Do You Still Believe in the “Chemical Imbalance Theory of Mental Illness”?

Bruce Levine

counterpunch.org

Originally published 29 APR 22

Here are two excerpts:

If you knew that psychiatric drugs—similar to other psychotropic substances such as marijuana and alcohol—merely “take the edge off” rather than correct a chemical imbalances, would you be more hesitant about using them, and more reluctant to give them to your children? Drug companies certainly believe you would be less inclined if you knew the truth, and that is why we were early on flooded with commercials about how antidepressants “work to correct this imbalance.”

So, when exactly did psychiatry discard its chemical imbalance theory? While researchers began jettisoning it by the 1990s, one of psychiatry’s first loud rejections was in 2011, when psychiatrist Ronald Pies, Editor-in-Chief Emeritus of the Psychiatric Times, stated: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” Pies is not the highest-ranking psychiatrist to acknowledge the invalidity of the chemical imbalance theory.

Thomas Insel was the NIMH director from 2002 to 2015, and in his recently published book, Healing (2022), he notes, “The idea of mental illness as a ‘chemical imbalance’ has now given way to mental illnesses as ‘connectional’ or brain circuit disorders.” While this latest “brain circuit disorder” theory remains controversial, it is now consensus at the highest levels of psychiatry that the chemical imbalance theory is invalid.

The jettisoning of the chemical imbalance theory should have been uncontroversial twenty-five years ago, when it became clear to research scientists that it was a disproved hypothesis. In Blaming the Brain (1998), Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, detailed research showing that it is just as likely for people with normal serotonin levels to feel depressed as it is for people with abnormal serotonin levels, and that it is just as likely for people with abnormally high serotonin levels to feel depressed as it is for people with abnormally low serotonin levels. Valenstein concluded, “Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.” But how many Americans heard about this?

(cut)

Apparently, authorities at the highest levels have long known that the chemical imbalance theory was a disproven hypothesis, but they have viewed it as a useful “noble lie” to encourage medication use.

If you took SSRI antidepressants believing that these drugs helped correct a chemical imbalance, how does it feel to learn that this theory has long been disproven? Will this affect your trust of current and future claims by psychiatry? Were you prescribed an antidepressant not from a psychiatrist but from your primary care physician, and will this make you anxious about trusting all healthcare authorities?

The info is here.

Psychiatry’s Incurable Hubris

Gary Greenberg
The Atlantic
April 2019 issue

Here is an excerpt:

The need to dispel widespread public doubt haunts another debacle that Harrington chronicles: the rise of the “chemical imbalance” theory of mental illness, especially depression. The idea was first advanced in the early 1950s, after scientists demonstrated the principles of chemical neurotransmission; it was supported by the discovery that consciousness-altering drugs such as LSD targeted serotonin and other neurotransmitters. The idea exploded into public view in the 1990s with the advent of direct-to-consumer advertising of prescription drugs, antidepressants in particular. Harrington documents ad campaigns for Prozac and Zoloft that assured wary customers the new medications were not simply treating patients’ symptoms by altering their consciousness, as recreational drugs might. Instead, the medications were billed as repairing an underlying biological problem.

The strategy worked brilliantly in the marketplace. But there was a catch. “Ironically, just as the public was embracing the ‘serotonin imbalance’ theory of depression,” Harrington writes, “researchers were forming a new consensus” about the idea behind that theory: It was “deeply flawed and probably outright wrong.” Stymied, drug companies have for now abandoned attempts to find new treatments for mental illness, continuing to peddle the old ones with the same claims. And the news has yet to reach, or at any rate affect, consumers. At last count, more than 12 percent of Americans ages 12 and older were taking antidepressants. The chemical-imbalance theory, like the revamped DSM, may fail as science, but as rhetoric it has turned out to be a wild success.

The info is here.

Dealing with all the behavioral conditions of unknown etiology

By Steven Reidbord
KevinMD.org
Originally published May 1, 2014

Here are some excerpts:

A few years ago I wrote that uncertainty is inevitable in psychiatry.  We literally don’t know the pathogenesis of any psychiatric disorder.  Historically, when the etiology of abnormal behavior became known, the disease was no longer considered psychiatric.  Thus, neurosyphilis and myxedema went to internal medicine; seizures, multiple sclerosis, Parkinson’s, and many other formerly psychiatric conditions went to neurology; brain tumors and hemorrhages went to neurosurgery; and so forth.

(cut)

Patients are told they suffer a “chemical imbalance” in the brain, when none has ever been shown.  Rapid advances in brain imaging and genetics have yielded an avalanche of findings that may well bring us closer to understanding the causes of mental disorders.  But they haven’t done so yet — a sad fact obscured by popular and professional rhetoric.  In particular, functional brain imaging (e.g., fMRI) fascinates brain scientists and the public alike.  We can now see, in dramatic three-dimensional colorful computer graphics, how different regions of the living brain “light up,” that is, vary in metabolic activity.  Population studies reveal systematic differences in patients with specific psychiatric disorders as compared to normals.  Don’t such images prove that psychiatric disorders are neurobiological brain diseases?

Note quite.

The entire article is here.

Thanks to Ed Zuckerman for this information.

Mental illness: is chemical imbalance theory a myth?

Torstar News Service
Originally published on October 19, 2013

Here is an excerpt:

Now, neuroscience would attribute such things as depression and psychosis to “chemical imbalances” — specifically to disruptions in the neurotransmitters that allow the brain’s billions upon billions of grey matter cells to speak to one another.

And so mental illnesses became normalized and destigmatized.

And so their treatments, to a huge extent, came off of the couch, out of the asylums and onto pharmacy counters.

And so a $70-billion drug market grew to feed tens of millions worldwide with daily doses of magic bullets — pills that could bring their brain chemistry back into balance.

Trouble is, in the minds of many neuroscientists today, that chemical imbalance theory has turned out to be a myth, with little more scientific or medicinal substance than poetry or song.

The entire article is here.

Thanks to Ned Jenny for this information.