The "Chemical Imbalance" Myth | Chris Kresser
ADAPT Health Coach Training Program Enrollment is now open. Learn more

The "Chemical Imbalance" Myth

by Chris Kresser

Last updated on

A theory that is wrong is considered preferable to admitting our ignorance. – Elliot Vallenstein, Ph.D.

The idea that depression and other mental health conditions are caused by an imbalance of chemicals in the brain is so deeply ingrained in our psyche that it seems almost sacrilegious to question it.

Direct-to-consumer-advertising (DCTA) campaigns, which have expanded the size of the antidepressant market (Donohue et al., 2004), revolve around the claim that SSRIs (the most popular class of antidepressants) alleviate depression by correcting a deficiency of serotonin in the brain.

For example, Pfizer’s television advertisement for Zoloft states that “depression is a serious medical condition that may be due to a chemical imbalance”, and that “Zoloft works to correct this imbalance.”

Other SSRI advertising campaigns make similar claims. The Effexor website even has a slick video explaining that “research suggests an important link between depression and an imbalance in some of the brain’s chemical messengers. Two neurotransmitters believed to be involved in depression are serotonin and norepinephrine.” The video goes on to explain that Effexor works by increasing serotonin levels in the synapse, which is “believed to relieve symptoms of depression over time.”

These days serotonin is widely promoted as the way to achieve just about every personality trait that is desirable, including self-confidence, creativity, emotional resilience, success, achievement, sociability and high energy. And the converse is also true. Low serotonin levels have been implicated in almost every undesirable mental state and behavioral pattern, such as depression, aggressiveness, suicide, stress, lack of self-confidence, failure, low impulse control, binge eating and other forms of substance abuse.

In fact, the idea that low levels of serotonin cause depression has become so widespread that it’s not uncommon to hear people speak of the need to “boost their serotonin levels” through exercise, herbal supplements or even sexual activity. The “chemical imbalance” theory is so well established that it is now part of the popular lexicon.

It is, after all, a neat theory. It takes a complex and heterogeneous condition (depression) and boils it down to a simple imbalance of two to three neurotransmitters (out of more than 100 that have been identified), which, as it happens, can be “corrected” by long-term drug treatment. This clear and easy-to-follow theory is the driving force behind the $12 billion worth of antidepressant drugs sold each year.

However, there is one (rather large) problem with this theory: there is absolutely no evidence to support it. Recent reviews of the research have demonstrated no link between depression, or any other mental disorder, and an imbalance of chemicals in the brain (Lacasse & Leo, 2005; (Valenstein, 1998).

The ineffectiveness of antidepressant drugs when compared to placebo cast even more doubt on the “chemical imbalance” theory. (See my recent articles Placebos as effective as antidepressants and A closer look at the evidence for more on this.)

Folks, at this point you might want to grab a cup of tea. It’s going to take a while to explain the history of this theory, why it is flawed, and how continues to persist in light of the complete lack of evidence to support it. I will try to be as concise as possible, but there’s a lot of material to cover and a lot of propaganda I need to disabuse you of.

Ready? Let’s start with a bit of history.

The History of the “Chemical Imbalance” Theory

The first antidepressant, iproniazid, was discovered by accident in 1952 after it was observed that some tubercular patients became euphoric when treated with this drug. A bacteriologist named Albert Zeller found that iproniazid was effective in inhibiting the enzyme monoamine oxydase. As its name implies, monoamine oxydase plays an essential role in inactivating monoamines such as epinephrine and norepinephrine. Thus, iproniazid raised levels of epinephrine and norepinephrine which in turn led to stimulation of the sympathetic nervous system – an effect thought to be responsible for the antidepressant action of the drug.

At around the same time, an extract from the plant Rauwolfia serpentina was introduced into western psychiatry. This extract had been used medicinally in India for more than a thousand years and was thought to have a calming effect useful to quiet babies, treat insomnia, high blood pressure, insanity and much more. In 1953 chemists at Ciba, a pharmaceutical company, isolated the active compound from this herb and called it reserpine.

In 1955 researchers at the National Institutes of Health reported that reserpine reduces the levels of serotonin in the brains of animals. It was later established that all three of the major biogenic amines in the brain, norepinephrine, serotonin, and dopamine, were all decreased by reserpine (again, in animals).

In animal studies conducted at around the same time, it was found that animals administered reserpine showed a short period of increased excitement and motor activity, followed by a prolonged period of inactivity. The animals often had a hunched posture and an immobility that was thought to resemble catatonia (Valenstein, 1998). Since reserpine lowered levels of serotonin, norepinephrine and dopamine, and caused the effects observed in animals, it was concluded that depression was a result of low levels of biogenic amines. Hence, the “chemical imbalance” theory is born.

However, it was later found that reserpine only rarely produces a true clinical depression. Despite high doses and many months of treatment with reserpine, only 6 percent of the patients developed symptoms even suggestive of depression. In addition, an examination of these 6 percent of patients revealed that all of them had a previous history of depression. (Mendels & Frazer, 1974) There were even reports from a few studies that reserpine could have an antidepressant effect (in spite of reducing levels of serotonin, norepinephrine and dopanmine).

As it turns out, that is only the tip of the iceberg when it comes to revealing the inadequacies of the “chemical imbalance” theory.

The Fatal Flaws of “Chemical Imbalance” Theory

As Elliot Valenstein Ph.D., Professor Emeritus of psychology and neuroscience at Michigan University, points out in his seminal book Blaming the Brain, “Contrary to what is often claimed, no biochemical, anatomical or functional signs have been found that reliably distinguish the brains of mental patients.” (p. 125)

In his book, Valenstein clearly and systematically dismantles the chemical imbalance theory:

  1. Reducing levels of norepinephrine, serotonin and dopamine does not actually produce depression in humans, even though it appeared to do so in animals.
  2. The theory cannot explain why there are drugs that alleviate depression despite the fact that they have little or no effect on either serotonin or norepinephrine.
  3. Drugs that raise serotonin and norepinephrine levels, such as amphetamine and cocaine, do not alleviate depression.
  4. No one has explained why it takes a relatively long time before antidepressant drugs produce any elevation of mood. Antidepressants produce their maximum elevation of serotonin and norepinephrine in only a day or two, but it often takes several weeks before any improvement in mood occurs.
  5. Although some depressed patients have low levels of serotonin and norepinephrine, the majority do not. Estimates vary, but a reasonable average from several studies indicates that only about 25 percent of depressed patients actually have low levels of these metabolites.
  6. Some depressed patients actually have abnormally high levels of serotonin and norepinephrine, and some patients with no history of depression at all have low levels of these amines.
  7. Although there have been claims that depression may be caused by excessive levels of monoamine oxydase (the enzyme that breaks down serotonin and norepinephrine), this is only true in some depressed patients and not in others.
  8. Antidepressants produce a number of different effects other than increasing norepinephrine and serotonin activity that have not been accounted for when considering their activity on depression.

Another problem is that it is not now possible to measure serotonin and norepinephrine in the brains of patients. Estimates of brain neurotransmitters can only be inferred by measuring the biogenic amine breakdown products (metabolites) in the urine and cerebrospinal fluid. The assumption underlying this measurement is that the level of biogenic amine metabolites in the urine and cerebrospinal fluid reflects the amount of neurotransmitters in the brain. However, less than one-half of the serotonin and norepinephrine metabolites in the urine or cerebrospinal fluid come from the brain. The other half come from various organs in the body. Thus, there are serious problems with what is actually being measured.

Finally, there is not a single peer-reviewed article that can be accurately cited to support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not list serotonin as the cause of any mental disorder. The American Psychiatric Press Textbook of Clinical Psychiatry addresses serotonin deficiency as an unconfirmed hypothesis, stating “Additional experience has not confirmed the monoamine depletion hypothesis” (Lacasse & Leo, 2005).

When all of this evidence is taken in full, it should be abundantly clear that depression is not caused by a chemical imbalance.

But, as Valenstein shrewdly observes, “there are few rewards waiting for the person who claims that “the emperor is really nude” or who claims that we really do not know what causes depression or why an antidepressant sometimes helps to relieve this condition.”

How Have We Been Fooled?

There are several reasons the idea that mental disorders are caused by a chemical imbalance has become so widespread (and none of them have anything to do with the actual scientific evidence, as we have seen).

It is known that people suffering from mental disorders and especially their families prefer a diagnosis of “physical disease” because it does not convey the stigma and blame commonly associated with “psychological problems”. A “physical disease” may suggest a more optimistic prognosis, and mental patients are often more amenable to drug treatment when they are told they have a physical disease.

Patients are highly susceptible to Direct-to-Consumer-Advertising (DCTA). It has been reported that patients are now presenting to their doctors with a self-described “chemical imbalance” (Kramer, 2002). This is important because studies show that patients who are convinced they are suffering from a neurotransmitter defect are likely to request a prescription for antidepressants, and may be skeptical of physicians who suggest other interventions such as cognitive behavioral therapy (DeRubeis et al., 2005). It has also been shown that anxious and depressed patients “are probably more susceptible to the controlling influence of advertisements (Hollon MF, 2004).

The benefit of the chemical imbalance theory for insurance companies and the pharmaceutical industry is primarily economic. Medical insurers are primarily concerned with cost, and they want to discourage treatments (such as psychotherapy) that may involve many contact hours and considerable expense. Their control over payment schedules enables insurance companies to shift treatment toward drugs and away from psychotherapy.

The motivation of the pharmaceutical companies should be fairly obvious. As mentioned previously, the market for antidepressant drugs is now $12 billion. All publicly traded for-profit companies are required by law to increase the value of their investor’s stock. Perhaps it goes without saying, but it is a simple fact that pharmaceutical companies will do anything they legally (and sometimes illegally) can to maximize revenues.

Studies have shown that the advertisements placed by drug companies in professional journals or distributed directly to physicians are often exaggerated or misleading and do not accurately reflect scientific evidence (Lacasse & Leo, 2005). While physicians deny they are being influenced, it has been shown repeatedly that their prescription preferences are heavily affected by promotional material from drug companies (Moynihan, 2003). Research also suggests that doctors exposed to company reps are more likely to favor drugs over non-drug therapy, and more likely to prescribe expensive medications when equally effective but less costly ones are available (Lexchin, 1989). Some studies have even shown an association between the dose and response: in other words, the more contact between doctors and sales reps the more doctors latch on to the “commercial” messages as opposed to the “scientific” view of a product’s value (Wazana, 2000).

The motivation of psychiatrists to accept the chemical imbalance theory is somewhat more subtle. Starting around 1930, psychiatrists became increasingly aware of growing competition from nonmedical therapists such as psychologists, social workers and counselors. Because of this, psychiatrists have been attracted to physical treatments like drugs and electroshock therapy that differentiate them from nonmedical practitioners. Psychiatry may be the least respected medical specialty (U.S. General Accounting Office report). Many Americans rejected Fruedian talk therapy as quackery, and the whole field of psychiatry lacks the quality of research (randomized, placebo-controlled, double-blind experiments) that serves as the gold-standard in other branches of medicine.

Dr. Colin Ross, a psychiatrist, describes it this way:

“I also saw how badly biological psychiatrists want to be regarded as doctors and accepted by the rest of the medical profession. In their desire to be accepted as real clinical scientists, these psychiatrists were building far too dogmatic an edifice… pushing their certainty far beyond what the data could support.”

Of course there are also many “benefits” to going along with the conventional “chemical imbalance” theory, such as free dinners, symphony tickets, and trips to the Caribbean; consultancy fees, honoraria and stock options from the pharmaceutical companies; and a much larger, growing private practice as the $20 billion spent by drug companies on advertising brings patients to the office. Psychiatrists are just human, like the rest of us, and not many of them can resist all of these benefits.

In sum, the idea that depression is caused by a chemical imbalance is a myth. Pharmaceutical ads for antidepressants assert that depression is a physical diseases because that serves as a natural and easy segue to promoting drug treatment. There may well be biological factors which predispose some individuals toward depression, but predisposition is not a cause. The theory that mental disorders are physical diseases ignores the relevance of psychosocial factors and implies by omission that such factors are of little importance.

Stay tuned for future articles on the psychosocial factors of depression, the loss of sadness as a normal response to life, and the branding of new psychological conditions as a means of increasing drug sales.

Recommended resources


Join the conversation

  1. This is so, so good. I wish it were required reading for every American. This issue is out of control and ruining the lives countless innocent (ignorant) people. 🙁

  2. I had depressions over some bad events in my life and sometimes season(winter) depression. They usually pass on their own after some time. Time can differ depending on the cause. Can be a week or two or a couple of months. The longest was for almost a year after the worst break up in my life. What I’m curious about is how do people even know if that’s the drug helped and not that just the depression passed on it’s own if , especially it takes so long for these meds to start working.

  3. I admire you have left your article open feedback, shows your willing to listen to others, that’s integrity and what earns respect in my eyes.

    I’ve battled a depressive state for many years.

    I believe as a youth environmental factors formed my generic expression as the point of homeostatic balance or generic factors have simply been passed along.

    I can alter this very quickly however most substances are very gene expressive, (Tolerance building) and would not be approved by the FDA due to the potential addictive nature or dangers of cessation… or dare say promotional and revenue associated with SSRI’s

    SNRI’s at least make me feel awake, but more anxious and happier.

    5HT’s 2C etc great for a cat quick cat nap?

    Dopamine… and the combination less Histamine makes me feel good, GABA lowers my anxiety via cns. All within minutes but all very reactive to building a very quick tolerance so I stopped experimenting and trying natural?

    Is just great to see an article moving away from the age old standard footprint of Serotonin.

    Thanks for the read.

  4. I’m 16. My family has a long history of mental health problems such as BPD and schizophrenia and it left me predisposed to having some issues myself. My parents are both very loving and as far as nature vs. nurture goes, it couldn’t have been nurture that caused it. Life was stress free. But slowly I started developing issues with my behavior and thought processes. Little things would set me off. I felt as though the world around me was crashing down. I started self harming and dreading going to school in fear that I would have an anxiety attack. I started having sleep disturbances. I would get maybe 6 hours a week. In 7th grade, I was finally diagnosed with anxiety and insomnia. I tried a year of weekly therapy and melatonin supplements and during that timeframe I tried to kill myself twice. I fell behind in school, and cried at the drop of a hat. I was shaky. Then the psychologist suggested that I go see a psychiatrist, just to see if he had any idea how to help. I was put on an SSRI, which didn’t work for me. It took a year or so to find something that helped more than it hurt. I had given up on ever feeling normal. I started on my current medication a couple years ago, and it’s honestly the best thing that ever happened to me. I still get stressed (as stress is normal and healthy) but I am able to cope with it now. I have no side effects and I sleep the entire night. Medication may not work for all, but please don’t dismiss it for all. I’m hoping that I’ll grow out of it eventually and that I’ll begin to taper off of my medication, but for now, it’s the solution I’ve needed.

  5. Do you have a Facebook Page to follow? This days is rare to open my email, and most of the links I follow comes from adds and shares in FB and get to more people sharing myself in this line, but I would like to know more from your page!

  6. Hi,
    I feelt at home in this discussion thread. Am from India. Mental illness is there in my family.

    To cut a 4 decade story short…..i come from a family of mental illness. I had anxiety depression from teenage though diagnosed at 30. Took pills for 6 months.

    Then tried ‘healing’ and it got healed in 4 phases over 11 years. after each phase thought it was healed only to relialize a new level came up. Had used Hynotherapy and other modalities. Also Used Brad yates EFT extensively. one one hand i am blessed to be healed of this complicated illnesss on the other hand it took a toll on my career, am broke and have lost my way. lot of struggle.

    I felt if had taken pills and continued with the healing it wouldnt have hampered my career and finances (was always in a emotional rut). Though after reading articles online, esp. the myth of ‘chemical imbalance’, now i think having the missing vitamins would be better than having pills. Though i wonder which vitamins. Pls do give your inputs.
    Bless all!!

  7. I am living with a severe mental health condition. No amount of talk therapy, acupuncture or essential oils helped. I just spiralled out of control and reached such a frighteningly low point that I was admitted to the hospital. I was put on medication. Are medications perfect? No. Are there side effects? Yes. But I got my life back. I nearly died, and I know I would be dead if not for medical intervention. Because of the medication, I have the mental capacity to do things that will help my health, such as exercise. Therapy, acupuncture, essential oils and ‘eastern treatments’ (I’m from Asia, so my family knows a ton of herbal treatments) augment and supplement what the medication is doing. I don’t feel zombified. Before I went on medication, I was non-functional. Psychiatric medication is not perfect, but please don’t dismiss it altogether.

  8. I suffered from suicidal thoughts and depression as a teenager. Therapy didn’t work, but once I started taking Zoloft, after a few months I felt much better. In my 30s I had chronic stress for two years and I couldn’t stay asleep from the intense anxiety. I was suicidal and sought help. Again, therapy did nothing. I wanted to feel better, but I couldn’t control my thoughts, they just kept spiraling out of control to negative thoughts. I felt like I lost control of my mind. I went to a doctor and was put on Zoloft and within a few weeks I felt much better and felt back in control of my mind. So I am a believer in the chemical imbalance theory for some people. My friend who was in a motorcycle accident and had severe brain trauma was also put on Zoloft for his depression, at a much higher dose, and it didn’t help him.

    • That’s good that you found help. But the fact that Zoloft made you feel better is not a validation of the chemical imbalance theory. SSRIs introduce abnormality into the brain, that’s how they work. They do not fix anything. So feeling better or different just means that the drug altered physiological function. If Zoloft actually corrected some defect, there’d be some objective measure to validate the defunct, and to validate the resolution. There isn’t.

  9. “There may well be biological factors which predispose some individuals toward depression, but predisposition is not a cause. ”
    I do wonder if these might be triggered by toxins altering gene expression, a la the epigenetics ‘tome’. What springs to mind is the mad hatters of the Victorian era who were constantly exposed to mercury fumes in their workshops and where subsequently there was a high incidence of “madness” amongst hat makers.

  10. Good article- good comments- but if you took away the abusive power psychiatry has – and uses- we probably wouldn’t even be here- discussing balance myths would we? Balance is a word you can apply to just about any thing you want- its relevant every time- but when its used to hurt someone- is really all that matters- and the only way to know about that, hurt– is by the report of the person effected– some of those people have been hurting for fourty fifty years- by the same people- psychiatry- so in my mind- and heart- i don’t believe anything they say or do. By the way a brain should sit in the back seat- and let the heart and the gut drive up front.

  11. The problem is that as soon as we speak of depression or other psychiatric illnesses as biochemical imbalances we immediately conclude that it means we need drugs to cure them. I am myself an example of how nutrition can cure depression, and there are many others. Take a look at Kathleen DesMaisons work in “Potatoes Not Prozac” which she wrote in 1998. She still today runs a internet-based community and gathers her followers in yearly seminars in the US and UK. See

  12. There is major logic flaw in this article. The fact that low serotonin doesnt cause depresion DOESNT mean that SSRI dont work for depresion.Actually studies you mentioned are inconclusive because of high placebo response not low response to SSRIs.
    Also higher ammount of serotonin and norephrine works trough BDNF and other second messenger systems therefore its really not professional to chose only dasta which supports you thesis.
    Here is much deeper and better expalantion how depression works.

    • Im a biochemist. The articles you sited are just as scientifically flawed as the articles you say are flawed in this article. Why? Because science is theory. Science is never proof. One article or a hundred articles doesn’t prove anything. Until the end of time a scientific experiment will always be a theory never proof. A real scientist always knows that every experiment ever done until the end of time will be nothing more than theories now out on the conveyor belt to be selectively disproven. Nothing is ever fact, only theory.

      Even gravity is still considered a theory because we simply haven’t disproven it yet. Everything is considered a theory until it finally can be disproven, and that is what true science is all about…disproving stated theories. True science never seeks to prove anything, because it knows it can’t. True science knows AT BEST, it can only disprove, never prove. And that IS the sign of a true scientist. Any scientist that says he or she has proven something, positive or negative, is not a real scientist, and we should discount them. They are fools. There is no proof of gravity, it is only a very successful theory which has yet to be disproven, and then only a theory attributable to earyh only.

      Science proves nothing and it never will. Is depression a physical problem? Who knows? She is correct in that it’s not been proven, but it’s not been disproven either, so the verdict is still out…and unfortunately always will be. We will never prove depression is caused by a physical problem, but we will never prove that it isn’t.

      I think the big issue here is the least of all errors. The pill model of treatment is highly dangerous, and antidepressants cause more physical problems than they cure. The ratio of physical problems as a result of antidepressants is greater than the result of any help and I think that’s what this author is trying to adress. We need to look not is there any proof, (because we will be arguing forever), but ask which is the lesser of all evils. Psychotherapy has been known to help without concomitant injury. Medicine has been known to help, but at a price of numerous concomitant side effects that are more damaging to the body than the original illness. I feel the point of this article is that why should we accept such damaging side-effects just because an insurance company cares more about the bottom dollar. And if we are going by proofs Eastern medicine has far more proof of healing than Western medicine ever has or ever will.

      Proof can never be attained so what we need to start asking ourselves is which treatment works the best hand therapy has shown greater results. But big Pharma and insurance companies have lobbied against that because they don’t want to pay for it so they have led us all to believe the depression is physical. Maybe it is maybe it isn’t what will we all need to start fighting for is the right to choose. If someone wants therapy they should have the right to choose that if someone wants medicine they should have the right to choose that but we need to be fighting for is not against ourselves but against the agencies who don’t want us to choose

      • Interesting comment. There is a major difference between the theory/science behind medical and psychiatric drugs though. When looking at their drug inserts under “mechanism of action,” pretty much all the medical drugs will give reasons as to how they work while the “mechanism of action” for ALL psychotropic drugs says, “Unknown.” That is the truth so anything they promote regarding the cause of a mental disorder being a “chemical imblance of the brain” is fraudulent marketing, not science.

      • I’m glad someone finally explained this. No one ever does.

        I tend to think our beliefs are almost always the deciding factor in the outcome. The latest energy therapies are a good example. Extraordinary testimonials abound on the internet yet there are zero studies behind most if not all of them, eg Theta Healing, EFT, TFT, Reiki, etc. I’ve personally met some people who have genuinely cured themselves of “incurable” diseases and difficult conditions using one of these therapies. I agree, we should be looking at what is the lesser of two evils, or preferably, options outside these two, where no evil abounds at all.

        I also tend to think double blind is irrelevant, since our subconscious is giving off and receiving signals constantly. So if an experimenter knows which is the control pill and which is not, they can subconsciously convey this information to the recipient through all manner of extremely subtle body language, spoken inflections and intonations, etc, that they are not consciously aware they are doing, and the recipient will inversely pick up the information subconsciously. We are all geniuses at doing this and have been practising since birth. The recipient can then pass this information on to someone else who passes to someone else, into infinity. So double blind or a hundred fold blind is irrelevant. The subconscious knows what is going on and will respond accordingly, dependent on other beliefs, eg, how much does the subject want to please the experimenter, etc? Hypnosis is a good example of this where a subject, in front of a live audience, may feel the need to conform / please the hypnotist in order to be rewarded in some way or other, even if the reward is just psychological, eg “oh, what a wonderful laugh you gave us” or whatever. The subconscious is really where it’s at and where we should be doing the research. If you don’t believe the subconscious is capable of such things, then start your research. There is plenty out there. An entertaining introduction is any show by Derren Brown. He is a master of reading people. Youtube him. You will be amazed. He has learned the art of reading the most subtle of body language, a quickening pulse in the vein of a neck, an ever so slight twitch of an eyebrow. Our bodies give us away all the time.

    • “There is major logic flaw in this article. The fact that low serotonin doesnt cause depresion DOESNT mean that SSRI dont work for depression.”

      Read Robert Whitaker’s “Anatomy of an Epidemic”. He does an exhaustive analysis of long term outcomes. Cuts through theories and beliefs. What emerges is a clear picture — people on psych drugs long term tend to fare the worst. Perhaps SSRIs “work” for a while, for some, but it’s important to recognize that these are essentially toxic agents that push the body toward disease and disability more often than not.

