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.

Are You Creeped Out by the Idea of a “Moral Enhancement” Pill?

Vanessa Rampton
Slate.com
Originally posted March 20, 2017

Here is an excerpt:

In its broad outlines, the idea of moral bioenhancement is as follows: Once we understand the biological and genetic influences on moral decision-making and judgments, we can enhance (read: improve) them with drugs, surgery, or other devices. A “morality pill” could shore up self-control, empathy, benevolence, and other desirable characteristics while discouraging tendencies toward violent aggression or racism. As a result, people might be kinder to their families, better members of their communities, and better able to address some of the world’s biggest problems such as global inequality, environmental destruction, and war.

In fact, the attempts of parents, educators, friends, philosophers, and therapists to make people behave better are already getting a boost from biology and technology. Recent studies have shown that neurological and genetic characteristics influence moral decision-making in more or less subtle ways. Some behaviors, like violent aggression, drug abuse and addiction, and the likelihood of committing a crime have been linked to genetic variables as well as specific brain chemicals such as dopamine. Conversely, evidence suggests that our ability to be empathetic, our tolerance of other racial groups, and our sensitivity to fairness all have their roots in biology. Assuming cutting-edge developments in neuroscience and genetics have been touted as able to crack the morality code, the search for a morality pill will only continue apace.

The article is here.

Deontology Or Trustworthiness?

A Conversation Between Molly Crockett, Daniel Kahneman
Edge.org
June 16, 2016

Here is an excerpt:

DANIEL KAHNEMAN:  Molly, you started your career as a neuroscientist, and you still are. Yet, much of the work that you do now is about moral judgment. What journey got you there?            

MOLLY CROCKETT:  I've always been interested in how we make decisions. In particular, why is it that the same person will sometimes make a decision that follows one set of principles or rules, and other times make a wildly different decision? These intra-individual variations in decision making have always fascinated me, specifically in the moral domain, but also in other kinds of decision making, more broadly.

I got interested in brain chemistry because this seemed to be a neural implementation or solution for how a person could be so different in their disposition across time, because we know brain chemistry is sensitive to aspects of the environment. I picked that methodology as a tool with which to study why our decisions can shift so much, even within the same person; morality is one clear demonstration of how this happens.            

KAHNEMAN:  Are you already doing that research, connecting moral judgment to chemistry?

CROCKETT:  Yes. One of the first entry points into the moral psychology literature during my PhD was a study where we gave people different kinds of psychoactive drugs. We gave people an antidepressant drug that affected their serotonin, or an ADHD drug that affected their noradrenaline, and then we looked at how these drugs affected the way people made moral judgments. In that literature, you can compare two different schools of moral thought for how people ought to make moral decisions.

The entire transcript, video, and audio are here.

Is It Possible to Create an Anti-Love Drug?

By Maia Szalavitz
New York Magazine - Science of Us
Originally posted May 19, 2014

Here is an excerpt:

A drug that precisely targets only one specific relationship for destruction may be decades away, but drugs that interfere with specific aspects of love like sexual desire are already here. And as scientists begin to tease out the chemical chronology and specific brain systems involved in love, they are already investigating how existing medications taken in carefully timed ways could, for example, prevent the "bonding hormone" oxytocin from initiating or sustaining a relationship.

This could forever change what it means to sever romantic ties. And the ramifications go beyond “Please let me forget”–type situations à la Eternal Sunshine. Anti-love drugs could also provide an intriguing new “treatment” for those trapped in abusive relationships.

The entire article is here.