophrenia and bipolar disorder, it's the interaction between the social world, genetic propensity and physical environment which can trigger, worsen or ameliorate the conditions. We can no longer talk about nature and nurture alone, or even social constructivism in isolation. They are interlinked.
However, after 6 years on this forum, and after extensive reading, I really do doubt that what we call MLC is one thing at all. In fact, there's no evidence for it. 10% of American men do have a something they crisis, but it's likely to be a cultural construction as this is not so prevalent outside the US, and absent in some cultures.
Occam's razor has been proven so wrong in biological terms. Almost every disorder is indeed multifactorial. There's no such thing as "this one molecule went wrong, so my brain crashed". Heart attacks? There are genetic predispositions, lifestyle predispositions, intercurrent illnesses and life events, all inhomogenously intersecting with the simple nature of narrowed cardiac plumbing - even that's not 'one disease' - but we approach heart attack as one disease based on commonalities of presentation, and commonalities as to how to treat it. I research the physiology of a fairly niche disease, and even that one the WHO has classified into 5 major types, each with over a dozen subgroups, each looking rather different from the other, with a somewhat different constellation of causes (...you should see the looks on my students' faces when I ask questions on this topic!). So, a relatively understudied phenomenon like MLC? Yes there are likely many underlying causes - but that doesn't mean we shouldn't group the similarities and study the whole grab-bag as a disease, while trying to sift out the lumps.
When I talked about a biochemical etiology, I do mean brass tacks. Biochemistry tells us very nicely HOW something goes wrong. It's a final common pathway ('because of all these things that each suddenly went out of step, now
this key doesn't fit into
this lock'). It says nothing about WHY. Childhood trauma, FOO, coping mechanisms, other mood disorders or underlying personality disorder traits, all collide with present events to decide WHY NOW (and possibly, WHY NOT THAT OTHER GUY). None of these theories contradict each other, they enrich each other (and make dumbfounded researchers struggle for their insights
).
I don't know that the phenomenon of MLC is truly more common in North America (many on this board from outside of NA). It may be that BD and the mayhem that surrounds it plays out differently in different cultures. Anecdotally, my uncle went through a full-blown MLC, but in his country and community, divorce is pretty much unheard of - following the stereotypical rages-and-withdrawal phase (followed the script to a T!), my uncle went off to live as a monk in a hermitage. My beloved aunt dealt, very much as this forum recommends. Eventually, uncle's MLC burned out, and he returned home. When my H's MLC started, talking with my aunt was an eye-opener. Yup, seems to happen everywhere.
Forgive my long-windedness... punchline: for MLC, biochemistry is only the lever. Psychology supplies the hand that pulls the lever.
"You have a right to action, not to the fruit thereof; shoot your arrow, but do not look to see where it lands." -Bhagavad Gita
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