  13. Within the article itself, it points to multiple causes and chemical imbalances in animals. Biology IS organic chemistry in action. It is a highly complex feedback loop of bio-chemistry and it spans ALL species. The illogic of this argument is, “if you haven’t found the answer, quit searching”. Even if the cascade of malfunction starts with the thought process, chemicals MUST be involved. This is why both cognitive and chemical interventions affect the feedback loop. Just because we are far from the answers, doesn’t mean we are completely off track. I would prefer a discussion with a biologist/organic chemist on this topic.

  14. I don’t think anyone is saying that “Mental Disorders” do not exist! It is the distinct difference between; Mental Health issues, and true clinical disorders/diseases of the brain. Depression is not a disease of the brain. In the vast majority of cases, depression is the root cause of stress factors, prolonged events, traumas, chronic pain, financial stresses and marital problems… etc etc. Very few people actually have a “diseased brain” that is causing their depression!

    • All of which initiate a chemical cascade, which when prolonged cause chronic conditions within the organism…any organism, human or otherwise. Where the stressor arises is irrelevant once the cascade is overwhelming to the organism.

      • I’m not surprised you prefer a conversation with a chemist. This is a War of the Researchers going on her of which there are two sides and of which we should be cognizant. One side prefers not to get into cause, but would like to medicate as a solution (big bucks)–case in point–while the other side would like to highlight cause and address prevention–how to treat our children better. Theories of inborn cause are harmful to humans and forestall insight.

    • That’s ridiculous…I knew something was wrong with my son at birth! Had a look of sadness and despair when I looked at him even the nurse commented. And from that point he has had mental issues..depression ..anxiety and he didn’t have time to build shredders as a baby…so that doesn’t is genetic ….he was born that way!

    • Hello. I have been living with a mental illness all my life. It first surfaced as a bedwetting disorder that; I could not stop. It then became voices I heard in the environment. These two conditions both began after two traumatic events in my life. My mother told me I was born with a chemical imbalance because I had two extra fingers (one on the end of each hand).I was diagnosed with schizophrenia when I was 46 before that it was called schizo-affective disorder. I seem unable to do certain activities like sex, exercise, or physical exertion (i.e. sports, shoveling, yard work). I have been able to graduate from college in 2014 with an Associate in Science degree. I am currently working on my B.A. in Psychology. I want to spring into fitness, how?

      • Hey Lawrence, I was reading your post and was struck by all of the things you have been up against. A lot of the problems you mentioned are in my family, but not all in one individual. I’m studying psychology too. I was wondering if you would like to talk. I might have perspective that you have never heard of before that might help you. If you would, my email is [email protected]

  15. The link between depression and biochemistry has been proven. 1) See–they are the experts who also continue gathering the clinical evidence and leading forward, 2) Chris Kresser now acknowledges pyroluria and other genetic/epigenetic vitamin and mineral deficiencies as a root cause of mental health issues. This article is out of date and should be taken down.

  16. All I can say to all this is anti-depressants helped me.I don’t care what anyone says or thinks.I am thankful for never know,one day depression might hit you.I have a great life,
    Wonderful husband,wonderful children.great family and a great God.

      • Mark; If it ‘worked’ for you- great! This does not mean that it ‘works’ (effectively) for everyone. Plus, many others do experience horrible SE’s

  17. Maybe there are people with chemical imbalances and others who are depressed solely due to external factors (nature vs. nurture). Perhaps someone with a chemical imbalance could be a person with a family history of schizophrenia, bipolar disorder, etc. I believe that most people don’t have a chemical imbalance though, and their depression is simply a natural reaction to external stimulus. If I hit you hard enough, the normal response is to feel pain and even cry, and not being cheery under such a stimulus doesn’t make you chemically imbalanced. The problem is that many people don’t even realize how shitty their lives are, so they feel guilty and abnormal for being depressed.

    I can’t recall the source, but I read an article about the prevalence of depression that claimed that the rates of depression are paradoxically higher in cultures where fewer individuals have a genetic predisposition for it. The point is, that even those who are predisposed might never feel depressed if their environment (culture, nurture, etc.) is healthy, whereas more toxic environments result in more people suffering from depression.

    My depression first developed after moving to the US as a teen. I was unable to find much meaning, deep friendships or a strong sense of community here (we got to admit that this is a very individualistic and segregated culture) and that made me depressed, which I had never ever experienced before, and I used to be an extremely happy and upbeat child/teen. My mom wasn’t very understanding of this, so I felt completely alone, whereas in my country I always had a huge support network. Because of this, I’ve always believed that our lifestyle and culture is what is making so many people feel so depressed.

    The US is a beautiful country, so it’s hard to explain. It offers better infrastructure, more comfort, more financial stability, but it lacks warmth, deep friendships, and people seem to live busier, but less satisfying or meaningful lives. For me, finding more friends and meaning in my life is what has helped me the most to recover from depression completely. For several years after recovering I was even thriving and extremely satisfied. Unfortunately, in recent years I’ve gone through hard times again, and since all of my friends except 2 have been immigrants some have already moved away, and I am starting to feel depressed. Hopefully, I can create a new network again, but I find it more challenging in the US than in some other countries.

    And for those who might doubt that I was suffering from “real” depression, I just got to say that having suicidal thoughts, feeling sad (even guilty), and crying on a regular basis for five years straight sure felt like depression to me.

  18. The haters will always hate. Unfortunately, for the big-pharma haters, medication does work for some people. A lot of haters are just misguided, paranoid and jealous.

    AD medication will not work for everyone, but just because it doesn’t work for you doesn’t mean it is the case for others.

    • Starlet, You say we are Jealous, Misguided and Paranoid

      What is it that the medicated with antidepressants are actually jealous of?
      What is the misguided perceptions we all have?
      What is the paranoia you speak of?

      Have you stopped to wonder what makes people hateful concerning these drugs?
      Could it be the lack of evidence of a chemical imbalance and the systematic abuse of the brain and psyche, the hundreds of thousands of people suffering with multiple ADRs (both mental and physical)?

      Please explain in detail how the chemical imbalance theory works, how Norepinephrine, Dopamine and Serotonin are measured and balanced evenly as science `suggests`.

      Haters are gonna hate indeed…. Sounds to me it is you who hates those who are having a hard time on these medications, regardless of having absolutely no knowledge of what you are idly waffling about…. Unless you please return with a sh#t load of information that will put us `haters` in our place!!

  19. Psychiatry is not far removed from the same psuedo-scientific quackery as many natural paths (some are great) that “prescribe” you a homeopathic remedy and send you home. It just isn’t all that science based. But, it absolutely is a physical disease and, for me, antidepressants help. I have a pretty significant family history of mental illness with a cousin with schizophrenia, an aunt with bipolar, an uncle with major depression and a few cousins with anxiety and panic disorder. I have – something – severe generalized anxiety with some depression and panic attacks. And, it’s definitely physical. Stress worsens things, but so does hormones (pregnancy is really rough for me) and an upset digestion really wrecks me. So it isn’t just a mind matter, but I’m not convinced that it is my brain either. When I was little and got sick, I would cry and feel just lousy. It feels exactly the same but with fear, frustration, a racing heart, and anger thrown into the mix. Oh, and forget sleeping no matter how tired you might be. It is definitely physical and debilitating. Maybe if we moved past the chemical imbalance hypothesis, we could start to unravel this for people.

  20. I just want to reiterate & point out a few truths.

    First, a theory is just that….a theory. We all must remember that. For example, the “gene theory” to this day is merely a theory. Now, we KNOW with epigenetics that defective genes don’t “cause” disease, but rather it is the environment it is found in. Why do we constantly put such blind faith in a psychological system (medical model) that propagates theories, but does not heal, change and/or transform the hurting!

    Second, the MIND is NOT an organ. It is NOT the brain…period. This is huge. As marvelous as the brain IS, our minds are far more spectacular. Our minds affect and CAN change our brains. It was demonstrated as far back as the 1800’s and now it has been demonstrated over & over. The brain’s chemical makeup & ways of perceiving the world CAN be altered by the mind.

    This leads to another significant point. The mind is the seat of our feelings, imagination, habits & long term memory. So, when se speak of behavior & emotional “disorders” we are speaking of unconscious strategies of living that the person has developed. I’m NOT speaking of a conscious decision of the will to live in a dysfunctional, destructive or useless way. No! Every behavior has a purpose…period! How can a behavior be a disease?

    Think about it. People don’t wake up one day & say, “I want to be REAL good at being depressed.” (anxious, compulsive, etc.) No! Yet, out of their awareness they developed a “skill” at being depressed & they do it REAL well. Right? Well, if this is true, then it stands to be true that the same mind that created this “useless” way of being is the SAME MIND that can create something totally different; more useful!!! THAT is how creatively genius our minds really are.

    The problem lies in the paradigm we are speaking into. I challenge anyone to do an honest search into the history of the “chemical imbalance” lie. It is tragic. As I always say, “Follow the money!” These issues that people are struggling with HAD to be explained biologically & physiologically in order for the medical industry to hijack it (psychology) for big profits. I might be pissed off, but I am NOT bitter. History simply bears this out.

    Finally, what really breaks my heart is that our current medical model system disempowers people and helps to perpetrate the victim mentality. “It is happening TO me.” I see it all the time in my office. People try hard to sell me on their label & then give me that “deer in the head lights” look when I begin to unfold to them who they REALLY are.
    My 2 Cents

    • No you are wrong – Theories are not “just theories”. That is layspeak. Theories in science are higher than facts. Theories explain facts. Theories are thoroughly tested for error and have been properly peer reviewed and are universally accepted. Theories are not established overnight nor are they refuted easily. They are the most solid pillars of scientific knowledge. There is NO ‘chemical imbalance theory’. Laypeople only speak like that. And with that there are not many theories – Newton laws are linked to gravitational theory and so on. Maybe what you are speaking about are Hypotheses. Which are explanations of phenomenon under investigation. I am sorry but your 2C is just that – two cents.

      • Speak for yourself!!!

        Your given 2 Cents has really been wasted here!!

        If every theory was to explain a fact, everyone who had a theory to explain the anything would be right regardless of being a contradicting theory….

        Theories ARE theories – Facts ARE facts!!

        Rational thinking or otherwise, scientific or otherwise you are being ignorant of the entire issue being debated here and ignoring `the theory of the chemical imbalance itself` – No hypothesis but, theory!. – which has absolutely no fact attached – synthetic disruption yes! (it can cause anything from hypomania to psychosis) that is the problem

        There is no such thing as a natural chemical imbalance causing a diseased mind into depression, anxiety etc – these are emotions not diseases

        Please in all your wisdom explain in full exactly how these drugs work as you seem to think the opposing factors are laymen understanding – we are all ears!!

    • Hi Anthony

      Sorry so long in responding.

      I hear all you are saying and agree with it all.

      Am pro psychology when alongside pscychiatry though but, I totally agree regarding the profit
      Business is business and big pharma is one of the biggest businesses on this planet!!

      I also agree with what you say concerning the mind – its capabilities etc

  21. I disagree with quite a few conclusions in your article. I dont think youve felt what many people with depression, ADD/HD, bipolar and other mental disorders have. I see your basis that there isnt much evidence of a “chemical imbalance” in the mind/body and medications; however these medications do affect the mind and nuerochemicals. Theres no way you can be in these persons’ shoes “, (including myself with ADD), but maybe try some of these medications and drugs and see how they make you feel and (positively) can affect your life.

    • As someone who USED to suffer from depression – and I mean real, chronic, suicidal depression, for literally two thirds of my life (yes, I was diagnosed by a psychiatrist as being “clinically depressed”, and I was given “antidepressants”, which only made me feel detached from reality, not “happy”), I have to say that I am in full agreement with the author of this article. I was told by my “doctor” that I had a “chemical imbalance”, yet – not one single “chemical test” was ever performed on me. He came to this conclusion solely based on my symptoms – the fact that I was depressed.

      Not once did it occur to him that my depression might have stemmed from the multiple problems in my life that I described to him – I was physically and emotionally abused for most of my childhood, my parents separated when I was very young, I felt detached from and unloved by my own family, I had very few friends, was teased and bullied mercilessly, constantly rejected by my peers and potential dating mates… long story short, I was sad and lonely. And angry, angry at my parents for abandoning me, for allowing me to be abused, angry at my peers for rejecting me, angry at the entire world for tossing me aside like I was a useless piece of garbage. And I felt like a useless piece of garbage. I hated myself because everyone else seemed to hate me, I figured the fault was my own. I was a reject, I felt like a reject, I believed I was a reject, I believed that god himself (if there is such a thing) specifically created me as a reject on purpose just to punish me for no apparent reason (perhaps his own sick twisted pleasure). I hated every moment of every single day, I hated everyone, myself particularly. I hated being me, and I wanted to die. Very few things in the world brought me any joy at all… the few things that did were solitary activities, because at least then I could “lose myself” in what I was doing, but ultimately at the end of the day, I still felt very much alone, and I didn’t want to be alone, but I had no choice because nobody would accept me.

      Now, it could be argued that my constantly feeling this way actually CAUSED my brain to alter its chemistry; however, I can say with 99% certainty that some inborn “chemical imbalance” was NOT the CAUSE of my depression. I was depressed because my life SUCKED, for lack of a better word. And if anyone wants to suggest that the reason I was abused and whatnot is because I was born with some kind of mental disorder, they can go stuff it, because I was a smart, happy child. I only began to develop psychological issues after suffering years of abuse. I used to be very expressive, excited and outgoing; I became introverted and developed severe social anxiety after being repeatedly rejected and abused by others. The same way in which a dog who is regularly beaten will cower or even bite when a friendly person attempts to pet it – it is not the dog’s fault, the dog was not born with a “chemical imbalance”. It is a LEARNED behavior.

      My depression – along with many, many, MANY peoples’ depression (no, not all, some are genuine mental / chemical or whatever disorders) – but my depression, and I would wager MOST depression suffered by people is the result of trauma, abuse, other so-called “learned behaviors”, and NOT, in fact, true “chemical imbalances”. IF there is an actual disorder, a chemical imbalance or physical damage of some kind, it could / should be detected via an actual TEST – not just some QUACK’S baseless conclusion based on a person’s symptoms or self-diagnosis. There are methods such as brain scans and whatnot to determine whether or not a person’s illness is caused by actual physical problems, versus psychological “learned behaviors”; any person with even a rudimentary understanding of psychology should understand the difference. To assume that ALL cases of depression are caused by mere chemicals is not only foolish, but potentially dangerous. You would not give blood pressure medication to a patient with perfectly normal blood pressure levels, would you? So WHY is it okay for psychiatrists to “diagnose and prescribe” potentially dangerous medications to people who may not need them, or worse, may respond badly to them? To anyone who doubts this is a valid concern, just Google “dangers of antidepressants”… or hell, just read the possible side effects on your pill bottle.

      Now, to dispute some of the pro-medication detractors here, I will concede a couple of points… one, it is possible that SOME people DO in fact suffer from chemical imbalances. But it’s very important that so-called “doctors” should learn to distinguish the difference before prescribing life altering medications. Two, it is also possible that people whose depression is not actually caused by chemical imbalances, may actually respond well to such medications. That doesn’t, however, necessarily mean that their problems were CAUSED by a chemical imbalance. It could be that the boosted (or inhibited) chemical levels simply made them feel better about their crappy lives, or it could just be a placebo effect. For example: say a person is in extreme physical pain, because they are unknowingly suffering from a disease. That person takes a strong pain killer, say… an opiate based medication… and suddenly feels better. Does that mean that they’re cured? Does that mean that they were simply suffering from an “opiate deficiency”? Of course not, that’s absolutely absurd. That’s about how absurd the “science” behind the “chemical imbalance HYPOTHESIS” (there, I used the correct term) actually is. Yes, the idea of chemical imbalance is a hypothesis, not an actual theory – and it’s a relatively weak one at that. But then, the field of psychiatry has a long track record of making up bullsh- er, excrement, in order to manipulate – I mean, uh, “treat” people (remember lobotomies? electroshock therapy? using “sexual aids” to cure women of “hysteria”? yeah… that’s right, THAT field of psychiatry…. remember, psychiatry is a “soft” science – you might want to look up what that means in terms of its validity). Not that I think researching the inner workings of the mind is a waste of time, quite the contrary – it would be great if modern science was able to explain why everyone thinks and behaves the way that they do. Unfortunately, at least for now, it can’t. And anyone who tries to convince you otherwise is either selling you a lie or has already bought it.

      Oh, and as for my depression – it’s “cured”. Not by drugs or therapy, mind you. It seems my personal issues “magically disappeared” once my life started getting better, and I was able to get away from those negative influences and surround myself with more positive ones. Imagine that! People are depressed when their lives are depressing, and happy when their lives are happy… who would have thought??? (again, as I noted before, this is not the case for ALL people, some people are just depressed for no apparent [or I should say no KNOWN] reason; it’s unfortunate, and I truly hope the flawed psychiatric system can find a way to help these people… even though the task of fully understanding the human psyche of EVERY single different INDIVIDUAL PERSON who all have unique factors impacting the way they think and believe, is a nearly insurmountable task… I guess this is my biggest beef with psychiatry, and the “chemical imbalance hypothesis”… the idea that all people are the same, and that all of their problems are the result of the same root cause, when CLEARLY that is NOT the case, there IS NO COOKIE CUTTER CURE for so-called “mental illnesses”, and I daresay there may NEVER be ONE single one-size-fits-all cure for something as incredibly complex as the HUMAN MIND)…


      • Oh and I do apologize Bill, for my comment appearing as a reply to your comment that you posted nearly a year ago. I meant to post it in the general conversation area, but then it’s also somewhat of a fitting reply to your dismissal of the author’s hypothesis… so I guess you could consider my comment to be a rebuttal to your rebuttal.. no offense at all to your point of view, I’m just offering an opposing opinion, from a person who has suffered from “mental illness” (if you can even call it that… still think it’s kind of silly that someone somewhere arbitrarily decided what constitutes “normal” mental behavior versus abnormal… maybe the crazy people are sane and the sane ones are crazy? LOL.. just food for thought.. the brain is insanely complex and it seems purely subjective for anyone to declare that all human minds are supposed to function exactly the same…)

        But I digress…

  22. Does this article even address the usage of all natural vitamins, minerals, and essential fatty acids? If not, this article means nothing because it only talks about using pharmaceutical medication to correct imbalances in a false manner. Using natural alternatives actually CAN truly correct chemical imbalances, and it has been proven to be very effective at treating a large variety of mental conditions. Read Nutrient Power, by William J. Walsh. It’s a good book.

    • But….. the imbalance explanation is a theory – The widespread belief of mental and emotional issues are caused by a chemical imbalance is wrong – please read beyond the given imbalance theory. A theory is not fact, regardless of whomever has jumped on the bandwagon, that includes nutritionists alike….

      You are right in saying vitamins and certain super foods do boost serotonin and other chemicals naturally and, this they do without damaging the brain – synthetic copies on the other hand do damage the organic everything.

      • Hey Miss Diagnosed! Just wanted to say hi. I haven’t been on here for a while, but I’ve read so many of the comments as they come to me. As always, I so appreciate your comments & your heart!

  23. The brain is an organ like many other organs in the body. Can you name another organ in the body that is incapable of having chemical imbalances? Because the liver, pancrease, and thyroid sure can. If fact all organs can and these imbalances are called disease.

    • You speak of physical organs, any physical organ can become diseased

      The mind, emotion is not physical – being unhappy is not a disease, being angry is not, worrying/anxiety is not – if they all were diseases? hell we all catch the bug, recover, catch it again etc… strange how we only catch it when life aint going right for us though

      There is no chemical imbalance nor disease in emotion

      • Why is it then that many people with seemingly fantastic lives (financial stability, job satisfaction, healthy relationships etc.) often fall victim to depression? Why is that so many people that face considerable and even extreme adversity in life are always optimistic and hopeful? By implying that the mind is separate from the brain, you are essentially saying depression is under a person’s control. If only they could change their mindset, force themselves to put on a pair of rose coloured glasses and start enjoy their wonderful life!!!! No matter if they’re in poverty, barely have enough to eat, have suffered abuse or trauma, if only they could see the light and the good in life?!?! Isn’t there so much of it?!?!


        Now, I am not saying that external factors do not affect biochemistry or homeostasis (because it certainly does, and has been proven time and time again in illnesses that do not relate to CNS) but to believe that a person’s mind and brain are separate entities is completely ludicrous. What does brain damage do to a person? Oh! I know! It changes their MIND. They lose intellectual ability, are prone to mood swings, cannot concentrate as well as they used to, lose social skills and many other abilities people with a healthy brain cannot even comprehend because of the assumption that people choose their thoughts. We can guide our thoughts, we can guide our moods, but we CANNOT force them. By stating that the mind controls the brain, you are dismissing a thousand external factors that affect the mind/brain/body (which are truly one) and blaming the victim.

        I am sure many people have healed from “depression” because they’ve changed their mindset by conscious will, but in their case their body was likely working perfectly fine until an external factor gave a shock to their system (divorce, loss of job, death of a loved one) but as soon as they were able to think things through, rationalise the event and have the rest of their life in order with adequate emotional support, the “depression” lifted. Other people are not able to find relief as easily because as much as they try, the depression is NOT under their control. As the author states, there is no definitive answer as to what causes depression, there are only HINTS and it is likely that there are many interrelated factors such as genetics, environment, nutrition, social relationship, lifestyle and TO AN EXTENT, mindset.

        As we do not have the ability to probe thoroughly through people’s brains for data collection about how well their brains are working, all we can use is anecdotal and minimal observational data in order to determine that someone is indeed depressed. Many people who are diagnosed as depressed, are not actually depressed and with a few lifestyle changes, they “recover”. Although I can not definitely say the mind and brain are the same as I don’t know, nobody knows for sure, all scientific evidence so far points to yes.

        • What scientific evidence points to the brain, body and mind being the same thing?

          What scientific evidence is there to solidify emotion other than the extremely flawed theory of chemical imbalance? (Which somehow neglects every other emotion evidence – Love, Hate, Joy, Anger)
          Ask yourself how sadness can be measured but, nothing else can be.

          Are you defined by your intellect? Are you defined by your physique?

          Or you defined by your mentally emotional being?

          What makes you the individual you are? Your Mind, Body or Academic skills?

          Please provide the evidence also of your statement the richer and preferred job status results in depression.

          Try looking into both the history of and today`s mental institutions, pharma archives and current mental health case files!!

          • I will say right off the bat that I am an RN but I use only natural treatments myself save for the occasional antibiotic. I home birthed my children, I do not vaccinate, vegetarian…all the typical crunchy parenting style stuff. However…I suddenly became very ill when I turned 18. I became severely fatigued, muscle weakness and twitches, nocturnal urine incontinence, severe memory loss, panic attacks and would cry for hours for no reason. I played varsity in highschool, had been nominated as the homecoming queen, had amazing friends, ect. My life became nothing but complete terrorizing at times. I had panic attacks at school, home, in bed. Didn’t matter. Fast forward TWELVE years and I find out it is Lyme disease and Babesia infection. My brain was inflamed big time from the toxins in the bacteria and the parasite Babesia was literally eating my iron stores among other things.
            I can without a doubt assure you my ‘mental’ issues were caused by a biological force. With treatment for Lyme and co infections, suddenly I felt as I had at age 17 again. And after treatment I found out my pathologically lying husband had cheated badly and molested our child. It was horrible but I had no panic attacks or depression even with finding out what a scumbag he was. If anxiety was situational I surely would have gone through the roof during the police interrogation of him, divorce and all the horrible horrible things I dealt with. Not once did I have a panic attack. So no way is mental anxiety and depression simply a situational issue. Pathogens can screw up with brain whether through causing encephalitis (as in my case), screwing with neurotransmitters, ect.

      • How do you explain babies and toddlers being depressed at a young age that have no life experience with stressers! If it’s genetic then outside influences had no bearing on the explanation of my son telling me he knew from 3 or 4 yrs old not wanting to be alive! Tired of hearing its life experiences and stressers that just cause it…maybe for older people sure..but that’s not a genetically depressed person.

  24. You are convincing in your argument that depression is not the simple neurotransmitter imbalance that the drug company would have us believe.

    You are also saying that depression is not an imbalance of neurotransmitters and therefore it is not physical. Besides neurotransmitters, don’t you think that there are other physical issues that are at the root of mental illnesses?

    Read “Nutrient Power: heal your biochemistry and heal your brain” by Dr William J Walsh.

    • I actually am glad you also recommended that book which I did so in my previous comment. It talks about how epigenetics play a huge role in a lot of mental conditions. This article does not address epigenetics and the methylation cycle which is much newer science than pharmaceutical medication which only can mimics certain neurotransmitters instead of correcting the actual imbalances.

  25. Hi Chris, wonderful website.
    I wanted some advice on some events that have been happening to me.
    I was diagnosed with bipolar type 1 10 years ago….I have been on anti psychotics for 10 years as well as with lithium.
    This year…I had several symptoms that my doctor blamed for me being bipolar not the pills. Extreme memory loss, a hard time getting things, and mostly just horrible apathy and emotional impairment. I trusted my doctor and pills for a decade only to see such strange changes. I found dr Breggins on you tube and it turns out it was the pills. I want to do a withdrawal but I`m noy sure if that`s a sure psychosis or severe depression. I also am anxious to know if the brain can be recovered and in what ways?? I don`t want to be dead and alive or numb for the rest of my life.
    Not a lot of people have an answer on brain recovery.

    • Diana, my friend and her mother are both diagnosed with bipolar. But both different types. She had stopped taking her medication and switched to an all natural medication. she said it really helped, not sure if that helps at all. But worth looking into.

    • This man is wrong…Plain and simple. I have nothing but contempt for the drug companies.. Monsters or worse. Listen to me please. It’s difficult… But you don’t need any of those dangerous drugs. Sadly we can not trust our doctors anymore as the desire for a good kick back beats out prescribing the correct options for patients. It’s a fight every day… but once you get in the swing of things of knowing how to make yourself the person you want to be… You’ll never go back to trusting anyone with your mental health. Remember, you know yourself better then any doctor will ever know you.. You can do this.. 🙂 Gabi

    • Diana, research has shown that while our body has limited regenerative potential, our brain has unlimited potential ! Remarkable recoveries are possible when eating clean food for your body type that combined with healing effect of high intensity exercise, & quality restorative sleep along with strategic supplementation can provide a healthy hormonal, neurotransmitter environment. Of course lets not leave out the all important aspect these docs never touch on in traditional medicine. You have power to choose your thoughts moment to moment, and be in charge of the emotions which follow those thoughts. words are containers of power also and are huge part of stress reduction, healthy nervous system! Most of us have settled into a normal life of complaining about everything because everyone does it and government, society have told us when we complain we get our way. In reality, when we get aggressive with our thought life and what we speak out in the universe, phenomenal change can begin to take place, little by little. No medicine will ever replace the human spirit and simple power to choose “belief” over fear/worry.

  26. When I was 18 years old, I was ‘depressed’ and suicidal and was diagnosed with clinical depression. I was prescribed Zoloft. I took one read at the side effects and decided there and then that I’d take my chances without it. I saw the therapist for a few months and lied that I was taking the medication and I was getting better. The truth was that I was just sad about being victimized at school and a break up in a relationship and was just really hormonal and angst as a teen. Yet this doctor thought it fine to diagnose a teenager with clinical depression and prescribe a dangerous drug without looking at all factors. Years later I’ve come to realize that I still do experience emotional lows and if anything is stressful in my life it becomes that much worse. I’ve realized however that it coincides with my period and premenstrual symptoms. My hormones. I recognize the cause as my bodies fluctuating hormones and know that it will pass. I do think it’s more probable that chemical/hormonal and other physiological imbalances can cause depression, anxiety etc but I’m not of the belief that that is the cause of every single case of depression and that anti-depressants is the answer for everything. I also think a lot of people are varying degrees of “sad” for reasons known to them but it’s easier to blame a physical cause than look at the true psychological cause and possible physiological cause. Perhaps it’s just that time of the month or low self esteem or the junk you’re eating. I’d much rather look at the problem holistically than jump to pharmaceuticals as a panacea.

    • Your comments are very honest and insightful. I agree with you in that some depressive type illnesses have a neurochemical, blood flow, or structural anomaly with corresponding abnormal endocrine (or neuroendocrine) functioning. I also agree that for many (majority) of people depression is psychological in nature and that no drug will ever be an antidepressant because in these cases it is an emotional, perception, thought problem that increases due to rumination.

    • There is some evidence that Hitler had Parkinson’s.

      It sounds as if you have a really ugly attitude toward the mentally ill.

  27. Your article is completely contradictory. You state in various places that brain neurotransmitters cannot be accurately measured. Yet in other places you mention the levels in relation to a diagnosis – for instance “Some depressed patients actually have abnormally high levels of serotonin and norepinephrine” If neurotransmitter levels cannot be measured then arguing depression is not related to these is equally silly as saying it is.

  28. Biochemical imbalances does not necessarily occur in the brain, but throughout the whole body. If the body lacks the necessary energy called adenosine triphosphate, derived mainly from glucose in the food, it cannot convert tryptophan found in food into serotonin. Studies have show that people who suffer from insulin resistance – either diabetic or pre-diabetic – have unstable blood sugar levels affecting the brain. When deprived of a steady amount of glucose, the brain will trigger the release of stress hormone – adrenaline and/or cortisol – which form the symptoms of uncontrollable mood disorders. Please read: Drug Addiction is a Nutritional Disorder

  29. Placebos have been shown to be effective in treating depression however it is ‘unethical’ to give a placebo. On the other hand, dangerous drugs with scant evidence of efficacy flood the legal drug market.

  30. I wanted to let you guys know about a group called TrueHope, which has developed nutritional support for both drug-withdrawal and to help fix any nutritional deficiencies. They have helped over 200,000 people live pill-free lives and feel A LOT better. They also have done several clinic trials using their nutrition on people labelled with depression, anxiety, PTSD etc. with wonderful results. check them out at

    • I ended up in another psych ER last month for suicidal thoughts (mostly by personal matters) but a really good psychiatrist mentioned that program to me and the fact that nutrition has a lot to do with it.

      If people is the middle ages were able to get by without them, why can’t we? Don’t get me wrong though, I take Zoloft and Lithium for MDD and Bipolar II, and I’m finally done with my suicidal thoughts.
      Thank you

  31. You are correct but missing the information on why.

    Fifty years ago engineers discovered a previously unknown problem with human physiology when it caused mental breaks for office workers. The cubicle was designed to stop believed-harmless episodes of psychotic-like confusion by 1968.

    Understand, they didn’t cause the problem they created a situation that showed it existed. It has always existed. Stories of ‘spontaneous remissions’ in scholarly books on the history of mental illness show, unrealized by the authors, that Subliminal Distraction filled mad houses in London 400 years ago. (There were no drugs or treatments 400 years ago. All recoveries were spontaneous remissions.)

    Today computers require the same level of mental investment as office workers must use so the mental break causing design mistake can be made almost anywhere.

    Everyone aware of it believes the problem only happens in incorrectly designed large, high traffic, crowded business offices. It’s a problem of human physiology not offices.

    Light exposure, too little to cause the full mental break will cause symptoms of fear, panic, anxiety, depression, and eventually thoughts of suicide.

    The problem arises from the suppression of the vision startle reflex in a location with detectable movement in peripheral vision. That causes repeating subliminal failed attempts to execute the vision startle reflex. Visit VisionAndPsychosis.Net for the full explanation of the problem.

    Because this is a normal feature of everyone’s physiology of sight I can produce depression with a physical experiment. … Yes I am saying I can cause psychiatric symptoms, depression, essentially on command with enough Subliminal Distraction exposure. … Anyone who can perform my demonstration of subliminal sight and habituation in peripheral vision can successfully perform the experiment. The demonstration shows the ability to suppress the vision startle reflex. (Link at the top of my Home page.)

    I do not publish the experiment on site for obvious reasons. If allowed to run too long it would cause the full mental break. I believe this is the long sought cause of college suicides, when students manage to accidentally create the design mistake and exposure peaks during times of intense study.

    This phenomenon explains much of the “mystery” of mental illness including why mental illness often starts in late adolescence and why the drugs don’t work.

    Psychiatrists are unaware engineers ever found or solved the problem and are mistaking chronic Subliminal Distraction outcomes for mental illness. No one screens for it before beginning treatment. (See my wife’s hospital record on site, her episode was mistaken for schizophrenia.)

    When the episode spontaneously remits after exposure stops the doctor and the subject believe that drugs or talk therapy cured their psychosis.

    There is no treatment possible. The episode will remit when exposure is stopped if done quickly enough. There may be no possible help for long term exposure victims. But depressive episodes or panic attacks would stop even for the severely mentally disabled Subliminal Distraction victims. But it is possible they would never recover the mental capacity they once had.

    Visit VisionAndPsychosis.Net or send an email for the instructions, precautions, and warning.

    You can use the Wayback Machine to show I began my project in the fall of 2002. There is a link to a forum post, 2002, on the bottom of my home page where I was accused of being an attorney trying to get information for a lawsuit. That post also shows when I began. Designers and engineers do not want to discuss the problem. No one wants to make the career ending mistake of revealing information that starts a flood of lawsuits against customers or employers.

  32. Chris,
    Thank you so so much for writing this! I have at least 6 family members that have been taking psychotropic medications for depression and other problems for decades, and they all continue to go through cycles of worsening; never getting better. They refuse to listen to me talk about how the medications are actually blocking them from healing and what they need to do in order to obtain permanent healing.
    I know that it took a lot of time and work for you to gather all the data and historical information in order to put it into one article and I greatly appreciate it; for I spent months searching for the facts about psychotropic medications in order to support the Truth that “chemical imbalance” is NOT the cause of emotional suffering nor dysfunction/”mental illness”/sin. In addition, psychotropic medications actually block permanent healing, not just temporary block feeling bad. I have sent your article to my mother in the hopes that my family will learn the Truth.
    From my experiences as a counselor, many people are unfortunately afraid to stop their medications because they are afraid of suffering, and even more afraid of suffering even more, because they believe lies about what is emotional suffering, what causes emotional suffering, and how to obtain healing for it. I know that fear is always the absence of Love (for ourselves and for others) caused by lies we believe, but few people know and understand this. All my clients for the 10 years that I was in private practice, who were not afraid, were able to permanently stop their psychotropic medications after I taught them the Truth about the psychotropic medications and how to obtain permanent healing for all so called “mental illness”.
    Anyone who has ever taken psychotropic medications knows that they do not heal anything and we always grow worse and have to increase the dosage and/or change the medications, making someone else very rich. As we have heard, the definition of insanity is doing the same thing over and over wanting different results.
    I pray to Jesus Christ our God that everyone will want these Truths that you have written. God bless you and your family.
    Thank you,

  33. This article hits the nail right on the head.

    I suffered from depression for 11 years. It got so bad that at one point I wrote a letter to myself that I would try ANYTHING for one year and if I was still depressed, I would kill myself.

    First thing I tried was antidepressants.

    That didn’t go over so well.

    I then had problems getting OFF the antidepressants, which is a whole other story.

    But, what is interesting, is I did use amino acids and supplements to “boost neurotransmitters” in my brain. With B Vitamins and Tryptophan, I was able to get off my antidepressant in a few weeks.

    I used amino acids for a long time and I definitely felt the effects. Not only that, but hundreds of people that I have talked to have felt positive effects as well.

    Now I don’t take any amino acids. Only magnesium some nights, fish oil, and B Vitamins. It got to the point where my brain was ok and I was restored back into balance. If I do get really bad, I can take a niacin or take tryptophan.

    My question is this: When a person is so run down from chronic depression, anxiety, and the stress this produces, why have I seen such dramatic results using supplements and foods that “boost” these neurotransmitters?

    What about the connection with Vitamin B3 and B6 in the synthesis of serotonin?

    Why did I feel such a dramatic effect with taking Tryptophan?

    There is certainly a giant myth out there and antidepressants are WAY too commonly prescribed. However, I have to thank the results of nutrient therapy and using supplements to get my “brain back in balance” to my success.

    As you can see, I am still alive.

  34. “Reducing levels of norepinephrine, serotonin and dopamine does not actually produce depression in humans, even though it appeared to do so in animals.””

    As someone with a background in animal research, this bothered me. The reason we use animals for testing, Chris, is because they have a lot of the same biochemical pathways as us humans. Often when a drug is first introduced, clinical trials on humans are considered too risky and unethical. This is why we rely on results from homologous organisms, to understand the effects of these drugs. I’m positive that if (and when) large scale clinical trials are conducted on humans, to test the association between depression and neurochemical imbalance, you will see an association in humans as well.

    Thanks again for the informative article. The legitimacy of neurochemical treatment is indeed controversial. Overgeneralizing and quote-mining however is only likely to create further confusion, especially for those that urgently need help.

    • Animal testing is worthless. For instance:

      Dogs and cats don’t get poison ivy. The active ingredient, urushiol, is highly allergenic to most humans and in primates in general. Applying a product to animals’ skin is not a valid test.

      Many years ago I read in a mycology book that in the old days folks used to test wild mushrooms on their dogs. I’m not finding anything about it online. I did find out that some mushrooms are poisonous to dogs but not cats. Trying a food on animals is not a valid test.

      In 2006, Six clinical drug trial participants suffered violent reactions to TGN1412, a new immune system boosting drug. The subjects were only given the equivalent of 1/500th the safe dose for “non-human primates.” The test subjects suffered searing pain and multiple organ failure within a few hours. The drug had been tested successfully in non-human primates, macaques. Giving a drug to animals is not a valid test.

      Many substances that don’t bother us are harmful to dogs and cats. Aspirin, lilies, onions… the list goes on and on. I submit that hundreds of lifesaving drugs never make it past animal testing.

  35. I did not read the entire article but off the bat, there was something I wanted to clarify.

    Your claim that ‘drugs that raise serotonin like amphetamines do not alleviate depression’ is over-generalized and incorrect. Amphetamines are known to increase dopamine levels by inhibiting reuptake. Chronically high dopamine levels cause symptoms like insomnia, and poor appetite. Serotonin is a neurotransmitter known to be produced during sleep. It is derived from amino acids like theanine and tryptophan.
    You see, when an individual is chronically depleted of proper sleep, and or essential amino acids such as tryptophan (as often caused by amphetamine use), serotonin levels actually decrease in the brain. This inturn causes symptoms like depression, anxiety and aggressiveness.

    I know this because I am actually prescribed amphetamines to treat attention deficit. In addition, I have a degree in nutritional sciences

  36. MAA

    I cant find your post but, it came through as an email…

    No one has the answers to cure feelings, but one thing is for sure, drugging people and messing about with their brains is far from any answer, regardless of the many who claim these drugs work, the truth and glaring fact is, many, many more claim they do not and it is those people who are overlooked as is also their being overlooked that is also swept under the carpet.

    No one can tell you how you feel nor how to `get over it` any mentally charged problems are individual to you and only you can identify them and work towards alleviating them. – which of course is easier said than done.
    Common sense in many cases deems environment and situation, when did you start feeling this way?, did a situation trigger these feelings?, do you feel better at certain times?, it sounds clinical but, it isnt.
    To seek the reason is to hopefully identify and work on, there really is no other way.

    I am happy to chat with you any time

  37. I have had clinical depression My entire 60 years , It is genetic – GrandMa had it and so did My Mother then I passed it down to My Daughter.

    Neurochemical imbalances are real although it is true that their is NO known way in science to test the actual neurochemicals in the human brain. I worked in the medical field for 35 years and well verses in the human sciences.

    I have looked at both sides of treatment that is medication and natural . Amino acids are the building blocks of all neurochemicals and I do believe that to varying degrees eating certain foods can change a persons mood. Been there done , I have experimented on Myself for decades.

    Exercise is also beneficial as it raised natural endorphins created in Our brains. I strongly suggest that anyone suffering from depression etc should do themselves a favor and read all the many articles on depression and neurochemistry then judge for themsevles.

    My now retired spychologist use to say the hardest thing to accomplish is to change the way We think. Again been there done that and yes it was most difficult. In My opinion genetics play a roll in mental illness and I believe from personal experience that certain foods and excersise wtih a touch of cognitive behaviour will help to balance neurochemicals which I stronly believe become imbalanced.

    Surf the web and read all the articles You have nothing to lose and its free.

  38. Hi,
    My name is Rebecca, having suffered from major anxiety in my life. I would like to say this. I have taken SSRi’s which helped me.

    I attended weekly Gestalt psychotherapy for 15 years.

    Also I have to agree with Kathleen DeMaisons when I have tried to eat low carb I do become a little anxious, as soon as I stop low carbing I feel fine again.

    I believe it is irresponsible to completely write drug therapy off. I understand you are saying it ruins some peoples lives, however it also saves some peoples lives!

    Some people only need therapy or hypnosis.

    However for me the combination of drugs, diet and therapy was the best combination.


  39. Hi Chris,
    I am not a doctor so can only share what has happened to me. I had a cocaine overdose at age 23. The doctor that saw me told me that do to this, there was a chemical imbalance in my brain that caused me to not be able to sleep. So at 23, I was started on a SSRI anti-depressant. Thru the years, anger turned to rages and every so often the doc would change my medication to a different anti-depressant. I would go into withdrawals and then the “new type” would seem to work again. It was the same spin that Miss Diagnosed described repeated over and over in my life. The rages continued…had no idea why.
    I am now 57 years old. I have been on these pills for 34 years. I moved down to Panama 3 years ago. The doctors down here are questionable to say the least. Since the scripts in North America cannot be gotten down here, my husband and I had to piecemeal my drug program to come the closest we could to N. Americas.
    The rages grew in size and number until I was suicidal and had thoughts of killing others. This scared me half to death and I came to a place where I could not trust myself. The picture that came to mind was hallucinated that the devil was snapping at me to consume me.
    The next morning, my husband discovered your website. He was afraid that I would not be willing to let the anti-depressants go because then I would become even more depressed. But I believed that what you were saying was too true. Since I was presently on a non addictive one called Stablon (even the name of it sounds appealing…) I stopped them and for the first time in 34 years, I tried life without an anti-depressant.
    Oh my gosh! The rages left. I was in peace inside and did not have that feeling that something was not right in me. Today I am free of these pills and the people that lied to me to make a profit. I think that back then the doctors probably really believed that they work but never the less they robbed 34 years of my life from me.
    At this time, I believe that the pills themselves caused the problem. I know that some will argue with me over this but the proof to me was the peace that flooded me shortly afterwards. I have dealt with the withdrawls of other SSRIs and they truly are a nightmare to come off of and only under a doctors care. The withdrawls will pass and you will see the world differently. We would never have questioned this if it was not for your website. A huge thank you for a new life for me, Chris! At 57, I am just beginning to live in sanity. Parents, raise your children to know that sometimes life sucks and sometimes it doesn’t. It is only the rhythm of life and to allow them to ebb and flow as part of the package that life provides. Only then, can they quit searching for a “happy pill” that will only destroy them and begin to live on life’s terms and not their own.
    God bless the ones that are brave enough to tell their doctors NO MORE. Funny that the Big Pharmas do not push their poison on 3rd world people that have no money but only on the 1st world people that can afford to buy it. If they were that concerned about our health, they would equally market the distribution. Once again, follow the money trail.
    Thank you for listening to my take on this subject. I would have never questioned the pills that were suppose to make me happy as being the source of anger and destructive thoughts to myself and others. I haven’t had an angry thought since I quit them. Not even one. Heartbeat is down, blood pressure is down. I feel like I have been rescued, Chris. Come take a vacation in Panama. You will find me cool, calm and collected under a Papaya tree.
    India Sorenson Panama, Central America

    • Awesome story India! I could relate to what you said because my mother went through something similar and when she got off the meds she was fine. All of the symptoms of her “mental illness” were gone. She had been taking those pills for over 30 years and she was miserable. Somehow she weened herself off of them and suddenly she was bright, funny, witty, energetic and most importantly she was happy.


    I just hate seeing stuff like this.

    There is massive evidence that that low serotonin levels are a common consequence of modern living. The lifestyles and dietary practices of many people living in this stress-filled era results in lowered levels of serotonin within the brain. As a result, many people are overweight, crave sugar and other carbohydrates, experience bouts of depression, get frequent headaches, and have vague muscle aches and pain. All of these maladies are correctable by raising brain serotonin levels. The primary therapeutic applications for 5-HTP are low serotonin states listed below. Conditions associated with low serotonin levels helped by 5-HTP Depression Obesity Carbohydrate craving Bulimia Insomnia Narcolepsy Sleep apnea Migraine headaches Tension headaches Chronic daily headaches Premenstrual syndrome Fibromyalgia

  41. I was placed on Deprokote and Zoloft… After less then 3 months of taking them I went Cold turkey. I realize now it was not the smartest thing. But I did manage to get off the peels. I am now about 3 months free, and my feelings, emotions and excitement for life is comming back. I do feel that God, Excercise, and support, also vitamins and eating good. Staying away from sugars has got my body to return to regular use.. If any one is going through the same please write back to share some information back to me..

  42. I support your theory, but would just like to ask you a question. One person told me that they had one type of anti-depressants and they helped them with their mood and when they changed the anti-depressants to another type they began to feel more depressed again. And the same happened to another friend of mine who said that he switched a lot of anti-depressants before he found the right ones that really helped him. How is this possible?

    • I am not sure to whom “Nick’s” question is directed, and my standard policy online is to reply only to fully signed comments or questions. However, I will say that it is not at all uncommon for depressed patients to have a worsening or relapse of their depression when they discontinue one antidepressant (AD) and/or start another. Each AD has somewhat different chemical properties, and people tend to have varying responsiveness to specific agents. Also, sometimes there is a “coverage gap” during the switch-over that leaves some people vulnerable to a relapse.

      But there are also many other variables in depression that may have nothing to do with the medication; for example, someone “gets worse” after switching from one AD to another–but this happens at the same time he or she is entering into divorce procedures or loses a job. This is why psychiatrists stress the “bio-psycho-social” approach to understanding mental illnesses. –Ronald Pies MD

      Note: For more on this, see

      • Dr. Pies, respectfully, whether any ORGANIZATION or ACADEMIC psychiatrist promoted the chemical imbalance theory, I personally have heard it from many mainstream (as in major hospital) psychiatrists, as have family members and friends. If nothing else, academic and institutional psychiatry have not done enough to debunk it the theory, leaving it to more radical elements to do so, despite knowing that the theory has been used to justify millions of prescriptions.

        • I am breaking with my long-standing policy of replying only to fully signed comments, because I think this issue is so important.

          I have no doubt that some patients heard the phrase “chemical imbalance” from some hospital-based psychiatrists, and I agree that more could have been done by those of us with academic and research experience to “debunk” this notion. But too many critics constantly claim that “psychiatry” endorsed the “chemical imbalance theory” when this was simply never the case–if, by “psychiatry”, we mean the profession as a whole.

          The original developers of the biogenic amine hypothesis themselves were among the early “debunkers” of any simplistic chemical imbalance theory. Thus, psychiatrist Joseph Schildkraut and neuroscientist Seymour Kety wrote in 1967:

          “Whereas specific genetic factors may be of importance in the etiology of some, and possibly all, depressions, it is equally conceivable that early experiences of the infant or child may cause enduring biochemical changes, and that these may predispose some individuals to depressions in adulthood. It is not likely that changes in the metabolism of the biogenic amines alone will account for the complex phenomena of normal or pathological affect.”

          Simply put, they were saying that mood problems are not just the result of abnormal brain chemistry! This was also the position of most responsible psychiatrists in academic and professional organizations, and in textbooks of psychiatry.

          Finally, when prescriptions are written for mood disorders or other serious psychiatric conditions, there is no need to “justify” them based on a theory of brain chemistry. The prescription is justified because the patient is suffering and often incapacitated, and there is good reason to believe the medication will help. For generations, aspirin was prescribed to relieve pain without doctors having a clue as to how it actually worked!

          Yes, psychiatrists could have done more to explain the nuances of treatment to their patients, using the bio-psycho-social approach most of us have always endorsed. But there never was a “chemical imbalance theory” put forward in a concerted way by the profession as a whole–and critics would do well to drop this canard and move on.

          Ronald Pies MD

          • Thanks for your reply and I have signed this with my full name (I am from Newton, MA), it was just habit that led me to use an initial. I think we are largely on the same page and I appreciate your candor. I do wonder, though, re your statement about there being reason to believe the drugs will help, do you disagree with the recent body of writings (e.g.Iriving Kirsch and Joanna Moncrief and Marcia Angell) which as I understand them suggest that except perhaps for the severely depressed, SSRIs don’t really work any better than placebos? I don’t have the scientific background to evaluate those claims, although given my admitted biases I did nonetheless find them appealing.

            • Hi, Mr. Spaeth,

              I very much appreciate your providing your full name–it is one of my biggest gripes about the internet, that people can engage in criticism without taking personal responsibility–so thanks!

              To answer your question in brief: in my view, Kirsch, Moncrieff, and Angell are mostly wrong, as regards anti- depressants. (And Angell is deeply wrong in her views on psychiatric diagnosis).

              While antidepressants (SSRIs, SNRIs, etc.) are not robustly effective agents, they are certainly superior to placebo for the treatment of acute, moderate-to-severe major depression. As the condition slides farther down the severity curve toward “normal sadness”, the drug-placebo difference becomes less pronounced, as one would expect–these are not “anti-sadness pills” or “happy pills.” For more on all this, you might take a look at the studies below, and the long paper I did on this topic, also cited.

              Thanks for your comment and take care down the road in Newton!

              Best regards,
              Ron Pies MD

              1.Stewart et al analyzed six placebo-controlled anti- depressant studies of patients with nonsevere MDD (Hamilton Depression Score <23) and found that “mild-moderate MDD can benefit from antidepressants,” with the NNT (number needed to treat) in the range of 3 to 8 (NNT<10 is considered clinically significant).
              2. In a re-analysis of the United States Food and Drug Administration database studies previously analyzed by Kirsch et al, Vöhringer and Ghaemib concluded that antidepressant benefit is seen not only in severe depression but also in moderate (though not mild) depression.

              1. Stewart JA, Deliyannides DA, Hellerstein DJ, McGrath PJ, Stewart JW. Can people with nonsevere major depression benefit from antidepressant medication? J Clin Psychiatry. 2012 Apr;73(4):518-25. Epub 2011 Dec 27.]

              2. Vöhringer PA, Ghaemi SN. Solving the antidepressant efficacy question: effect sizes in major depressive disorder. Clin Ther. 2011 Dec;33(12):B49-61. Epub 2011 Dec 2.


              • Dr. Pies, thank you for your reply and for your very informative and balanced article. While my personal experiences with medications do bias me against them, I nonetheless can appreciate your perspective and insight and certainly this is an article anyone interested in the debate should read. I am frankly surprised I had not seen it before as I have read quite a bit in this area. It can be very frustrating to the layperson ( and, I am sure, the doctor) that there are so many complexities instead of simple, objective truths in medicine. As we know, data can be spun many ways, so it’s hard sometimes even to trust clinical trials or meta-analyses (as you point out re the re-examination of the raw data examined by Kirsch).

                W/r/t the point in your article re ADs being overprescribed in some settings, I must say that it really bothers me that my daughter, who at most has very mild situational depression, can walk into psychiatrists’ offices in upscale communities where presumably one is seeing very well-qualified doctors, and come out in one appointment with prescriptions for various psych meds. It should not work that way, in my view.

  43. There is indeed an “emperor with no clothes” in this story, Mr. Kesser, but it is not the field of psychiatry. No responsible academic psychiatrist, psychiatric organization, or textbook ever spouted the sort of nonsense that has become known as the “chemical imbalance theory” of mental illness. (Readers: beware of “science writers” who can’t explain the difference between a hypothesis and a theory).

    To the extent the “chemical imbalance” notion became part of the popular culture, it was owing to distorted versions of the catecholamine hypothesis [see link] appearing in drug company ads, in pop psychology magazines, and now, on uninformed websites and blogs.

    The paradigm most characteristic of American psychiatry from the 1980s to the present has been the “bio-psycho-social model” (BPSM) developed by Dr. George Engel. This stresses the complex interaction among biological, psychological and social causes, in bringing about mental illnesses such as schizophrenia or bipolar disorder.

    In their 2005 statement to the general public, the American Psychiatric Association acknowledged that the precise causes of mental illnesses are as yet unknown– not that mental illnesses are caused by “chemical imbalances.” Sadly, this albatross has been hung around psychiatry’s neck–it is time to remove it and move on. There is much suffering that needs to be addressed, and most psychiatrists understand that a holistic, bio-psycho-social approach is required to address it.

    Ronald Pies MD

  44. Alternative medicine is just as guilty of perpetuating false treatments based on neurotransmitter imbalance myths as mainstream medicine. Look at some of the absurd surveys many practitioners use all starting with Julia Ross’s “The Mood Cure” to see if serotonin, gaba, or dopamine are your “issue.” And with the recent obsession with methylation it’s all coming back into play again, as the theory du jour is now that methylation cycle SNPs somehow result in inadequate neurotransmitter production. Uh, evidence please?

    • And I should add that these surveys are often supplemented by absolutely unproven urine tests allegedly measuring neurotransmitter levels, and other unproven tests supposedly yielding “markers” of neurotransmitter levels. And of course the treatments are 5htp, amino acids, and all sorts of other unproven supplements. I have seen this over and over again in personal experience, including from MDs. It’s ironic to me that alternative medicine, which so decries drugs, bases treatments on the same demonstrably false paradigm.

      • You ask a reasonable and complex question, which I think would best be answered by a knowledgable and caring psychiatrist or other MD who specializes in addiction medicine. The answer will likely differ depending on which opiate/s you are/were using, time since last use, whether or not you are currently on an antidepressant, which one/s, for how long, your response, and your reactions to prior antidepressants, if any. It will be important to choose your doctor carefully. Doctors, like everyone else, come from homo sapiens, and not from any angelic race. Blessings to you on your journey.

  45. I’ve been searching for someone knowledgeable to ask a question i have concerning heavy illegal drug use and Serotonin. From what I’ve read I might be able to find an answer to my question here. My question is this, is it possible that after thirty years of heavy drug use, mostly opiates, would that cause the body to stop making serotonin on it’s own? If so, is there any way to get the body back on track to making it on it’s own or will the drug user have to always rely on anti-depressants?

    • Hi Doug.

      The body will never quit producing serotonin in as much as it will never quit producing melatonin, norepinephrine nor dopamine..

      Are you on antidepressants now or street drugs?

      Years of substance abuse (whether street drugs or medicinal) will take its toll eventually and damage the natural healthy cycle and recycle of these otherwise organically produced brain chemicals.

      The problem you now have (if dependent on, or addicted to seratonin producing chemicals) is getting back to the organically producing nature of these chemicals.

      From what I have learned in studying these drugs is, The longer you are on them, the longer it takes to come off.

      For me it was 2001 – 2009, then a further two and a half years of weaning off. Those who have taken them for, say a year, the time taken to come off will not be as long, although different people and their pain threshold will differ so no one can be put into any scientific graph or chart as to exactly how long it will take.

      It also depends on dosage, my dose began at 75mg daily, within a year it was 150mg and eventually became over 300mg – Today, 75mg is considered too high a dose to begin with.

      My reduction process was done via liquid doses and they were a god send to a degree, as it managed me mls at a time (too big a dose drop is both dangerous and brutal to the system, causes psychosis and much more).

      You do not have to rely on these drugs forever, not if you are prepared not to. But, you do have to work hard to come off and it takes time, stamina and willpower. – Include the family in all decisions you take because they will also be affected and you will need support.

      Thirty years of damage to repair is not going to be easy but, it is indeed possible.

      Please think about reading Peter Breggin (esp Medication Madness) and read David Healy ( these guys are experts in the field of pharmapsychology and know exactly how medication and street drugs are abusing the brain and body, the dependence trauma and withdrawal dangers
      – They both include patient testimonials in their research (which is the real scientific evidence) and are both non judgemental concerning street drug use.

      Always do your own research and go at your own pace, you will need a medical professional to prescribe liquid doses but, if you go it alone without one, just go slow and research, research, research throughout (hearing other peoples stories of success is truly a way forward and powerful enough to determinate and justify your struggle).

      Please come back and let us know how you are getting on, I will always respond.

  46. To Phil Pulve,

    Your comment came through to my email but, I cannot find it here on the site.

    You say you have run out of Lexapro, please go and see a medical professional asap, and please check out and type in Lexapro.

    You need see a medical professional asap because stopping any snri / ssri abruptly is extremely dangerous, can cause psychotic outbreaks and many more symptomatic dangers.

    There may be a way of obtaining the drug from a medical professional and paying later – It took me 2.5 years to be weaned off of Venlafaxine via small reductions of liquid doses.

    You ask why, you feel Lexapro is working? I cannot speak for you, only myself (and thousands of other Doctor and patient testimonials) that when a patient is on the drug they are conditioned to believe it is working, it is only when free of it they know otherwise.

    Also, when, like us both, you are switched to another drug and the withdrawal kicks in you believe those symptoms are your actual depressive state – going back on the original takes the withdrawal away and you believe again, the drug is working in your favour. – Its a vicious cycle

    Your, 1 week of weaned Effexor was both dangerous and just nowhere near enough time for your body to accept the changes. SSRI / SNRI withdrawal is brutal and sadistic.

    Like I said after many years of upping, downing and switching my mental state became excessive deterioration and it then took 2.5 years of minimal dose reductions of a liquid dose (at times half a ml was dropped over a period of 2 – 3 weeks) – during the reduction I had many psychotic breaks and much, much more. It was knowing I would recover that kept me going.

    Doctors call this `Trial and Error` but believe me hon, this aint nothing but error all the way They are not going through it, you are. – Your experience is a world apart from their text book knowledge.

    Do as much research as you can for yourself, read patient testimonials, clinical trial data in medical archives of Lexapro, read Moncrieff, Healy, Breggin etc, and not pharma promotions because you need the truth and the option to discontinue this drug.

    Note I am not trying to be a Doctor (God forbid ha ha) but, I urge you to seek out the truth for yourself and help yourself.

  47. It is my believe that all mental illness is caused by a nutritional imbalance. Much like the Witch’s of Salemn.

    The best choice is a 100% organic diet.

    Yes 10% of mental illness will never be explainable.

    But at least we now know that 90% is due to poor nutrition in water, food and our toxic atmospheres The mental illness rates and modern rise of chemicals prove this, and not so much the new testing laws for mental illness.

    Don’t be tricked. Mental Illness like any business is a Trillion dollar business. And like all business’s their are the good guys and the bad guys. Unfortunately the Bad guys rule not only Health but sadly Mental Health as well.

    The answer = 100% Raw Vegan, its the best on offer. Not perfect but the best of the best…………:-)

  48. I think what Chris is saying makes some sense. It seems a little too simplistic that mood could be attributed only to serotonin (and dopamine, norepinephrine, epiniephrine, GABA, etc.) Oh if only that were the world we lived in. This is coming from one who takes amino acids ala “The Mood Cure” by Julia Ross and they really seem to have the functions they are claimed to have as far as stimulating/sedating/antidepressant. And they seem to work best for me in combination, lending credence to the theory of other amino acid researchers like Mary Hinz that too much of one will imbalance the other neurotransmitters if the aminos are improperly used or combined. These treatments are specifically based on chemical imbalance theory, and yet, is there not a lot more the amino acid precursors can do than only convert to these chemicals? Is it possible they affect other functions in the brain, also affect the biochemistry of the body in ways that have nothing to do with serotonin?

    • In my ever so humble opinion The Mood Cure is complete quackery. GABA doesn’t even cross the blood brain barrier, for instance. I have taken tons of it with no effect at all. Her response, of course, is that oh clinical experience shows it works. That is not good science. Clinical experience shows sugar pills work quite well.

        • Although sugar pills don’t give you the permanent nocternal bruxism, restless leg syndrome, permanent tinitus or head zaps that the 3 years of venlafaxine I took did. I was emotional when my partner left me. The doctor would have been doing a far better job if he had prescribed me a 20 minute run and a pep talk rather than a life sentence of side effects. Doctors are largely unaware of the withdrawal symptoms of ssris . It took me three individual visits to my local hospital brain scans ecgs and eventually self diagnosis via google ! to find that head zaps were related to venlafaxine. My psych, doctor and a major hospital all argued they were not associated. Hopeless

  49. Hi again Chris…
    Seems to be a time bomb here for the 21st Century.
    I’m so depressed. I did not want to be part of “other people’s opinions”. Seems everyone has them.
    Antidepressants have, long term, killed anything that I would have hoped for in life…
    In the last 6 mos.I have, ama, weaned myself from the pills that I’d become unresponsive to 26 years ago, I am actually less miserable now, than I have been in the last 29 years…why they still keep insisting that I take them? Hmmmm
    LOL is all I can say….
    Big money, big power… big government… etc…
    Could never share my whole story here… not enough room, not enough time…and seriously, who really cares!! 😉
    I look to God, knowing that he loves me… and all who suffer…
    I do know of those who have benefited from these drugs. Very short term though. (like one year for head injuries…).
    In these drugs, I do not trust… in the long run, after they stopped working, and I was told to continue taking them, they dragged me into a deeper darkness of despair than I could ever have known, left to my own CHEMICAL IMBALANCE…. 😉

    Jeannie 🙂

  50. Chris…
    So totally agree with so much that you have shared with us….
    Ultimately, can you tell me WHY depression has destroyed my life?

  51. “As Elliot Valenstein Ph.D., Professor Emeritus of psychology and neuroscience at Michigan University…”
    — Dr. Valenstein is Professor Emeritus at the UNIVERSITY OF MICHIGAN. There is no such place as “Michigan University”.

    “I also saw how badly biological psychiatrists want to be regarded as doctors…”
    — psychiatrists ARE doctors, and are regarded as such.

    • Of course they are….. The majority of Psychiatrists and Doctors are both arrogant drug pushers and indeed drug advocates, so it`s apt to put them into the same category. (most noted exceptions being Breggin,(US), Healy (UK), Nutt (UK) and Kresser (US) – the handful of brave whistleblowing professionals who care more about people than profit
      At least Psychology focuses upon getting to the root of a problem without disruption of organic brain chemicals via the time again flawed imbalance theories

      . Why you argue `Right to drug` as superior in an opposition to `actually having morals and sense psychology` is rather odd. In any situation it should be about helping people, not who has rights of titles.

  52. Anon,

    It seems ignorant to generalize your unique experience to millions of people who suffer from depression/anxiety throughout the world. Do you honestly believe that every single person in the world who is suffering from a mood disorder can be treated in exactly the same way? Did you ever take time to consider that what you experienced as one individual out of 7 billion may have been very different than what someone else has experienced? Perhaps your mood disorder was caused by experience-related psychological mechanisms or lifestyle patterns whereas the mood disorders that other people experience and also call “anxiety” or “depression” are caused by chemical deficiencies? Is that not a possibility? If you deny this possibility, then it would seem to be out of either obstinacy or ignorance .

    I have a problem with websites such as this that make sweeping generalizations about mental illnesses without providing empirical proof (not just interesting speculation), because such websites do a disservice to the public good. Claims should never, under any circumstances, be made about a subject such as this when a solid arsenal of hard, empirical proof is lacking–especially when the wellbeing of others is at stake. What doesn’t work for you may work fantastically for someone else, and that is a fact. So let’s deal in facts, shall we? If you truly care for others and are humble enough to admit to a degree of uncertainty, then you will.

    On a final note: Although I was initially going to dismiss the off-handed comment about “pharma”, I feel it necessary to debunk such an outrageous comment, for as a human being who fervently cares for the wellbeing of others, I have no motive or agenda other than to debunk dialogue on websites such as this that has the potential to misguide and misinform the opinions of people who are genuinely suffering from emotionally painful and exhausting neurological disorders.

    That is all I have to say on this topic, so thank you for your time, patience, and deliberation. My best wishes to all!

    • pHARMa`s MOTTO…….A patient cured is a customer lost!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!…… can you deny such a fact???????????? curing a patient will lose it`s business will it not? To cure a disease will lose billions in profit would it not?
      Business is business and business is profit. Are you so damn deluded to that fact?.
      You talk about `fact` and I have presented two. Please provide the proof of a chemical imbalance for us all to see…. show us the evidence. Pharma trials for six weeks then puts drugs to market and prescribe for years do you deny this?
      I am far from ignorant but, You. what are you? aside from deluded within whatever your job description is.
      As for psychological mental problems the whole world has them and yes many life styles cause them but here`s a fact for you….. Love cannot be bottled,measured, touched, seen nor heard, nor can stress nor anger nor hate….. but pharma tells us depression can be…. it has no evidence of it but tells us it can be……. how can pharma bottle one emotion but not any other????? because, it cannot!!!!
      Facts are facts and you have none. I urge you to come back with hard evidence to debunk my evidence then we can have an intelligent and civil discussion.

    • Talking about lack of proof, the whole field of psychology is theories. There is no proof. Do you even know what psychology is? It’s the study of human behavior. Have you ever taken psychology? Probably not. You’d love it because there are no facts, all theory about human behavioral “disorders”. Psychologists are pretty much a bunch of quacks. My theory about you is that you’re ignorant. I believe it’s a chemical imbalance though so please get checked by a doctor in psychology.

      • Millennm…I am so sorry you are so angry and bitter. I’m not sure why, but I’m sure there is good reason. The reality is ignorance is facing the truth and refusing to see it and admit it. Seriously, when it comes to the “chemical imbalance” claim, the facts are just not there. ALL behavior has purpose. The medical world framed behaviors as “disorders” & “illnesses”, but there is no known causes. They are not illnesses but rather mental strategies to live out there own style of living learned early on in life. I’m sorry if you’ve suffered or loved someone who suffered with mental issues. I’m sure that would be very hard.

        • “They are not illnesses but rather mental strategies to live out there own style of living learned early on in life.”

          Oh and please don’t waste everyones time diagnosing me on a message board.

    • Perhaps just show us where the peer reviewed study showing that depression is caused by low seratonin is. If it does not exist then the article is correct.

  53. Dear Chris,

    Your objective seems contradictory. You stated the following in bold font: “it should be abundantly clear that depression is not caused by a chemical imbalance.” However, you incorrectly claimed that there is no evidence to support that depression is caused by a chemical imbalance. In fact, there is abundant evidence. I am living proof.

    Ever since I was in fifth grade, I dedicated my life to trying to feel better. I was always extremely self-aware and knew that something inside of me wasn’t right. I would always look around and wonder why everyone else seemed so vibrant and energized, and why I always felt scattered and exhausted.

    Over the years, my symptoms got progressively worse. I was probably the biggest skeptic of chemical imbalance theory out there, because even though my parents repeatedly tried to get me into counseling and on medication, I vehemently denied there was a problem and said that I could “fix” the way I was feeling myself. I spent years and years trying to do this, simply because I firmly believed people can always control the way that they feel. But as everyday activities became more and more difficult and as I started getting more and more exhausted by my scattered thoughts and lack of focus, I became severely depressed. It was physically impossible for me to get out of bed and to behave like a “normal” individual. I turned to every possible explanation BUT chemical imbalance theory to explain why I was miserable. I thought maybe if I pushed myself really hard in everything I did–in school, in ballet, etc.–then I would be rewarded somehow by feeling better. I was always guilty about everything for no apparent reason, and I blamed myself for every little thing that went wrong. I thought I felt the way I did because I was a bad person.

    Now I am a senior in college. I have been miserable for most of my adolescent life until now. A year ago, my parents forced me to go see a psychaitrist because my grades were slipping. I dug my heels into the ground because I didn’t want to believe anything was “wrong” with me even though I was so miserable and tortured–I took it as a personal failure. They finally made me go, and my psychaitrist wanted to start me on 50 mg of Zoloft. I was so averse to the medication that she compromised and started me on 25 mg instead–which is half the normal starting dose. Everyday I hated taking the medication because I thought it labeled me a “crazy” person. Even though I started to notice small differences, like slightly more focus and energy, I still wasn’t exactly feeling great or comfortable. I took these small changes to be coincidence, and I convinced my parents and psychaitrist to let me go off the medication in December.

    Over winter break, and through the beginning of this past spring semester, I started realizing that I still had no energy and felt relatively scattered throughout the day. It was still hard to get out of bed. After I met a girl my age from my university who went through the EXACT same experiences and had the EXACT same symptoms, I no longer felt lonely in the world anymore. Although my doubts about chemical imbalance theory were still shaky, it felt so good to know firsthand that I was not having unique feelings and experiences.

    After meeting her, I decided to give the medicine a try one more time, but this time I took the standard 50 mg dosage. The difference was undeniable. I started to wake up in the morning feeling physically energized and vibrant. I began seeing the world around me completely differently. I no longer felt neurotic guilt throughout the day, and EVERYTHING BECAME EASIER. When my mom and dad were helping me through my illness, they always told me that everyday life shouldn’t be that hard. And they were right. But a major part of the disease is a tendency to blame yourself for everything. You simply don’t feel good, so you blame yourself and try so hard in everything you do because you think that will change the way you feel.

    Mr. Kresser, I implore you to reassess your objective in writing this blog. There are people out there who are sick, miserable, and desperate because of a chemical imbalance in their brain, and if they see this blog in their quest to find an explanation and decide to buy into it, it could ruin their lives. You can’t try to explain the way someone feels unless you experience it yourself. If anything, that is the most important lesson I have learned during my years of misery: NEVER MAKE ASSUMPTIONS. Your blog simply does not allow room for the possibility of chemical imbalance theory, yet in my instance, I know for a fact that I suffered due to a chemical imbalance in my brain. IT IS UNDENIABLE. I was the hugest skeptic of all. I didn’t believe it until I DRAMATICALLY STARTED TO FEEL BETTER WITHOUT EVEN TRYING.

    Please, please, I implore you from the deepest parts of my heart and soul. Reconsider and revise this blog. It is doing a disservice to people out there who truly need medical help.

    With the utmost outpouring of love,


    • Nice try trying to persuade people. How much did big pharma pay you to write that? I was also classified as having a chemical in balance for anxiety and depression. I tried zoloft, effexor, serequal and every medicaton for anxiety. After doing exercise, proper nutrition, therapy, i was able to overcome my anxiety and depression. Its not about taking pills, its about a lifestyle changes.

    • THERE IS NO SCIENTIFIC EVIDENCE OF A CHEMICAL IMBALANCE THEORY…..It was first theorized in 1883 by Kraeplin and has been just that `A THEORY` ever since. no evidence suggests such a theory to be concrete evidence….. The only evidence in hard fact is that overloading serotonin creates mental instability, hence the raise in suicidal ideation/mania etc ….. theories are ok only when they do not affect another….. and in this case, the flawed theories affects the lives of millions both mentally and physically.
      This blog is not to stop people from getting help but, instead to expose peoples experiences to the flawed theories.

  54. Hi, I am very grateful blogs like this exist, many/ most medical professionals are unwilling to accept pharma can be wrong and instead ignorantly deem patients backward regarding symptoms actually being adverse reactions to excessive serotonin intake.
    I was diagnosed with mild depression by my Dr, on 2001, medicated snri Venlafaxine/Efexor 75mg, by 2003 my mental state had deteriorated so bad (suicidal thoughts/inability to absorb information/anger and violent outbursts) and physical symptoms were beginning to manifest (bowel trouble/severe dehydration/arthritic/skin discoloration/Hypersomnia/loss of libido). My Dr insisted the drug did not and could not cause such symptoms it had to be me with an underlying depression not formally recognized and upped the dose to 225mg then to 300mg. I spent until 2009 in mental and physical torment being sent for both psychological and pyschiatric evaluation, I was always deemed in denial of my own mental stability until another Dr, decided to send me for a polysomnography (because of the excessive hypersomnia,) This led to a realization that I was unable to fully fall asleep, my brain was not shutting down properly and despite not knowing, I was awake virtually 24/7. The medication was thus reviewed and after 2.5 years of excruciating withdrawal in the reduction process, I finally regained my normality and intelligence. Since having come off of the drug (Feb 2012) my skin is back to normal, my arthritic condition dispersing, my bowels are working normally, my mental state and alertness all back to normal I sleep on average 10 hrs at a time etc, etc.

    I have spent 2009- to date researching the drug, clinical trials, medical journals, case files and more, I now know serotonin is present in the gut (hence the high risk of bowel trouble related to this drug) I also have learned there is no hard evidence of chemical imbalances and is merely a theory of Kraeplin whom theorized this in 1883. Science is pretending it knows everything dangerously and that it can treat the everything too. I have further learned, treatment is not curing, treatment merely suppresses one symptom (for a while) whilst introducing the many more instead. most of which the medical professional does not relate to the actual cause and thus persists to wrongly treat on top of all else.
    The most scary reality I have discovered is, clinical trials only last week, this in comparison to the years of prescribing, If a trial results with only 5 out of 20 participants falling victim of an adverse reaction, that adverse reaction is considered rare and not always added to pharma`s list for patients nor Doctor`s, I once had respect for scientific evidence, I believed it as factual hard truth. this not the case at all. It instead focuses on desired result and tidy result, little bits of evidence denied if does not fit.

    No one knows the reality of what a serotonin norepinephrine drugged patient is going through, This can even include the patient, they are deemed mentally unstable, clueless etc, I was until another Dr stepped in. Most patients are totally ignored when attempting to challenge the drug. Observations and arrogantly ignorant theories of `experts` are dangerous.
    My medical history, prior to the drug was clean of any mental and physical problems whatsoever, as is now, a year on after discontinuation. The profit is all that seems to be the reality of pharmas denial of mass evidence regarding patients on ssris and snris.
    Is pharmas motto A patient cured is a patient lost? I believe so.

    • So, I just happened upon this site because I’m out of Lexapro and can’t afford to buy it until next week. I would love to be off all meds and I know for sure I can drop some (hoepfully all with a better diet and more exercise – I’m diabetc as well.) But, I was so fascinated by your post about Efexor – I was on it for the month of Dec. 2013 and it was awful – I was crying daily and thought about suicide often. It finally dawned on me that a fill-in doctor had changed my meds and I didn’t question it. I chalked up the change in my mood to some stressful life situations (Xmas time during a divorce) but this was beyond bad – I asked to be switched back to Lexapro and weaned off Efexor over a week or so. The difference was amazing. So, the big question is – why am I thinking the Lexapro is working? I can’t afford this stuff (over $100 a month). I’m intrigued on the whole “chemical imbalance” theory is wrong.

      Anyway – had to chime in when I read your Efexor experience. So sorry it lasted for so long. We put doctors in such high regard but they’re just people too.

      • There is a predecessor to Lexapro which is very inexpensive. Lexapro is a portion of the molecule of the original drug. You may want to ask your doctor what he/she thinks about this. Also, it’s useful for you both to discuss/document your symptoms and their severity during treatment but before starting a medication. That way, you both have objective measures to guide the next step.

  55. I have suffered from depression, anxiety and OCD for most of my 46 years on this earth. I have been to many different therapists, psychologists and psychiatrists that pretty much offered the same advice and drug therapy. I’ve been on virtually all of the SSRI’s and several different types of benzo’s. It was decided by my last psychiatrist that I remain on Prozac, the first SSRI that I started on. I kept telling this doc and the other docs before him that I wasn’t benefitting from the drug. The doctors insisted that I “appeared better off” taking Prozac?! Are these doctors suddenly trying to be mind readers? Better off? How? Talk about egregious statements!

    Being a fool I stayed on Prozac for nearly 20 years, and being virtually bankrupt from the drugs and therapy. I finally had enough of this and quit the Prozac. I had been on Valium for years and it was very hard to wean myself of off a benzo.

    I decided to try an alternative route (though I’m extremely skeptical homeopathy) and I went the route of herbs, supplements and dietary changes. To my dismay, after spending more money and adhering to this “natural” approach for 2 years, I found myself no better off than when I was on the scientific based meds.

    I still suffer from depression and the anxiety is a killer at times. My OCD symptoms are dormant at times, but when my anxiety kicks in so does my OCD big time. This confirms my belief that hell only exits right amongst the living here on earth.

    Being 46 years old I know that I’ve lived out more than half of my life. And when your mind is perpetually consumed in an incurable, misunderstood vacuum of static discord, then I find a small degree of solace in knowing that someday my pain will fade into oblivion with my passing.

    Sorry to be so macabre, but if you’ve lived with depression, anxiety and OCD for all of these years and struck out with the docs, and even the holistic ones, then you’ll feel that your ship has encountered the eye of the hurricane. Your vessel has tipped over and you’re tossed in the story seas. Blackened skies squelch the light, and the pounding surf roars, with a devious ferocity, striking you like a raging bull. I’m pulled down fathom depths. It gets only darker. Frigid. I fall unconscious. The darkness is immeasurable. I shall never see the light.

    • To David: Sorry to hear you have such a “resistant” depression. OCD itself can be worse than most people can imagine. Just torment. Some meds specifically target OCD while also helping depression. But perhaps you have tried all these. There is an organization called The OCD Foundation. I have not been on the site for a while, but It seemed useful and informative.

  56. I read this article in hopes for answers, but it really doesn’t help. If depression isn’t a chemical inbalace or at least not a total chemical inbalance then I don’t know what else to do. I’ve had depression since I was 6 years old. I had no tramatic event, I had no change in diet, and no hormonal in balance. I’ve tried changing diet, talk therapy, excersise, and all the other things that have ever been suggested. They don’t get rid of the depression, they impove it but it’s still there. Add a major life event and my depression explodes, and get extreme. But it’s never gone, it’s never even 90% better. Am I doomed to spend my whole life either being majorly depressed or just being moderatly depressed?

  57. Chris,

    I thought this article, and the debate that followed, were absolutely brilliant! Informative and insightful. That being said, I am curious to hear your thoughts on the literature citing the connection between emotional state and the functioning of the enteric nervous system.

    Evidence has shown that probiotics and fermented foods have a direct influence on our emotional state via the “gut-brain axis”. The enteric nervous system (ENS) of our gut evolves from the same embryonic tissue as our central nervous system and remains connected throughout our lives via the vagus nerve. The ENS makes use of more than 30 neurotransmitters, most of which are identical to the ones found in the CNS, such as acetylcholine, dopamine, and serotonin. In fact, more than 90% of the body’s serotonin lies in the gut, as well as about 50% of the body’s dopamine.

    Thanks again for a great article,

    “Your Backup Brain” Dan Hurley, Psychology Today, November 01, 2011.

    “More than 1 in 10 Americans on Suicide-Linked Antidepressants” Anthony Gucciardi, Natural Society, October 20, 2011.

    “Do Probiotics Help Anxiety?” Emily Deans, M.D., Psychology Today, June 17, 2012.

    • Chris is right about antidepressants, the monoamine theory of depression has no factual proof. Antidepressants themselves have been shown to have no statistical significance, except possibly slight improvements in severely depressed people. All classes of antidepressants were ‘discovered’ accidently during the development and trials of drugs intended to improve other conditions. Anecdotal evidence of mood improvement during clinical testing is often cited as the initial period of ‘discovery’ and their respective efficacy. The problem is that several independent meta-analysis of published trials showed no statistical difference from a placebo, and only a slight statistical significant improvement of some symptoms in severely depressed patients only. Furthermore, the monoamine theory of depression was first introduced BASED on medications that have not even been proven to work using statistics; ironically the only initial proof-since proven incorrect-provided by the drug manufacturers themselves. There is no scientific, nor is their even enough reasonable proof to support a monoamine theory as the cause of depression. The diagnosis of depression itself is largely a subjective process defined by a subset of observed or described symptoms. Very little is known if any pre-existong physical abnormalities play a consistently central role in depression, as well as any consistent physical changes that occur during depression at this time. Unfortunately, that is the case. Their is likely an overlapping subset of people diagnosed with depression or similar undefined illnesses (such as CFS) where physical abnormalities in the CNS and/or endocrine system (genetic or not) do exist.

  58. Hi Chris,

    I’m not sure if this is the best place for this question, but here goes: I have had several friends who (after having children) have had severe anxiety creep up. A couple of my friends suffer from anxiety attacks and others just live with constant anxiety and seem to be “revved up” all the time and unable to enjoy life. I have witnessed that those who decided to try medication (usuallly zoloft) have found relief and the anxiety has subsided and they report to feel like themselves again. Anxiety seems to be different issue than depression and I’m wondering what you think about these cases? I also suffer from constant anxiety (after having children) and I contemplate trying medications sometimes as well. But I don’t want to go down that road if I don’t have to. I eat really well and do lots of other self-care. What are your thoughts on people reporting that Zoloft is working for anxiety? And do you think there are cases where medication is warranted?
    Thanks so much.

    • Hi Adam,

      My response was actually for Miss Diagonsed…I should have pointed that out.

      That said, I currently take an SSRI in conjunction with eating as well as I can, supplementing for iron and exercising per my doctor. I am honestly pro whatever helps a person not experience the fear and uncertainty of depression and anxiety. I don’t doubt that diet and excerise help, but it’s not the end all be all for some of us who experience these things to debilitating degrees. Sometimes it’s trial and error.

      Anyway, I appreciate your response, but I simply don’t agree. My opinions are largely aligned with Charley and there is no point in rehashing what’s been discussed.

  59. Dear Chris,
    thank you very much for your posting. It is very important that people know that there is no evidence that chemical imbalances cause depression.
    There is well-made documentary on this topic:

    Now, what’s your advice to a guy like me who’s suffered from depression for years? I am currently taking Mirtazapine and at least it helps me sleep. But I’ve become highly skeptical on this issue and don’t know what treatment is the right one.

  60. No scientist actually believes that a chemical imbalance is the cause of depression. However, increasing neurotransmitters does cause downstream effects that fixes depression in a lot of people. Depression is a complex disease as it can be caused by numerous problems and this is why a lot of antidepressants work only mildly better than placebo. There are even opioid receptors that can be involved in depression which the standard SSRIs would never even deal with it. It could be that over the years receptor downregulation occurs and taking an antidepressant causes decensitization of presynaptic neurons. There are so many reasons, but the fact is these drugs save lives so don’t put them down. As a scientist I have never heard anyone in the community believe this theory, it was an old theory from a long time ago. Sometimes you want to give the consumers of a product the easiest description possible and unfortunately this is where the chemical imbalance theories come in and stay strong in the marketing field.

    • Depression is not a disease though, it is a natural human emotion like anger, stress, anxiety, happiness, love, hate etc.

      That`s the problem today, calling natural emotions a disease is allowing science to make billions of profit on something that will eventually heal in time

      • I don’t know if you have had severe depression, but no: sometimes they don’t heal in time.

        Mental illness is also not an emotion as you so simply try to categorize it. Are you going to tell me that things like PTSD, schizophrenia, anxiety disorders, and bi polar disorder are also all just “natural emotions” that their sufferers must overcome? You’re trying to gloss over the complexity of the brain by attributing it all to nature. Just because something occurs naturally does not mean it’s beneficial or benign.

        I’m not saying throw pills at any and every person who exhibits symptoms of depression, but the idea to so many that depression is just temporary bouts of sadness to overcome demonstrates painful ignorance.

        • Hello Ciara,
          I do understand your concern when hearing someone speak in simplistic terms when it comes to mental health. I often will catch myself saying some of the same things that Miss Diagnosed stated.

          I am so sorry if you personally have suffered with severe depression. I have & I know what it’s like. At one time, I had allowed myself to be diagnosed with “bipolar disorder”. I was so depressed & had attempted suicide, but because of my beliefs & understanding of how our minds work I shifted my thinking & returned to my beliefs (regarding the mind & life) & my life changed.

          Ciara, the reality is that the very ones (psychiatrists) who are using the term “mental illness” are the ones who agree that there is no known cause for everything in the DSM – from depression to schizophrenia….period!

          I believe it was in the ’30’s that psychiatrist (in collusion with big pharma) had to call (frame) mental conditions as “illnesses” in order to validate their practices as “doctors”. You see if it is an “illness” (they would believe) like the flu for example, they then could “treat” it. But the reality is unlike biological illnesses, there is NO KNOWN causes for the supposed “mental illnesses” they are treating.

          My intention is NOT to upset you or anyone else, but personally I do not believe in the term “mental illness”. My depression (& all other “disorders” of the mind) are serving a PURPOSE. All be it, its probably pretty useless now, but there is an unconscious purpose.

          Our minds were masterfully created to protect us from all things real or imagined. Therefore, as we developed a belief (mistaken/interfering) about something that made sense at the time (i.e. as a child) or it was useful, but now, it’s not so useful.

          I wish I had more time & space to elaborate. The bottom line is that the allopathic medical model created the “frame” by which we look at human behavior. Therefore, EVERYTHING is defined through this pathological frame or lens.

          My framework is that of health & wholeness. Our minds are NOT sick (ill), but rather ARE normally functioning (even though it may be useless now). The challenge is that we are functioning off of “sick” or screwed up or silly strategy(ies).
          Most Sincerely,
          Anthony Verderame

          • Anthony,
            are you a Dr?

            If so, thank you for going beyond medical school and seeing people as people, not diseased subjects.

            I am afraid I do talk simplistic at times it is probably because I have gone into detail time again and now just assume everyone knows what I am talking about.

            My Bad, no one elses. Its not that I get annoyed at peoples ignorance so much as their refusal to think logically and outside of their conditioned boxes, again my bad, so much is drummed into us all from such an early age and we have to endure something and come out of it to know whats truth and what isnt.

            I know 13 years ago, I would never have believed a Dr (let alone several) could nor would have put me through what I went through, furthermore 3.5 years ago I was still unaware that I was mentally ill due to drugs, despite the obviousness of it – please note on these drugs you no longer have rational nor logical thought.

            In 2004, I asked my Dr if the pills were making me so ill and he replied No, they were uppers and would not affect me in that way.

            My faith in him was the worst mistake in my life, as was being put on the drugs in 2001.

            I never had a mental illness prior, and have not had since a year after discontinuation (that is not to say I have recovered the physical symptomatic stress fully).

            I first began to worsen in 2002 6 months after being drugged.

            My Dr stated, I was merely showing underlying symptoms that the drugs were helping to bring out, he upped the dose….. Life just went down from there, the dose upped, downed, drug swapped to an ssri, then back to a snri.. etc – Call it an excruciating excuse for any existence.

            My only aim in life is to educate others on the evils of these drugs and those who make them, nothing more. I never demand I am believed and urge anyone to research themselves the everything not just pharma one sided sites.

            I cannot help screaming from the roof tops the what I know. If it helps just one person stay away from these drugs? then I am happy.

        • Yes I have had severe depression and it was caused by anti depression medications.

          If you look back over my posts here you would see that I was initially diagnosed with mild depression for what was really an upsetting time of being a young single parent and bullied by an ex, My Dr saw fit to drug me and I went downhill from there.

          To psychotic breakdown to suicidal ideation, self harm and attacking my daughter amongst many more disturbing adverse reactions.

          Emotions are being played with by Pharma for a profit as for `disease` No emotion is a disease that can be drugged to cure.

          Please research brain medicines and cures there has been none, all drugs treat symptoms whilst creating a multitude of other symptoms to boot this is fact.

          I do not deny many people suffer from many forms of psychosis and mental health issues but these are not diseases that we are led to believe.

          Whether schizophrenia, anxiety, adhd, depression etc have you ever heard of a cure? or even why, how, they exist?

          The reason is because pharma do not care why or how, so long as they can treat and make billions in profit.

          I did hear voices in my reduction withdrawal, I personally believe the psychospiritual has a lot to do with the mind and the messing around with it – drugs open up a whole new area that science is clueless about, Like I say above, emotions (unlike science`s ever testimonials of what is real must be seen, touched, heard, smelt and tasted to ever exist) are non physical and cannot be proven to exist despite our knowing that they do because we have felt them.

          I do not have a go at you here but urge you to think outside the box and attempt detatchment from the conditioning since childhood….. Drs are not Gods, They prescribe toxic chemicals, no diferent from the chemicals on the street.

          However, street drugs are taken knowingly of effect, are usually taken in moderation giving the body and mind time to heal… Medications are taken daily, on continuum, never give time for the body and mind to heal and taken because a so called expert said you needed them

          The Dr pushing pills did not trial them, test them and only knows what pharma states as fact. furthermore so many drugs are being introduced, esp generics that the Dr is actually clueless of pharmaceutical difference and bioequivilent difference making it more dangerous every generic he prescribes.

          Please do proper research via patient testimonials, case files, original medical journals etc. Like I say I am not having a go at you I just want everyone to be safe from these drugs as would anyone who has endured them and lived to tell the tale

          • That last post was meant for Caira, ust like to add that Bipolar, unipolar and ADHD only arose/ were invented since the onset of medications reboot in the 1980s.

            Also Post Traumatic Stress Disorder is a situational depression caused by severe distress, it is not a disease

            I am not saying mental illness is emotion I am saying pharma is inventing diseases or claiming emotions as a means to treat. ADHD/Anxiety/ Bipolar/GAD/ SAD etc

            Most Psychological issues need time and careful working through not drugs.

            I do not simplify the brain, ironically science does saying it can treat what it cannot

  61. I know this post and the discussion is old, but i just stumbled upon it and would like to comment.

    Although the discussion swiftly moved to the Evil Big Pharma corporations and the unproven/probably harmful effect of drugs, i found the first part most interesting, between you and Kathleen DesMaisons, and felt it should have been discussed more. I’ve read her book, and i agree that you are throwing out the baby with the bathwater. You say that low serotonin isnt proven to cause depression, and you talk about your beef with SSRIs, but you also attack nutritional approaches to reversing imbalance, and i dont understand that.
    Your belief is that life problems and stress are what cause depression, and even serotonin depletion, which is true, and thus, imbalance theory is false. Life affects brain, not vice versa. Explain to me this then: why do i (and countless others), when sitting down with friends, having a great time, (or during any other pleasant or neutral experience), suddenly get a HUGE dose of anxiety? Or during times of absolutely no stress in your life, good job, good relationships, sudden bouts of severe depression? In these instances youre left there scratching your head. You look around, try to see what could be the cause, but there is no trigger at all? There is a definite and palpable disconnect between those bouts of anxiety/depression, and what is actually happening around you, both in that moment and also in you life at that time? What else can explain this? And ive heard the tattered cliches about “well, there must be some unresolved issues in your subcounscious…” , but their sudden onset and the sheer dose of it, combined with the clear absence of triggers, leaves no other conclusion than: this originated in the brain. I mean yeah, maybe youre subconsiously thinking about your job not being great, but why would your heartbeat triple to near heart-attack level, and feel a fear that would be more appropriate to being chased by a T-rex, and not your job being less than ideal?

    Finally, my greatest beef with articles like these, with respect, is that it is just being Iconoclastic (for lack of a better word), without adding anything positive. What its saying is: “hey folks, you know that ‘chemical imbalance’ theory that gives you hope? TA-DA!! I have ripped it to shreds! Have a good life!”, then leaves the reader with the bleak finale: “Drugs wont work. Chemical imbalance is bunk, so nutritional approach wont work. The brain is too complex to understand, so your issue will never be solved, not in your lifetime at least! The end.” How is this helping people?

    • In my experience, some people do well with psychotherapy or cognitive therapy or other non-medical therapy. Others require medication. Medication with talk therapy is ideal.
      It is somewhat amusing, in a sad way, that some individuals spend years and substantial amounts of money on various talk therapies, alternative therapies, life coaching, etc, yet will not allow a much shorter period to assess their response to proven remedies.
      I guess people can pick this to death about what “proven” means. We all have our own standards. For myself, that standard has been met through many years of providing talk and medical therapy, as appropriate to each individual.
      As I look at the advances in medical and neuroscience in my own lifetime, which are so amazing and growing exponentially, I find it quite interesting to learn about the lack of support for the serotonin theory. I am anxious to learn more, as more discoveries unfold. However in practice, the theory is useful if even only as a construct. When something better comes along, I will embrace it with open arms.

  62. Interesting post Chris. What is your take on Seasonal Affect Disorder (SAD) (winter depression) ? Is there a chemical imbalance, a hormonal imbalance, nutritional deficit or something else going on?

  63. “This clear and easy-to-follow theory is the driving force behind the $12 billion worth of antidepressant drugs sold each year.”

    You’re way behind the times. It’s obvious that you’re just copying from the book, I know because I have it right here. 12 billion may have been true in 1997, but in 2007 the combined spending on “anti-depressants” and neuroleptic “anti-psychotic” drugs was 67 billion.

    Better, more up to date reading would be Robert Whitakers Anatomy of An Epidemic.

  64. All of this reminds me of this movie “Equilibrium”, where a drug was used to take away emotions because they were considered a sort of disease. Freakin’ movie turned out to be true after all. Scary. I fear the day that all emotions will be regulated with such drugs. That’s why Equlibrium was so frightening…it’s entirely possible.

    If it happens, well…we’re screwed.

    I just hope it doesn’t come to that.

  65. I have been having an argument with my best friend about the chemical imbalance myth. She is a card carrying PETA member/vegetarian who supports the pharmaceutical industry. My guess is she’s not taking into account all of the testing done on tons of animals for decades in the name of these drugs.  But that’s not really my biggest concern. I am very glad to have found this site.  It disgusts me how many people actually think they should take a pill for everything…..and that taking a pill will change your cognition. It’s ridiculous and hilarious at the same time. I signed up for your daily email.

  66. Heartfelt thanks for all your research and meticulous care in explaining so responsibly and thoughtfully, this dangerous  mythology.

    I wish the psychiatric medical establishment would take heed. LISTEN. And return to talking therapies. They work. 
    In 1991, after 16 years on Lithium Carbonate for psychosis with mania, then called Bipolar Disorder (except I never get depressed), I was diagnosed with Acute Iatrogenic Endstage Kidney Failure. I was practically comatose in the Emergency Room of a teaching hospital in Toronto after spending 24 hours in physical restraints in the psychiatric in-patient unit of that hospital.

    My psychiatrist of 16 years was head of psychiatry there at that time. He hadn’t been monitoring my Lithium levels and later, it was discovered that I was born with only one kidney.

    I almost died, but didn’t.

    Instead, I faced 18 months of getting sick enough to go on dialysis. First Hemodialysis. Then, after two bouts of surgery, when both AV fistulas in my arms failed, along with other spots on my anatomy – I have thick blood and thin veins, a bad combination for hemodialysis – I went onto Peritoneal Dialysis. After a two-year complication-filled ordeal, including about 5 surgical procedures, 18 months on an off in hospital and nine blood transfusions, my sister saved my life by donating her kidney.  

    The trend today is to neurosciences in psychiatry. No one seems to want to listen. Big Pharma is so powerful. I hope I live to see the day when all this madness ends. But I don’t know. I take an innocent-for-me anticonvulsant that stopped my twice-yearly psychotic episodes cold. That was more than 20 years ago. As long as I get enough sleep.

    Psychoanalytic psychotherapy since 1991 has helped me to recover.

    Not drugs. There is no insight in a pill bottle. I wrote about you today in my blog, “Coming Out Crazy.” A mention. But I linked to this post. And another.

    Keep up the good work. I’m a new fan.
    Sandy Naiman

  67. Well, on another note. I thought I’d share this… It would sure be nice if our lives could be lived this way…

    <!– @page { margin: 0.79in } P { margin-bottom: 0.08in } –>
    The Song of A Life

    When a woman in a certain African tribe knows she is pregnant, she
    goes out into the wilderness with a few friends and together they pray
    and meditate until they hear the song of the child.

    They recognize that every soul has its own vibration that expresses
    its unique flavor and purpose.

    When the women attune to the song, they sing it out loud. Then they
    return to the tribe and teach it to everyone else.

    When the child is born, the community gathers and sings the child’s
    song to him or her. Later, when the child enters education, the village
    gathers and chants the child’s song.

    When the child passes through the initiation to adulthood, the
    people again come together and sing. At the time of marriage, the person
    hears his or her song.

    Finally, when the soul is about to pass from this world, the family
    and friends gather at the person’s bed, just as they did at their birth,
    and they sing the person to the next life.

    In the African tribe, there is one other occasion upon which the
    villagers sing to the child.

    If at any time during his or her life, the person commits a crime or
    aberrant social act, the individual is called to the center of the
    village and the people in the community form a circle around them.
    Then they sing their song to them.

    The tribe recognizes that the correction for antisocial behavior is not
    punishment; it is love and the remembrance of identity. When you
    recognize your own song, you have no desire or need to do anything that
    would hurt another.

    A friend is someone who knows your song and sings it to you when
    you have forgotten it.

    Those who love you are not fooled by mistakes you have made or
    dark images you hold about yourself.

    They remember your beauty when you feel ugly; your wholeness
    when you are broken; your innocence when you feel guilty; and your
    purpose when you are confused.

    You may not have grown up in an African tribe that sings your song
    to you at crucial life transitions, but life is always reminding you when
    you are in tune with yourself and when you are not.

    When you feel good, what you are doing matches your song, and
    when you feel awful, it doesn’t.

    – Author Unknown

  68. Have a family ever done a psychological number on a kid or a kid done a psychological number on their family? Of course.

    Have you ever known a real schizophrenic? I mean someone who is brilliant and wonderful in every way, who’s mind descends a dark stairway into a place where voices tell them to do things? Real voices. Not “imagined” voices – not guilt-trips from a religious education, not drug flash backs, not “the little voice talking to me inside”… REAL live voices that won’t stop.

    What about images? Images of shadows approaching from every angle? Sheiks, howls and cries that nobody else can hear? Yet they are so REAL and relentless.

    The only way these experiences have ever been reproduced in a sustained and predictable way is through the use of psychoactive drugs –

    And, regardless of how any of us feel about drug companies, psychiatrists, or psychotropic medications, the anti-psychotic drugs are one of the only ways most of those so seriously afflicted are able to return to anything resembling “normal” society. And, note my use of the word “normal” suggests a WIDE range… Surely if people can’t feed themselves, bathe themselves, maintain shelter, or any of the other things we consider “normal” they need *something*. And without committing them to locked wards for the rest of their lives, what other options are there?

    Most represent only a danger to themselves. However, many represent a danger to others –

    If we all spoke the same language, prayed to the same god, and lived in a circle of grass huts in the land of milk and honey it would certainly be an easier social question to answer. Maybe we could send them out into the woods with scheduled envoys to pay visits with food until they got “better”.

    I don’t have an answer. I have seen with my own eyes where despondent people came onto a psych unit, clearly detached from the same reality the rest of us were sharing (wide ranging though THAT reality was…). Within days on psychotropic meds I was enjoying dinner and conversation with a brilliant human being who days earlier had been a sloberring, shit spreading, ranting and raving lunatic. I’m pretty certain my medicated dinner companion was somewhat closer to the “real” human being than that frightening and very troubled person he was previously.

    We could talk about side effects and I’d agree with you. We could talk about drug companies selling the public a feel good med for every ail. We could talk about a society who wants to solve everything with a pill and I’d probably agree with you.

    But there are certain things I just know… Because I’ve seen them… And lived them… And blaiming schizophernia, and suggesting treatments, based on the psychodynamics of an individual’s environment? I think not.

    • Sure. But, how many people are prescribed ssris for very minor moments of depression and then live with permanebt side effects.

  69. Another reason why the chemical imbalance idea is popular , is that the parents of the chemically-unbalanced-brain patient who perform mixed messages/”Double Bind”
    get to continue perform their insanity on their child.
    “when examining a patient with suspected hysteria, try not to embarrass or threaten the patient.”
    or the patients family in the case of mental illness.

  70. sorry about that!! more n more people are becoming aware of the fact that the fda is putting out pills that are proven to make poeple sicker n perhaps even die from them!! money money money!! n this is just not right!! i know i’m just nother person to put out a comment like this!! but we need to stop this visiouse sycle!! in my opinion i think fda does have the cure to almost if not all desieses but they keep making pills to sell making people think its the only way to deal with that sertain desiese!! if they know or are aware of the herbal substance that affects the sertain desiese dont you think they have the herbal plant to cure the cause? every one wants to be rich or at least have security but some pople are just doing it the wrong way!! my point is this the fda eventualy will lose its power due to evidence of its conflict of interests!! i wish i had a pland or the herbal remedie to give to you if you yourself want to do something to beter your mental health but the truth is that i myself am having trouble getting it!! be safe eat healthy or just drink a crap load of water lol and alot of salads LOL

  71. This is the theory I was given behind the shrinkage of the hippocampus:

    The hippocampus has the function of routing experience to parts of the brain that  store it as  recallable and verbal memory.  In trauma, the hippocampus route is shut down to keep the memory stored in the amygdala (the fight-flight-freeze) part of the lower brain.  In severe trauma, the memory is stored as a sort of sensory template in the amygdala for future reference (that is, situations similar to the trauma, from a sensory point of view, but not a verbal point of view — memory as sights, sounds, smells, etc.).  These memories are not accessible consciously, and are triggered by similar events, or even sudden sounds.  They can produce nightmares and flashbacks, all without words.

    For people who have severe PTSD, a lot of daily experience is colored by the anxiety and other biological components that are related to this.  As the hippocampus is kept out of the experiential loop, it starts to lose mass.  Over the years this becomes visible and measurable.

    This is based on the work of Bessel van der Kolk. As I’m a bit out of my league at this point I only offer it for comment.

  72. <!– /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:””; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:”Times New Roman”; mso-fareast-font-family:”Times New Roman”;} p {mso-margin-top-alt:auto; margin-right:0in; mso-margin-bottom-alt:auto; margin-left:0in; mso-pagination:widow-orphan; font-size:12.0pt; font-family:”Times New Roman”; mso-fareast-font-family:”Times New Roman”;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} –>

    /* Style Definitions */
    {mso-style-name:”Table Normal”;
    mso-padding-alt:0in 5.4pt 0in 5.4pt;
    font-family:”Times New Roman”;}

    Part of the reason I hesitate to write in an abbreviated manner is how much it leaves open to interpretation or more aptly, misinterpretation. My goal was to lend data and skepticism to the notion that psychological issues are due to a chemical imbalance. Toby, you made some extensions to what I said, none of which I endorse. I don’t think that PTSD can be diagnosed by an fMRI nor do I believe that it is primarily a medical condition. I do think that there are profound changes in the brain as a result of experience, traumatic and otherwise.
    I completely agree with your statement that
    In boiling us down to hippocampi and dendrites, biological psychiatry is doing us a huge disservice.  It tells us that we are servants of our bodies, hopelessly subject to the whims of nature and nurture.
    There is a great deal of evidence supporting theories of neuroplasticity. The case could be made that cognitive behavioral therapy could not work or would not work for long, without neuroplasticity. Therapeutic interventions should be the first approach for resolving any psychological issue and good therapy should be guided by neurological awareness, but not limited to it.
    There are a huge number of behavioral and habit changes which a person can make, such as mediation, corrective experiences (usually experienced in therapy), self affirmations, good sleep hygiene, changing their attentional focus, NLP techniques, etc.
    Based on your second post, I think we are in broad agreement. We are not victims of our brains but custodians and engineers. By using the power of choice, combined with evidence based techniques, we can exercise a great deal of control over the continued development and maturation of that gift we call the human brain.
    <!– /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:””; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:”Times New Roman”; mso-fareast-font-family:”Times New Roman”;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} –>

    /* Style Definitions */
    {mso-style-name:”Table Normal”;
    mso-padding-alt:0in 5.4pt 0in 5.4pt;
    font-family:”Times New Roman”;}

    Charley, I think your intuitive theory has some good backing. First, it is estimated that internal dialogue runs at about 1500 words per minute, or 10 times the speed of speech (Wiley N (2006). Inner Speech as a Language: A Saussurean Inquiry. Journal for the Theory of Social Behaviour. 36(3), pp. 319-341). Combine that with the theory of learning that states neurons that “fire together, wire together” and you could make the case that by thinking the same thought over and over, you are strengthening that thought pattern. If you think of it like highways, the brain is paving “roads” where there is repeat traffic. It is reasonable to theorize that these 1500 word per minute inner conversations are widening those roads or thickening the pavement.

  73. You’re welcome, Chris!

    Charley’s viewpoint is very valuable because it helps me clarify my own.

    I look forward to your weighing in on the subject.

  74. Hi Toby & Charley,

    Thanks for such a fascinating dialogue!  I’m away from home and have very limited internet access.  When I return I’ll share some thoughts.

    Happy Holidays,

  75. Charley, I think we both agree that psychological and emotional problems can come from a wide variety of sources.  Some can be physical: measurable ailments such as encephalitis or Lyme Disease, extreme allergies, vitamin or mineral imbalances, and so on.  These are treatable.

    What I am against is the use of psychotropics to handle so-called “chemical imbalances of the brain,” which I think we also agree is a myth.

    Brain scans are useful for picking up tumors or lesions which also may cause mental problems.  Again, these are valid physical problems that must be checked and verified before an effective handling can be done.

    But the problem with biological psychiatry is that it attempts to address “disorders” that can’t be proven to exist as a provable, testable medical pathology — such as “depression” or “bipolar” or “PTSD,” which are then treated with very strong chemicals that can cause dependency and severe side effects.

    You have mixed together the two separate arguments from my last post.

    Let’s start with the brain scan.  Because patterns or blood flow change so much during the day, brain scans simply cannot give a reliable indication of any kind of “mental disorder.”  [Also, brain scans follow the “chicken and the egg” argument: does brain function cause behavior or does behavior cause brain function? Can’t be proved] 

    As for my other point — “PTSD” is yet another arbitrary psychiatric diagnosis that can’t be proven.  I think we both agree that it is a convenient name for a very wide variety of psychological and emotional complaints — and not a medical disorder that can be proven as a pathology.  Therefore, the claim that a shrunken hippocampus “causes” PTSD is simply unfounded.  A link is not a causation but a correlation.  The argument is circular because you are presupposing the existence of PTSD in order to prove it exists.

    If you can prove to me definitively that the broad category known as PTSD is caused by a shrunken hippocampus, I will agree with you, and then we can set about to fixing the problem.  You’ll have to pardon my cynicism, though, but this “shrunken hippocampus” argument sounds suspiciously like another “chemical imbalance” sales pitch designed to sell psychotropics.  If you’ll look through the psychiatric literature you’ll find literally dozens of other theories.

    I must admit that we do differ on your statement that “everything about our existence is physical, my friend.”  As I mentioned before, the human mind is capable of a great deal — witness the amazing ability to heal the body through the placebo effect or other such mind phenomena.  Something observably does profoundly influence behavior above and beyond the physical organ called the “brain.”  Freud believed this, for example, and up until recently this went unquestioned in psychology and even in psychiatry, until it was hijacked by the drug industry.

    So in summary, yes, there are times when bad things happen or we get down for some reason we can’t understand.  And if it is not provably physical and its true source directly treated, then we have a problem of a different nature.  Instead of medicating it away, we need to find a way (using friends, relatives, counselors, whoever) to master it ourselves. 

  76. Nobody is going argue that, at best – at it’s most optimistic and hopeful best, that psychiatry is even close to an imperfect science, let alone a “real” one –

    You are comparing apples and oranges.

    PTSD is a convenient name for a group of symptoms in patients who share similar events in their history. Nobody is saying PTSD is an illness like bone cancer or syphylis.

    As for the constant, and unrelenting onslaught that all people suffering from the symptoms of mental illness can “master something within themselves” – this is the SAME argument and you are contradicting yourself. WHAT evidence shows this to be true?

    If you have high triglycerides in your blood – what exactly does THAT measure? It could be lots of things, yet the doctor will tell you it is because you eat a bad diet without even taking pause to measure what you eat. Is that science?

    EVERYTHING about our existence is physical my friend. Every thought in your head, down to the lowest function of your body is governed by physical processes.

    Are you saying you can control all of them through positive thinking? Do you have proof?

    So why is the concept that there may be measurable and treatable parts of mental illness trouble you so much?

    Sure there is an easy market to sell a pill. Sure doctors can be lazy. Sure people want an easy way out. Agreed. But this does not make your argument.

    If you take PTSD subjects, and you compare such data as this against a similar sample of “normal” people, and you find significant structural diffeences – this is not a circular argument. It is science. The shrunken hippocampus in this image is NOT caused by “daily flucuations”. If your brain mass changed that much in a day, you’d be dead or in a coma at best. I used to work in radiology. I’ve seen scans.

    I’m listening to both sides of the argument here – but…

  77. As learned as the above seems, I have to take issue with the previous post.

    Functional MRIs do indeed show that the brain is changing by measuring blood flow in the brain. But flow patterns change constantly during the day — this is true for everyone. What brain scans do is take a “picture” of what the brain is doing in that particular moment.  This is not a static thing.
    Furthermore you state that the hippocampus is shrunken for people with PTSD.  Are you diagnosing PTSD on the basis of a shrunken hippocampus? If you are, you have crossed the boundary from psychiatry into neurology. 

    Or, as I assume, have you taken a social construct known as PTSD that has never been proven to be a medical disease, “diagnosed” people with it and then measured their brains?  This would be a fundamental error in logic — a circular argument.

    As far as the quote about dendrites is concerned, I have read so many of these conflicting psychiatric studies that I am skeptical of the veracity this claim.  But let’s assume for the moment that this is true, that SSRIs really do restore the branching patterns of dendrites in the brain. 

    We also know from meta-analyses of all clinical studies submitted to the FDA (Kirsch 2008) that SSRIs are statistically no more effective in patients than placebo.

    Does this mean that placebos restore the branching patterns of dendrites, too? 

    Might there be any other non-drug options without the severe short and long-term side effects of SSRIs that can restore these patterns?  Seems like this might be a more worthwhile investigation, albeit less profitable.

    Which brings me to my thesis: Contrary to what we may all read in the mass media, there are many folks (including me) who do not believe that human psychology is medical.  How else do we explain the placebo effect, “mind over matter,” and a host of medically unexplainable human mind abilities?

    In boiling us down to hippocampi and dendrites, biological psychiatry is doing us a huge disservice.  It tells us that we are servants of our bodies, hopelessly subject to the whims of nature and nurture. 

    This is not to slight those who have been traumatized by events in their lives. Rather it is to suggest that it is not their brains that are causing their trauma but something within themselves that they can eventually master.

    Fortunately, this opens the door to some real, permanent solutions.

  78. Thanks for this Michael – I had an argument in a therapy group one evening a long while back. I said that obsessive thoughts and behaviors could cause “brain damage” – and I was nearly laughed out of the room. I wasn’t quite able to back it up, but I knew I’d heard evidence of it.

    I just sent this link to the the psychologist in charge of that group.

  79. There is a great deal of evidence to show that trauma causes structural changes in the brain and subsequent behavioral changes.  Most are animal studies but recent brain imaging technology shows human brain changes. If you go here, , you can see pictures of how the hippocampus is damaged (shrunken) in people with PTSD. From my own paper, “Early childhood and the ability to cope with trauma”,  highlights from animal research:

    […] pups of stressed [rat] mothers […] were more fearful and irritable and
    produced more stress hormones. […] prenatally stressed monkeys […]
    result[ed] in a wide range of impairments including neuromotor
    difficulties, diminished cognitive abilities, and attention problems.
    Researchers hypothesize that a mother’s stress hormones can damage
    the developing brain of the fetus. Very recent research shows that
    maternal stress hormones released during pregnancy may adversely
    affect human fetal brain development (Stien, Kendall, 2004, pp. 21-22).

    Also, from the blog of a psychiatrist called “How do anitdepressents work?”, (, this quote:

    Earlier studies have shown effects of SSRIs on neurons in the hippocampus, an area of the brain involved in memory and emotions– SSRIs increase the ‘volume’ if this structure in animals, and also affect the degree of branching of dendrites, the receiving-portion of neurons, in this part of the brain.  During stress the dendrites in this region lose their complex branching pattern, and antidepressants restore the branching pattern, in essence having a neuroprotective affect during severe stress.

    The pun is intentional;  the chemical imbalance theory is clearly imbalanced.

    Finally, I agree that the label “depression” is both deceptive and harmful. I think a better description would be post traumatic grief

  80. Charley,

    I agree that we need a better definition for depression.  One of the problems with that is that the definition has become less and less specific over time, and more and more inclusive of the shifting moods and feelings that one could expect to experience in a normal human life.

    For example, in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a person is allowed precisely two months of grief after the passing of a loved one.  After those two months are up, if the person continues to grieve they are then labeled “clinically depressed” and presumably become candidates for medication.

    And that’s exactly the point.  Pharmaceutical companies are actively involved in redefining depression and creating entirely new conditions out of thin air (i.e. premenstrual dysphoric disorder) in order to expand the market for antidepressant drugs.  A former CEO of Merck famously remarked that his dream was to sell his drugs to healthy people, since that was by far the largest market of all.

    30 million people take antidepressants, and yet only 12-14 million have a diagnosis of clinical depression.  Of that 12-14 million, I would suggest that only a small percentage have a truly entrenched depressive disorder that is not responsive to changes in diet and lifestyle and psychological or spiritual work.

    I agree with you that the term depression has become so diluted that it is, in practice, almost meaningless.  But keep in mind that diagnosis is the basis for treatment.  In modern Western medicine, treatment means drugs or surgery.  The only way pharmaceutical companies will sell more antidepressants is to expand the number of people that are labeled as depressed, or to expand the number of conditions that can be treated with antidepressants.  They are vigorously involved in both strategies.

    What if we didn’t rely so much on the term “depression”?  What if a patient came and reported their feelings and experience to their doctor without even using that word?  What opportunities would open up for treatment if both the doctor and the patient let go of the idea that the patient is “depressed”?

    In my experience with depression, I’ve found that the term “depression” closes doors rather than opening them.  It can discourage us from inquiring more deeply into the state we so readily label as “depression”, and it can create a powerful “story” about ourselves that, in my opinion, obstructs rather than promotes healing.

    I have a friend who committed suicide.  I spent time with him before he took his own life.  The thing that ultimately pushed him over the edge, I think, was the idea that he was a “depressed” person and would have to struggle with depression for the rest of his life.  That was too much for him to bear.

    There is no such thing as a “depressed” person in the sense that there are tall people, white people or left-handed people.  There are only people who are experiencing feelings that we label as “depression”.  For what purpose?  Part of the reason is to try to help them, but another part is to sell more drugs.  In either case, however, I think the label of depression does more harm than good.

  81. It seems that we need a definition for “Depression”. Define “Intelligence” for example – do all intelligent people have large brains? Is there any characteristic that is 100% uniform among all “intelligent” people?

    Are there different types of intelligence that can be measured in different ways?

    Can different types of intelligence be observed objectively? e.g. a PET scan?

    What we here are calling “depression” might be 100 different things. Like “headache”.

    Do all people with headaches have dehydration? No. Do many? Yes. Are many people helped by drinking water? Yes. Are all headaches fixed by drinking water? No.

    Maybe this argument has lost it’s meaning?

  82. I have seen a lot of evidence suggesting a correlation between depression and neurochemical changes, but this is very different from suggesting that neurochemical factors cause depression.

    What do you mean by this exactly?  Can you give any examples?

  83. I think there is evidence regardless of how twisted it may be used and presented by those with ulterior motives…

    I think we do agree more than we disagree.  I’d love to know what evidence you refer to here, because I review any legitimate data regardless of whether it supports my view. 

    I have not seen evidence that supports a neurochemical cause for depression.  I have seen a lot of evidence suggesting a correlation between depression and neurochemical changes, but this is very different from suggesting that neurochemical factors cause depression.

  84. It certainly seems we agree on more than we disagree. I simply stop short of completely abandoning any idea of drug treatments and chemical explanations. I think there is evidence regardless of how twisted it may be used and presented by those with ulterior motives…

    I completely support your indictment of the pharmaceutical industry – and those capitalizing on falsehoods to woo the public with magic pills.

  85. I agree with almost everything you say, Charley, except for the last two sentences — and I certainly don’t wish to insult you.

    No one is denying that psychological problems are a part of this crazy game called life.  We’ve all been there to one degree or another, some more than others. 

    The only real beef I have with psychiatrists and drug companies is that they purport that these drugs are “brain medicine,” which they clearly aren’t.  We’re actually talking about very potent and often highly addictive chemicals that can wreak havoc throughout a human body (obesity, heart problems, neurological disturbances, etc.), especially if taken long term.

    There are many other non-drug solutions ranging from alternative medicine to nutrition to severe allergy handlings to exercise to lifestyle changes.  I know these types of solutions sound “airy fairy” to someone who is truly suffering emotionally.  As I say, I’ve been there, I know.  But the right one IS the way out, not drugs, which even psychiatrists admit only “manage” mental conditions. 

    But as I think we agree, we’re not looking at a proven pathology here.  There is no lab test, no chemical imbalance to prove the existence of a visible “disease state.” (Not that what you or I may feel isn’t absolutely real)

    I don’t mean to do a disservice to you or anyone else, but in my opinion, as someone who has been down that road, too, all people taking psychotropics should know what they’re getting themselves into, and if they’re still OK with it, then it’s their right to do with their bodies as they wish.

    Best of luck.

  86. Chris –

    Here is where I *think* we agree – psychiatry is *clearly* no science. Nobody can tell you exactly how these drugs work. There is no blood test for depression.

    My concern with the arguments here are that you’ve reduced this argument to one like anemia and iron deficiency. You are tired, a blood test shows you are anemic, the doctor finds out why, you take iron supplements and fix it. Cured.

    There is no such phenomenon as “too little serotonin” – it doesn’t work that way. This is simply a vastly oversimplified explanation for lay people who’s only understanding is “too little/too much/more is good”.

    There are multiple types of receptors for serotonin. Serotonin is involved is much more than mood regulation. Different circuits in the brain utilize chemical mechanisms of communication in different ways. This is why I say “complex” – it is *incredibly* complex – I’m not an organic chemist, nor a neurologist or any other ‘ist’ qualified to give a lengthy dissertation on chemical systems of transmission and feedback in the brain. But come on – clearly you can see this much is true.

    The fact that serotonin is involved in the regulation of mood is inferred from the changes seen when this chemical is manipulated in the brain. Much of our knowledge in science is made by inference.

    We probably agree that this over-simplification has led to convincing a public that all their ills can be solved with medication. Clearly that is not the case. Insurance companies don’t want to pay for lengthy (an often unsuccessful) therapy. Pharmaceutical companies like to sell drugs. No secrets there.

    Serotonin isn’t the only chemical involved – dopamine, nor epinephrine, epinephrine, GABA – all play huge roles. Add to the fact there are multiple types of receptors and that these chemicals and receptors are utilized in different ways and for different reasons in different people and yes, the chemistry is INCREDIBLY COMPLEX.

    In a more self-centered vein I consider myself a “real” sufferer. This in contrast to someone in a period of soul-searching who seeks a remedy in a pill.

    All of this is not to say I think ‘chemical imbalance’ is bunk. Is the change in chemistry a result of environment, bad behavior, bad habits, overbearing mothers or genetics. I don’t know.

    What I *can* tell you is that medication has been the cornerstone of managing this ‘phenomenon’ for me. I hate taking medicine. Side effects? You better believe it. Medicine has even hurt me at one point by pushing me into a manic phase. Medicine alone does not work. I had to completely change my life. I had to stop drinking and using other drugs. I had to develop a different philosophy. I had to change jobs and surround myself with people that were congruent with my new direction. However, the meds remain a key. Without them I am erratic, suicidal and cannot function.

    You make the comparison to alcohol. I’ve been there too. In fact, finding a way to address the underlying issues I was *medicating* with the alcohol allowed me to put it, and other drugs down an maintain strict sobriety for the past six years. It was a psychoactive drug called Depakote that allowed me to do that.

    You just can’t over-simplify this. Between comments like ‘the true solutions to emotional and psychological problems just can’t be found in a test tube’ – and a drug company’s promotion of the idea that these issues can be solved with a pill is a reality: – and that is that these medications can be an invaluable *part* of successful treatment.

    To say anything less is grossly insulting and does an incredible disservice to those in need.

  87. Precisely, Chris.

    No one is arguing that there is no such thing as severe depression or that people suffering from it are somehow inferior or “not strong enough.” 

     The argument is that there is no proof that problems like this are medical in nature caused by a “chemical imbalance in the brain.” 

    Psychoactive drugs may or may not cover up the symptoms, but they are not the cure, and worse, can come with considerable side effects, especially in the long term.

    It would be nice to believe that modern medicine can solve all our problems for us.  But years of fruitless research has proven that true solutions to emotional and psychological problems just can’t be found in a test tube.

  88. @Charley:

    I’d be happy to read any evidence you send me which suggests that depression is reliably correlated with neurochemical function. The evidence overwhelmingly does not support such a correlation, as I’ve detailed here and on other posts.

    I’d like to know what “complex chemistry” you’re referring to. I’ve reviewed literally hundreds of studies and quite a few books and textbooks on the neurochemistry of depression, and I have not found any consistent explanation for how dysregulated neurotransmitters cause depression. Again, I’ve written about this at length on my blog.

    I have also suffered from life-threatening depression, so I do not wish to diminish in any way the intensity, seriousness and reality of such a condition.

    However, the fact that whatever lifestyle changes you may have tried didn’t resolve your depression is not proof that it’s a disease caused by a neurochemical imbalance or dysfunction.

    It sounds like you have had success with drugs. I’m very glad to hear you found something that works. But again, the fact that you improved with drugs doesn’t prove that depression is caused by a chemical imbalance. People with severe anxiety will usually experience relief when they drink alcohol. Does that prove their anxiety is caused by alcohol deficiency? Hardly. This kind of ex juvantibus reasoning is very common in the antidepressant/depression debate, but unfortunately it is fatally flawed.

    If you wish to convince us that depression is caused by neurochemical dysregulation, you’ll have to do more than offer a vague reference to “chemistry” that is too “complex” to go into here.

    I have no agenda. I was a fellow sufferer of severe depression, and began researching it years ago to learn more about it and find my way through it. This is the conclusion I’ve come to based on that considerable research and personal experience.

  89. Its not “too little serotonin” or “imbalance” –

    Those of us who have suffered personality changing, life threatening depression aren’t often cured by a change in diet or reading a book any more than we are by going back to church.

    You’ve reduced the entire psycho-pharmalogical subject to a comic strip.

    It has more to do with what the brain DOES with these chemicals and how they work in the brain than it does with amounts.

    The chemistry is far too complex to make this argument here.

    The fact is that some of us, unable to function otherwise, have been able to reclaim our lives as a result.

  90. Jane & Froscha,

    Thanks very much to you both for sharing your experience with us.

    The insulin analogy is ridiculous, of course. In the case of diabetes we can measure insulin deficiency quite easily, and the role of insulin in regulating glucose metabolism and producing diabetic symptoms is well understood.

    In contrast, there is no test to establish a so-called “chemical imbalance” in depressed people, and nor do we know how psychotherapeutic drugs produce their effects.

    The Merck CEO quote came from a book called “Selling Sickness”, by Alan Castells. I recommend it.

  91. Hi Chris,

    Thank you for writing this. My pill-popping family is convinced I should be on drugs for life. My mom makes great use of that analogy between diabetics taking insulin and depressed/bipolar patients taking psychiatric drugs. I disagree, at least as far as my own use, and now I can point to something substantial. Besides, insulin -helps- diabetics whereas the variety of drugs I’ve tried have only sent me down a spiral of dependency and side-effects that are more debilitating than the condition I supposedly have.

    My psychiatrist recently agreed with me that I had been misdiagnosed as bipolar 5 yrs ago. The ridiculous thing is, I had one all-out manic episode AS A RESULT OF an antidepressant I later found out is a known trigger. (This information was not on my hospital discharge papers; a nurse happened to mention this to me privately after seeing traces of the drug in my blood.) I had also been on Paxil for two years before that for unipolar depression, though I had stopped a year before my episode — I now regard Paxil as the beginning of my descent into this medical nightmare. It made me too punchy at work too.

    I have not had another manic episode since then and I did not go on drugs right away. I was doing fine, actually. However, I was scared into it by a lecture from a new GP who has a bipolar brother. She told me that it is normal for newly diagnosed bipolar patients to discount their diagnosis (ie. pathological denial), and that if I didn’t go on the drugs I would -inevitably- have another episode, only worse, and once I had a second I would be even -more- likely to have a third, and so on, with episodes becoming increasingly frequent. I was horrified at the idea of turning manic at work so I fell in line.

    I am happy to learn this new word “iatrogenic” as I think my remaining problems (sleeping patterns increasingly erratic than before treatment, increased irritability, dark thoughts, not being able to hold down a job because of side-effects — NOT because of behavioural issues as one might expect from someone labelled bipolar) are caused by my so-called treatment on a variety of drugs these past 4 years. Okay, honestly, the Lamotrigine I’m currently on may help with depression/anxiety but it’s hard to separate true benefits from avoidance of the unique sickness and mood swings that happen with decreased dosages of anticonvulsants — in essence, the effects of detox rather than proof of the original pathology. Going back on full dosage as I’ve had to do recently (due to lack of support/stability in other areas of my life) seems akin to a heroin addict using again to avoid withdrawal rages.

    I may still have a “mood disorder” (ha, don’t most people?!) but I’m starting to recognize the clearly observable link between my state of mind with external stressors, diet and sleep. I’m also on a waiting list for CBT therapy through an agency that offers free programs — but because it’s free it also takes a long time to get in. I was told I could expect to wait up to 10 months. As you say, the medical support system (even here in Canada, as idealized as it may be by Michael Moore, et al) is set up to profit by drug treatment, not support potentially more effective cognitive therapy, or dietitians, or alternative practitioners or the like.

    Do you happen to have a full quote or reference to the Merck CEO’s dream? That reminds me of having read that Ron L. Hubbard once told someone he was planning to create a religion since his other get-rich-quick schemes hadn’t panned out — but, I cannot substantiate that quote. Wish I could.

    Warm thanks,

  92. Thank you Chris for your excellent work with this article which I will propagate to my youtube viewership.

    I can only speak for myself but I understand what depression is and how it is cured.

    My depression manifested at age 7 with a crayola crayon drawing of me lying dead with a knife in my heart and blood everywhere.

    My parents fighting with each other and their constant toxic psycho emotional histrionics made me depressed.Growing up thinking some Commie was going to nuke me in the 80s made me depressed.

    Child abuse for years made me depressed. Bullying at school made me depressed. Religious guilt made me depressed. The crappy weather of New England made me depressed. The smoky, rundown, unlit home I grew up in made me depressed.

    Being abandoned and turned over to the State made me depressed.

    Later the psychiatric hospitals, the juvenile group homes, the psych meds all made me even more depressed.

    Failing everything I tried to do as a young adult furthered my depression.

    By the time I was 20 life to me was only depression of varying degrees of intensity. I wanted nothing more than to be free of my life.

    By the time I was 32, I had been suicide attempt and depression free for a decade.

    Following my last suicide attempt at age 20 I had a near death experience that changed my life and my approach to living.

    I began each day by communing with the sun and ended each day by watching the sun set.

    Later I substituted my coffee and cigarettes with yoga and tai chi as I continued my rituals.

    In time I learned to meditate properly.

    Year after year I healed everything in my life that had happened to me.

    I forgave myself for not having any power of the events of my life. I forgave those that had trespassed against me and harmed me. The years of practicing tai chi and yoga 6 hours a day kept me feeling young and relaxed. The meditation allowed me to defuse all my triggers. I moved to a bright and sunny place with no winter and escaped SAD forever more.

    I did everything in my power to micromanage and cope with everything that had ever made me depressed.

    In my family my mother, sisters, brothers. They all continue to suffer from recurring depressions but not me

    I alone escaped. I did the one thing no one in my family has ever done. I slowed down my life, took total responsibility for my past, present and future and I learned to unconditionally love myself and care for myself.

    I have been depression free ever since.

    I know what causes depression. I had physical,emotional,psychological and spiritual reasons for it. I fixed them all. As a result I know how to fix depression without therapy or drugs. In so doing, proved, at least to myself, that depression was no life long genetic chemical imbalance.

    It pains me to read the comments left by teenagers on videos on youtube about depression, bipolar, etc, etc. These 13-19 year olds swear their problems are biological brain diseases or genetic chemical imbalances and they are growing up uncritically believing in and spreading the chemical imbalance pharmaganda to their peers. They encourage each other to use different psych meds. It works for ma and pa right?

    Thanks for this article. You are doing good work Chris.

  93. The answer to this insanity is websites like yours, Chris. Neither drug companies nor psychiatrists are going to give you the truth.

  94. @Toby:

    I couldn’t agree more, Toby. The so-called biological diagnosis of depression is analogous to the diagnosis of so-called diseases like “high cholesterol”, “seasonal affective disorder” and “pre-menstrual dysphoric disorder” which are indistinguishable from normal physiology. It’s all an attempt to push drugs to healthy people.

    30 years ago the CEO of Merck upon retirement stated that his dream was always to “covert healthy people into customers”. Looks like his dream came true.

    Only 10% of psychiatrists practice psychotherapy now. People are often prescribed drugs on their first visit and told they’ll have to take them for life.

    This is criminal IMO.

  95. Thanks for the good work, Chris.

    You are absolutely correct in stating that there is no such thing as a “chemical imbalance” in the brain. Sure, there may be vitamin or mineral deficiencies, and these can be found with simple blood tests or hair analyses.

    What outrages me the most is that psychiatrists will tell you that you have a “chemical imbalance in the brain” to convinced you to take psychotropics, knowing full well that a) they haven’t given you a test to determine if you have one, and b) knowing full well that no such test exists, and c) that no imbalance even exists!

    If any other doctor gave such a serious diagnosis involving a lifetime of care (i.e., drugs), without even so much as a simple blood test, they would most probably be brought up on malpractice charges and their license pulled.

  96. Hi Jessiqua,

    Welcome to The Healthy Skeptic and thanks for your participation.

    I’m glad to know the article will be useful to you in the future. I also hope that many doctors, patients and parents will read this before deciding on antidepressants.


  97. I knew there was a huge conspiracy behind it all. This is why I absolutely refused to believe anti-depressants and the like would ever help me, and eventually I learned how to be happy on my own and deal with my problems. Time is the best cure.

    More people need to read this, and I’m so happy to have found it because now there is a way for me to explain to people why I believe it’s not the way to go.

    Thank you for the wonderful article!

  98. Jacqueline,

    I have defined “chemical imbalance” in this particular article as the idea that depression is caused by a deficiency of serotonin or norepinephrine in the brain.

    I certainly don’t dispute that there is likely some biochemical involvement in depression. If that is what you mean by “chemical imbalance”, then we have had a very big miscommunication!

    I am glad that Radiant Recovery has helped you to heal, and I was not suggesting that you don’t pursue it. If it works, it works! I was only curious (genuinely) to know what evidence you were basing your belief in “chemical imbalance” on.

    Best wishes,

  99. I am smiling at your hint that I am somehow unable or unwilling to question my diagnosis after 40+ years of untiring research on my own behalf.

    I think there is some confusion between ‘chemical imbalance’ and ‘seratonin deficiency’ in this. No it is not seratonin on its own – there are other chemicals and hormones out of ‘balance’ but we could argue terminology for days and probably get a huge Betaendorphin lift from the process LOL

    I wish you well with your blog – I will continue to pursue my interest in Radiant Recovery and would invite anyone who is suffereing from depression, insomnia or addiction who is reading your blog to have a look at us on the website.


  100. Jacqueline,

    I would not state the simple version as “no one knows what causes it”.

    The simple version is: “the evidence is clear that depression is not caused by serotonin deficiency.”

    That statement is not controversial according to the scientific literature. Furthermore, as I pointed out in my last post, it is extremely unlikely that depression is caused by a single “mysterious little neurotransmitter” – whether identified or unidentified.

    I am glad that people like you have discovered something that works. That does not, however, prove anything about serotonin’s role in depression. The dietary and behavioral changes suggested in Kathleen’s program address depression through many different mechanisms of action. There is no proof that any of these mechanisms involve changing serotonin levels in the brain.

    And of course, there is abundant proof that her program doesn’t work by raising serotonin levels. How do I know this? Because if that is how her program had its effect, then any intervention that raised serotonin would alleviate depression and any intervention that depleted serotonin would cause it. We have repeatedly seen that this is not the case.

    May I respectfully ask why it so important for you to be sure of a diagnosis of “chemical imbalance”? In the face of so much evidence to the contrary, why and how do you continue to embrace this diagnosis? Does it somehow validate your experience in a way that wouldn’t happen if it were absent?

    If we remove the “chemical imbalance” diagnosis from your equation, the fact remains that you were able to heal yourself using food and behavioral modifications from depression. Is that not enough? Why is the “chemical imbalance” theory necessary at all?

    Jacqueline, is it possible that there is a belief system operating here that you are unwilling or unable to truly question? I ask because I still have not heard any compelling reason from you or Dr. DesMaisons why you continue to believe in “chemical imbalance” in light of the complete lack of evidence to support it.

    There is no “argument” in the scientific literature. The literature is resoundingly clear that depression isn’t caused by serotonin deficiency, as I have presented in great detail here. The only argument is in the minds of people who have been conditioned to believe in the “chemical imbalance” theory by years of advertising, promotion and misinformed health care professional and media.


  101. Sticking to the simpler version you are happily admitting that no-one actually knows what causes it.

    If we make an assumption (even if it is erroneous or incomplete) and in seeking a cure for this assumption we discover something which works then is this not a good thing.

    We could argue about the science for an eternity, even if this mysterious little neurotransmitter were discovered and labelled, but the bottom line surely is that people are suffering. Some of those people, in pursuing healing, have discovered something which really works.

    Would further investigation of this human proof of pudding not warrant further refining?

    Thank you for making me even more sure of my diagnosis though and do continue to make us think.


  102. Kathleen,

    I tried to email you but when I clicked on your name I am taken to a URL that must have a typo:


    Even when I changed the comma to a period, it still didn’t work. You can send me an email through the “Contact” form on the blog.


  103. Hi Rob,

    Welcome to the Healthy Skeptic and thanks for your comment.

    Again, sorry to be a stickler here but the fact that you improved on Equalibrex doesn’t prove that serotonin deficiency is at the root of your problem. As you mentioned, it could well be a placebo effect. Placebo is very powerful and can’t be discounted. Also, a product with several ingredients could have non-specific effects (i.e. effects not specifically related to serotonin) that could relieve the depression. It’s more than possible that the life changes you referred to could be responsible for the improvement. Finally, the shift could simply be due to regression to the mean.

    And of course, it is *possible* that you improved because the supplement increased levels of serotonin in your brain. I am not saying it’s impossible. I’m just saying that the overwhelming majority of evidence doesn’t support that as the most likely explanation.

  104. Jacqueline,

    I can certainly see your perspective, i.e. that learning you had a “serotonin imbalance” led you to seek out natural remedies that could improve your condition.

    I will steadfastly continue to point out that there is absolutely no way you can know whether you had a serotonin deficiency or not, nor does the evidence support a role for said deficiency in causing depression even if it exists.

    I’m sorry to sound like a broken record here, but I’m sticking to my guns until someone presents evidence that changes my mind. While I greatly value personal experience and intuition in the healing process, one person (or even an entire country’s) belief that their depression is caused by serotonin deficiency doesn’t convince me that it’s so.

    As Anatole France said, “Even if 50 million people say a foolish thing, it is still a foolish thing”. At one time nearly everyone thought the world was flat, and the earth was the center of the universe.

    I certainly don’t mean to imply that what you are saying is foolish. Rather, I simply wish to point out that sometimes even our most sacred and unchallenged beliefs turn out to be false.

    I completely agree with your statement that “empowering the sufferer and offering sound, practical and proven advice is the most powerful tool for healing we can give.”

    • My son was placed in a mental institution in 2011 i was told he had psychosis here is his meds (risperdal) he will need this the rest of his life he gained 50lbs in four months went off his meds broke into the neighbors house made over a thousand dollars of charges on my debit card over the internet then got caught shoplifting he has violent episodes out of nowhere for no reason and threatens to harm me with what ever is nearby bats frying pans wooden poles had to call police on him several times……currently he is parinoid thinks snipers are after him and all his friends are plotting against him then at times he can seem somewhat normal for a few hours what is wrong with him can i fix him without all this antipsychtic meds

      • Dianne – having lived through your situation and obeying the doctors’ orders time and time and time again – I can safely bet your son is self-medicating himself with something…anything…everything he can get his hands on. We went through multiple diagnoses icluding bipolar, depression, schizophrenia, schizo-affective disorder, to whatever else the flavor of the day was. (My favorite – oppositional-defiant disorder – straight A student, super respectful to his teachers & loved by all of them…what a CROCK!!) Also told he would have to live his life on any number and/or combination of medications, all of which completely turned him into a zombie. At any rate, here we sit, more than a year later and multiple medications later – miracle of miracles –> he’s clean, sober, and drug free. Had no idea it was recreational drug use, mixed with everything else, but he admitted it later. No docs, no meds, no disorders – WOW! Narcotics Anonymous – get him there immediately and kick him out of your house – period. He will find someone there who will hold him accountable and he will learn quickly the natural consequences of his actions if he doesn’t. That is to say, hopefully he’s old enough to live on his own at this point (i.e. 18)

      • There is not adequate information to answer your question. He may have a psychotic disorder for which he will need lifetime meds. Not all cause weight gain. He might be using drugs. If so, he may be using them, or alcohol, to quiet frightening voices in his head. He may be using them simply because he is curious, or because of peer pressure. Abusable drugs all affect the brain. Some can cause psychosis or trigger latent psychosis, which may or may not be long-lasting. Some can cause psychotic symptoms when they have been used in high dose and are stopped suddenly. Some can cause depression, which might be short or long term.
        If your son is using, he may lie or steal also. In either case, given the physically violent component, it is important to realize there may be a real and serious risk of potentially deadly violence.
        Not everything can be sorted out all at once. It is important to take first things first, which seems in this case to be his behavior. This may involve having the Sheriff pick him up to take him to a hospital for an evaluation, or to arrest him, depending on the circumstances. However, things are handled differently in various places. There should be local resources to help your decision-making, as well as relevant online forums.
        The psychiatrist who treated him may be a good person to help advise you. Sometimes it is important to get symptoms under control quickly. A medicine without the weight gain may have been part of a longer-term plan. If you do not feel comfortable with the psychiatrist, please seek someone who can help direct you. You can learn a lot from other parents who have been in similar situations.
        From your description, this is not a situation which will take care of itself. Blessings for your journey.

    • btw it’s also a (latter day) myth that ‘at one time nearly everyone thought that the earth was flat’. Really interesting article and discussion. Thanks .

  105. Kathleen,

    I am completely open to another point of view, so long as it makes sense to me and there is evidence to support it. By evidence, I am not exclusively referring to double-blind, placebo-controlled randomized trials. I do not think that is the only type of scientific inquiry we should engage in.

    You should know that before I started researching depression, I believed what everyone else believes – that it was likely caused by some chemical imbalance in the brain. I clearly saw the role of nutrition, behavior, psychosocial, and other factors, but I thought that they were simply altering brain chemistry and therefore addressing the underlying chemical imbalance.

    When I started the research I approached it with an open mind, and thus my mind was changed after a thorough review of the evidence.

    I have looked at the studies you linked to, and when considered against the bulk of published research I do not believe they offer compelling evidence to support the serotonin hypothesis. As you well know, it is always possible to choose a study or even group of studies to support one’s view.

    That’s why I have great respect for the work of researchers like Kirsch, Moncrieff, Valenstein, Hollon, Healy and others. They’ve spent the majority of their careers investigating this issue and reviewing all available and relevant studies, and their conclusions are all the same: when taken as a whole, the research does not support the theory that depression is caused by a chemical imbalance.

    Is there a study out there that contradicts their conclusion? Sure there is. But there are so many more studies that support it. There are also fundamental flaws in the reasoning of the “chemical imbalance” hypothesis:

    1. The psychiatric literature has rarely addressed how or why an excess or deficiency of serotonin or dopamine explains any particular mental disorder. There have been few attempts to explain how the proposed changes in neurochemistry actually affect the psychological phenomena called depression.

    2. More than one hundred different neurotransmitters have been identified in the brain. Some of the NTs bind to as many as fifteen receptor types, each of which can presumably trigger a different cascading sequence of physiological changes. Add to this seemingly overwhelming complexity the fact that the receptors are continually changing in number, sensitivity and state and it becomes clear why their ensuing effects may differ from moment to moment.

    3. In the case of serotonin, fifteen different receptors (5-HT1-15) have already been identified, and there may be more. Each of the fifteen receptor subtypes can be further subdivided (5-HT1 can be divided into 5-HT1-2, 5-HT1-3, etc.) There is virtually no information about what behavior or psychological states are likely to be affected by stimulating or blocking a particular receptor subtype.

    4. There is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance.

    5. The claimed efficacy (which has been successfully disputed by Kirsch et al.) of SSRIs is often cited as support for the serotonin hypothesis. This is ex juvantibus reasoning – the fact that aspirin cures headache does not prove that headaches are due to low levels of aspirin in the brain.

    6. EVEN IF it we could find a biochemical, anatomical or functional difference in the brains of mental patients (which no one has been able to consistently demonstrate), it would be wrong to assume that such differences are the *cause* of the disorder. The abnormalities could just as easily be the result, rather than the cause, of the disorder. Furthermore, it is well established that psychotherapeutic drugs used to treat mental disorders may induce long-lasting biochemical and even structural changes, which in the past were claimed to be the cause of the disorder, but again could just as easily be an effect of the treatment. It is now difficult to find mental patients who have not had a history of drug treatment, and because of this many of the brain abnormalities found in these patients are probably iatrogenic (produced by the treatment rather than being the cause).

    7. Various experiences can also modify brain anatomy and function. Numerous experiments have shown that exposure to stressful situations can produce long-lasting brain changes. There is also evidence that stress can produce long-lasting changes in the same class of dopamine neurons that make them hypersensitive not only to drugs such as amphetamine, but also to subsequent exposure to stress.

    The idea that serotonin isn’t the cause of depression may sound radical, but in fact it is not. As I pointed out in the article neither the DSM nor major psychiatry textbooks claim that depression is caused by serotonin. Furthermore, many well-known and influential psychiatrists (even those who prescribe antidepressants) and researchers have publicly stated their disagreement with this hypothesis:

    “Given the ubiquity of a neurotransmitter such as serotonin and the multiplicity of its functions, it is almost as meaningless to implicate it in depression as it is to implicate blood.” – John Horgan, The Undiscovered Mind

    “A serotonin deficiency for depression has not been found.” – Psychiatrist Joseph Glenmullen, clinical instructor of psychiatry at Harvard Medical School

    “Indeed, no abnormality of serotonin has ever been demonstrated.” – Psychiatrist David Healy, former secretary of the British Association for Psychopharmacology

    “We have hunted for big simple neurochemical explanations for psychiatric disorders and we have not found them.” – Psychiatrist Kenneth Kendler, co-editor-in-chief of Psychological Medicine

    “Although it is often stated with great confidence that depressed people have a serotonin or norepinephrine deficiency, the evidence actually contradicts those claims.” – Professor Emeritus Elliot Valenstein, Michigan University

    “I spent the first several years of my career doing full-time research on brain serotonin metabolism, but i never saw any convincing evidence that any psychiatric disorder, including depression, results from a deficiency of brain serotonin.” – Stanford psychiatrist David Burns, winner of the A.E. Bennett Award given by the Society for Biological Psychiatry for his research on serotonin metabolism

    Kathleen, you suggested that I perhaps am not approaching this with an open mind. With respect, I ask you to consider whether that may not be true for you? I have presented what I think most people would agree is very compelling evidence against the serotonin hypothesis, and so far it would seem that you have been unaffected by this data. You have responded with two studies, neither of which indicate a role for serotonin in depression and neither of which contradict any of the claims I have made in my article.

    I am honestly curious to know what *evidence*, however you are defining it, is the basis for your continued belief that depression is caused by serotonin deficiency? I really would like to see this evidence, because, contrary to what you implied in your last comment, I *am* approaching this with an open mind and have been from the begninning… way back when I also thought depression was caused by a lack of serotonin.

    My review of the evidence changed my mind completely. Is there room for yours to change as well?

    I’m not sure what part of my personal journey you’re referring to, but I would be happy to have a dialog offline with you. I do not believe there is any such thing as an “untreatable condition”, and I reject the validity of several Western medical diagnoses that use this language. There are too many examples that prove otherwise, and if even one person recovers, then the condition is no longer “untreatable” or “incurable”.

    • Thank you so much for all your work and your kind disposition. I appreciate your honest approach and respect for others. I am so tired of seeing wonderful people in my practice who have been drugged to be less than human. In other words, they just don’t feel or emote the way we were designed to. I can’t tell you enough how much I appreciate your personal journey & thorough research. Thank you much!!!

    • Wish I had your brains and knowledge, I speak from experiences on this drug and my own research that thankfully led to my being weaned off (not without brutal symptomatic distress I will add)

      I fight my corner so fiercely because my life was ruined as was my daughters because of me on these drugs – In my case Venlafaxine xl – AKA- Effexor xr.

      I never had a mental health problem prior to these drugs and the excuse for putting me on them was `mild depression` (aka – I was at that time a young single mum being bullied by an ex, I needed help to cope with his bullying and was upset) – 10 years on, dose had gone from 75mg to 325mg – I was a psychotic, manic depressive, suicidal, homicidal wreck.

      No Dr/Psychiatrist would admit the drugs were to blame, and in fact demanded I take responsibility for my own mental instability, time again I was forced to say I was a manic depressive because admittance is the way forward, all bar one….. it was then I had to research and get myself weaned off via liquid doses ( I religiously read David Healy and Peter Breggin – without them I would have given up)

      What I went through, in the reduction withdrawal was more brutal than I could ever explain, I lost all emotion, I fantasied evil thoughts, I attacked my daughter via strangulation…. alongside much, much more.

      No scientist has ever tried out these drugs first hand so I do not know how they can really believe they know what they do because they do not,.
      Observing a few week trial is not evidence. Reading peer reviewed / ghost written journals is not evidence.

      How has it come to this?

      • Hi Miss Diagnosed –

        Thanks for your e-mail and your concern on the Lexapro issue. I’ve been off a week and haven’t had any issues to speak of.

        I’ve done a lot of reading since my original post and I whole-heartedly agree with you that there is a vicious cycle. I can say with confidence I’ll never take another anti-depressant again.

        For what it’s worth – and just from my own thoughts on this issue – depression is nothing more than fighting feelings that we don’t want to have instead of just being aware of them. Your feelings won’t hurt you and it doesn’t mean that something bad is going to happen – they are thoughts in your head. I know it does not feel that way when you’re in the thick of it. To me it is so freeing to think I can notice a feeling and say “oh, this one again – hi, I remember you thanks for stopping by but see you later.” 🙂

        Might seem trite but it’s what I’m starting to do.

        Thanks again and good luck and best wished to everyone experiencing depression.

  106. It’s a hard call. I’m taking a supplement called Equalibrex ( which is a 5-formula system of natural ingredients intended to increase well-being or alleviate depression or whatever. Many of its ingredients affect seratonin levels(5-htp and sam-e, for instance). I’ve noticed quite a noticeable difference in how I feel which is hard to pin on the placebo-effect. Now, i’m not discounting behavioral variables in equation, as I’m now a lot more active than before, but I do feel “picked up” so-to-speak.

    Seratonin levels may very well be an indicator of depression, but I’m not going to assume some people are endemic to low levels and some are not. If one forcibly or artificially raises levels to make themselves feel better (through medication/supplement/exercise), of course seratonin would be the deciding variable – this does not mean those levels are “normal” or “raised” in other people for non-medicinal reasons.

  107. Could we review ‘irresponsible’ for a moment.

    If the patient accepts this diagnosis and then puts themselves utterly in the hands of the Pharmaceutical or Psychiatric industries then this would indeed be negating self responsibility.

    However if acceptance of this diagnosis (and I utterly accept it after two years of personal experience) means feeling empowered to seek a natural, science based and proven program of healing then self responsibility is actually enhanced.

    Sometimes empowering the sufferer and offering sound, practical and proven advice is the most powerful tool for healing we can give.

    However I am still with you that this second option is not often offered by our current health service and I am glad to see you confronting the Pharmaceutical giants. Please though don’t bring a diagnosis which so many ‘know’ to be true as ammunition in your fight – rather address what they do with it.


  108. Hey Chris,

    one other thought here…

    I just got some context from your personal journey.
    I have a feeling that our backgrounds are very similar.

    I would be delighted to talk with you about treatment of some complex issues that medical science has written off as untreatable.

    We could have that dialogue off line.


  109. And we can simply agree to disagree on the definition of *evidence*.

    And I am very happy to continue with the premise that of course depression is caused by a chemical imbalance, LOL.

    Lotrich FE, Pollock BG.
    Free in PMC Candidate genes for antidepressant response to selective serotonin reuptake inhibitors.
    Neuropsychiatr Dis Treat. 2005 Mar;1(1):17-35.

    Lotrich suggests that that the differences in outcomes or impact may be a function of gene types. You might want to read that one

    And here is Prakash suggested that the analysis makes a difference…

    Prakash A, Risser RC, Mallinckrodt CH.
    The impact of analytic method on interpretation of outcomes in longitudinal clinical trials.
    Int J Clin Pract. 2008 Jun 16. s

    Therefore, whether or not underestimating (overestimating) within-group changes was conservative or anticonservative depended on the relative magnitude of the bias in each treatment and on whether within-group changes represented improvement or worsening.

    Perhaps the difference is that I am open to hearing the other side and you are not, LOL….

    I just think your argument would be more powerful if it were balanced.
    I am learning a lot in the process.


    • Kathleen, I have reread your posts and have to add, that science has duped even the smartest of people to believe theories are fact.

      You even state yourself that Lotrich and Prakash `suggest` analytic methods etc.

      All medicinal based data is termed awfully in a manner that expresses fact and this is not so.

      To say `suggests`, `believes`, is probable, seems to, appears to etc is not evidence.

      Even anti depressant in box leaflets express how the drug is `believed` to work.

      How can so many intelligent people be so ignorant of the what they are reading and absorbing is beyond me. `

      • Exactly!! The Drug co.’s own advertisements use those same words; “believed to..” “thought to..” and so…that of itself validates that “they” do NOT know! They are simply theorizing…and wrapping it up as factual/ evidence-based science! And…yes, people believe it as if it IS FACT!! What they have successfully proven is the power of the Psychology of Marketing!

  110. Hi Jacqueline,

    I agree that behavioral change is likely to be important in treating depression.

    However, at the risk of beating a dead horse, I feel I need to again point out that there is no evidence that antidepressant drugs or dietary changes relieve depression (when they do) by increasing serotonin levels or modifying brain chemistry in any other way.

    To be fair, it is possible that the drugs and diet work on other as yet unidentified neurotransmitters, or by some unknown mechanism involving brain chemistry. However, unless we discover that is the case – which is by no means inevitable – I believe it is irresponsible to continue promoting the idea that depression is caused by a “chemical imbalance”.

  111. Well I found all that utterly fascinating and thank you both very much.

    As a psychologist as well as a ‘patient’ could I point out the ‘double whammy’ of the PnP programme has been in addressing both seratonin levels/brain chemistry AND behaviour. Built into the steps are numerous changes in behavioural patterns which are missing in purely pharmaceutical intervention and might throw light onto the delay factor in the effectiveness of artificial seratonin raisers.

    I think the human organism, for mental health, needs to be proactive in changing negative attitudes/habits at the same time as the brain is healing and this is why the subtle mixture of behavioural and nutritive intervention works so well.


  112. Hi Kathleen,

    Nice to hear back from you. Indeed, serotonin may be a part of it – but is it a correlation or a cause? It has been shown that certain life events and behavior can deplete serotonin levels, so the possibility has been raised by researchers that depression may cause serotonin deficiency and not the other way around.

    Actually, in a previous article on the blog I have cited longitudinal studies which indicate that treatment with antidepressant drugs (which increase serotonin levels) is associated with poor outcomes over the long-term. In contrast to the six-week clinical trials you mention, these studies are looking at results over periods of months and even years.

    Although food may have a placebo effect (nearly everything does), I do believe there are biochemical mechanisms influenced by nutrition that contribute to depression. I just happen to think serotonin isn’t primary in this equation.

    I also agree that getting well is what matters most. However, *how* someone conceives of their illness and *how* someone gets well is also important. I like what Joanna Moncrieff, who is one of the foremost researchers in this field, has to say about this:

    “The promotion of antidepressants has convinced millions of people to ‘recode their moods and their ills’ in terms of their brain chemistry (Rose 2004).

    If people believe that it is brain chemicals that have made them depressed and that they only improved because a drug helped to rectify a chemical defect or imbalance, then they are likely to fear the recurrence of depression with every difficult period in their lives. In addition, they are not likely to recognize the things that they did to help themselves out of depression, because they attribute their recovery to a drug. If in contrast they had managed to get through the period without taking a drug that they thought sorted out their biochemistry, they would have had an experience of self-efficacy that could build their confidence and help them to face future problems with greater strength.”

    This is analogous to the “give a man a fish, he eats for a day; teach a man to fish, he eats for life” parable. Teaching people that depression is caused by a chemical imbalance that requires drugs to correct is profoundly disempowering (not to mention completely false, according to the scientific literature). But it does wonders for drug sales!

    Thanks again for your contribution, Kathleen.

    • I would just like to say your article and further comments are a very much welcomed breath of fresh air. I felt after reading this comment in particular that I would like to comment. What Joanna Moncrieff mentions about the prevailing mind with the absence of medication is so true, I speak from experience, my brother died in 2000 on his birthday when I was 12. I suffered from depression, though at the time I did not know that was what it was. I refused openly and aggressively to no therapy, medication or any form of help that was not my own thought process. It took me years to finally become comfortable enough to talk about him, and what happened that day. What I didn’t realise at the time, was that I was actually performing my own self therapy. I would write in a notebook, just nonsensical stuff,swear words, scribble, anything to give my mind the release t needed. Orr I would scream into a pillow, listen to music, or go for a walk. But what I found is that I am so proud that I did it by myself, I now feel I am a stronger person for it, and I feel it has helped me to live my life in a better manner than if I had been subject to medication. I do now feel I chandler any situation by myself, and I am confident I can do it all on my own.

      It’s the one very small light at the end of the tunnel, and it continues to help me 13 years on. I still continue to adopt some of the methods I used back then, now, I use music and walking to help clear my head and help put things into perspective.

      Kind regards,


    • When you acknowledge that serotonin may play a part, you falsify your claim that it is false that depression is caused by a chemical imbalance. You need to edit your article to reflect that. Clearly these drugs do something for some people even if it is merely to mask some of the symptoms of depression. Also, the common effects of cocaine and amphetamine are contrary to the symptoms of depression. If that were not the case, there would be no black market for these drugs. Why they are not legitimized treatments has nothing to do with their effectiveness.

      • What they do, over many weeks, is increase brain derived neurotrophic factor (BDNF). This sprouts some new connections and can help some people start to feel better. The improvements have nothing at all to do with serotonin. That theory is bunk.

        • Could you please provide a reference for that? I’m familiar with evidence of BDNF’s ability to differentiate neuronal stem cells in the hippocampi of adults with dimentia, but I have never heard of an association between BDNF and mood disorders.

      • I have OCD and was an anorexic runner for a long period of time. When I used a medication that corrected my seratonin levels, my recovery was immensely boosted. If I did not have the seratonin medication, I would not be alive today, much less with a running career.

        • Always a little dubious of people who do not divulge any info other than cliched `illness` and rave about the product.

          You dont say how long you were on the medication nor which medication you were taking other than `serotonin boosters`
          This is strange considering exercise alone (and you being a runner) boosts serotonin naturally as do many foods (and you being a runner and healthy would normally know this)

          You may well have to excuse my skepticism because your little input here is fishy at best and what with Pharma trolls everywhere…….

      • “play a role” vs. “causal determinate” are two very different things. And so, he does not undermine his own opinions! 🙂 Just say’n.

  113. Well, we can have fun agreeing to disagree

    I think serotonin can be a part of it. And the studies you are citing doing a test in a very short term interval. It may be that serotonin depletion that persists for 6 weeks is a more accurate measure. For example, people who do Atkins generally crash into depression reaction about 6 weeks in…

    But, honestly, I am not trying to convince you, only to nudge your healthy skeptic to stay open to the store.

    The interesting thing for me is watching people get well. That is what I care about. Some might say doing the food is merely placebo. Could be.
    But results are what counts.

    I love that you are so thoughtful.


    • The interesting thing for me is watching people get well. LOL, as long as your making money, you don’t care how they get well or what the get well from.

  114. Jacqueline & Kathleen,

    Thanks for your comments and participation.

    I happen to agree with both of you that nutritional deficiencies are likely a contributing cause of depression. I also agree that dietary changes can relieve depression, and have seen that in my own experience (although I believe that increasing intake of saturated fat and cholesterol, rather than simple carbohydrates, is the best way to do it).

    However, the fact that changes in diet can contribute to or relieve depression does not prove that depression has anything to do with a “chemical imbalance” in the brain. If dietary changes had their effect on depression primarily by acting on serotonin levels, then anything else that raised serotonin levels would relieve depression and anything that depleted serotonin levels would alleviate it. The evidence I’ve included in my article clearly suggests that is not true; therefore, the serotonin-depression theory is unsupportable.

    There are several different pathways by which nutritional changes could act on depression that don’t involve serotonin or other brain chemicals as a primary mechanism. For example, deficiencies in both micronutrients (such as vitamin D) and macronutrients (fatty acids) have been shown to cause depression. The fact that dietary changes affect depression is not evidence that it is caused by low serotonin levels.

    For the record, I didn’t say that depression is only psychosocial. In fact, I believe that depression is a multifactorial, heterogeneous condition with many different causes that are not necessarily the same in each person. To speak of a single cause or even single set of causes that is consistent for all people is overly reductionistic.

    Yet this is exactly what the “chemical imbalance” theory does: it reduces a complex phenomenon (depression) to a simple imbalance of chemicals in the brain. It’s bad enough to blame depression on a single cause, but when that cause (serotonin deficiency) has been repeatedly disproved in the scientific literature, clinging to it as a viable theory is not only reductionistic – it is also misguided and inaccurate.


    • Chris…is there a proven cause of depression? Wat deficiencies shud I b testing for? I’ve been vitamin D deficient for like 4 years and took the maximum rx forever and it never raised to normal but Dr wasn’t concerned so I just let it go. But I’ve read this entire article and comments and really wud like to no if there are tests I cud request to try and give me answers. Never have had drs wanna do any. Thx so much

  115. I think you have presented a very valuable analysis. And yes, absolutely the market has been driven by the drug companies. However, I think you are throwing the baby out with the bathwater. I am the author of Potatoes Not Prozac a book that outlines alternatives to treating depression using a change in diet and behavior. It is not psychological, it is biochemical. And the results reported from hundreds of thousands have been profound. Depression lifts and goes away when people eat good food at regular intervals and take sugar out of their diets.

    To say that depression is simply *psychosocial* is as incomplete as saying it can be treated only with drugs.

    I think there is way more to the story, and I love a good dialogue.

    • I think a critical point for you to bear in mind, is the sweeping statement “it is not psychological, it is biochemical.” Huge generalisation with little proof to enforce it. I would like to read some of your research papers, or ones that inspired you to write this book as I feel it is a contributing fact. However to claim its one and not another I do disagree with.

      The change in diet, introduction of exercise, strengthening of the mind, establishing coping mechanisms, facing and understanding the trigger(s) and finding an expression/release to calm the mind. These were all key for me during my recovery, there was some extremely dark days but once I hit rock bottom the only way is up. I found my vice in walking and music, it helped me to beat out my thought process and organise my thoughts so i could begin to understand. The understanding was the hardest thing to come by, once I began to achieve understanding, logic prevailed and I managed to think constructively about the events that happened in my life. It was a sense of clarity. Anyways I could waffle for ages about it, so I won’t lol.

      Main point is the use of drugs is/was and never will be okay with me, I find it disheartening and worrying that DR’s are issuing mood and personality alertering drugs to all ages. What’s the difference between to the mood altering illegal drugs to these legal mood altering. There’s side affects attributed to both, Prozac has some horrific side affects, but for some reason are tolerated by dr’s and the people taking them. If from this entire post one person opts to make the tough decision to try something alternative, I truly wish them all the luck and support. It takes a strong person to make their own decision when many others oppose one way or the other. But I insist do your research before using any form of treat,net proposed, whether it be drugs, therapy, dieting etc.

      Always willing to listen to anyone, take care and all the best.

      • Chris Overton…..alwaz willing to listen caught my attention. I was dx w depression at 18.. now 20 years later,worse than ever. I’ve tried every rx,tried no rx,been to counseling on off for 20 years,several Dr’s, nut houses,….. u name it and I think I’ve tried. 1st attempt at suicide at 13. Granted from age 9 I’ve had horrible life……..but everyone Dus and I just can’t understand y sum get thru it and others don’t. The only time I got relief was win I was prescribed loratabs in 2006 for my back which is all metal, concrete and rods now. I was on them for 6 years and felt fine. Didn’t take anything else. Didn’t get the high ppl talk about…….just finally felt normal. Like my brain was wired right. I functioned better and excelled at my job in surgery. Really cudnt understand wat was so wrong w them. Had no side effects …unlike all the antidepressants,antipsychotics,mood pills ….etc. Idk. I stopped them in 2012….soon b 2 years April 1st. And I’ve went way down hill from there. I truly am researching and want to have electroshock treatments. I’m suicidal, cry constantly, anxiety so bad I won’t leave my house,my kiz are living w my sister bc I can’t even b a mom. The worst is…..I don’t even want to shower! I’ve given up on myself and anyone ever being able to help. I’m going back to nut house tmrw and pray they believe me win I say that I’m crazy and need something dun b4 one of my suicides work. Anyway …..w all that sed….u got any advice? Research material that cud help? Or anything? Or Dus anyone think they can guide me to a road to sum relief? Thx so much

      • I have seen the lives of people transformed through the use of antidepressants. For some, severe depression and anxiety are like storm clouds that roll in leaving the depressed person with no real control over their mood- you can’t control the weather in your own brain. It is incredibly painful when intellectually you know what the coping mechanisms are, but you are powerless to stop yourself from falling into a dark spiral that’s last days on end. Only to recover from that spiral momentarily and be swept back down. To totally discregard the possible ability for these medications to effect real and lasting change in people’s lives is a view that is far too narrow. I find that those who have not truly experienced the depth of this kind of despair caused by mood disorders tend to be fairly dismissive of medications, recommending picking yourself up by the boot strap and going for a jog as the only real methods for relief.

        • “you can’t control the weather in your own brain”.
          Ok then just lay there and pretend your misery is controlled by outer forces. I’m sure you’re on public assistance too.

  116. Well I’d agree that antidepressants aren’t the answer and with the psychology of the psychiatric profession.

    However, andecdotal though my evidence might be, I suffered for over 40 years and now I have been calm, happy and energetic with no relapse for over two years since I changed my way of eating with Kathleen des Maisons book Potatoes not Prozac.

    I know what I feel in my body after years of trying everything else and if it worked for me then there is hope for anybody.


    • My psychiatrist and my drugs have saved my life. While I agree psychiatry is still in the dark ages and likely that is due to Capitalism big drug companies who ever they are to you. There is a lack of understanding of how the brain works, however I am ever so happy that after 13 years of suffering I finally turn to psychiatry and western medicine. Just thought I should share the other side of the story. For years I tried eastern medicine, diets, acupuncture even this weird magnet therapy, cognitive therapy none of it helped until I got onto some meds that work for me. Now that my mind is clear I have room to focus on all the other important things that make a healthy human being including nutrition, exercise, relaxation and good cognition.

      • First, I am thrilled that your mind “is clear.” You said, “psychiatry is still in the dark ages” and I must agree. They are because they walked away from their roots….hypnosis! Historically, as early as the late 1880’s MD’s began using the patients own mind to help them in what they called “educational” and/or “moral” and/or “emotional” purposes. They began using “hypnosis” prior to this, for somatic healing. The same mind that created our neurotic ways of being in this world is the same mind that can heal, change or transform us. I wish continued freedom and health!!!
        Anthony Verderame

        • The root of psychiatry is not hypnosis, but Freud. The implicit agreement with “many Americans” that Freud (informed by a multitude of poor media representations of talk therapy and the phenomenon of repression) equals quackery is beyond disappointments. I’m so irritated with these perceptions of psychoanalytic psychotherapy (the most evidenced-based talk therapy in existence).

          • By the time Freud used the term “psycho analysis”, Pierre Janet had already been using a technique he called “psychological analysis” for several years. Janet also used the term “unconscious” years before Freud did.

            Before both men talked of psycho-therapy (“mind healing”), this word was first used by Dr. Daniel Hack Tuke in England for somatic conditions & soon after it was then adopted by Dr’s Van Eeden & Wetterstrand in Denmark. This word spread across Europe & Russia. The common denominator in all these MD’s is their training in, usage of & experimentation with “hypnosis” (“mind healing.)

            Both Janet & Freud were trained by Dr. Charcot in hypnosis. The problem is that it was a horrible foundational training, because it was based on hypnosis being abnormal & a form of hysteria. Thus, after using hypnosis for the 1st year of his practice he stopped because HE was so ineffective. He did not have the foundational understanding of the basic principles of the mind/hypnosis.

            Anyway, I have read countless books published in the 1800’s & early 1900’s & it is undeniable that without the discovery, experimentation & usage of hypnosis we would not have known of the power of our sub-conscious minds & its efficacy in healing.

            • Let’s clear the fields and consider what the main issue is and the best way to approach it. We can all debate as to what causes the issues we all face at one time or another in our lives but I didn’t see anyone clear the field and step back to realize that our views are obstructed by so many factors.
              This I’ve done and I can promise very positive results. It is understood that this may not be very easy for many if not most , I do understand that. I learned this approach by pure accident.
              In the last few years I’ve traveled tens of thousands of miles by car ( jeep lol ) and I’ve seen places that removed all thoughts from my mind only to replace them with pure acceptance and an extreme sense of just how insignificant our issues are and how simple the world around us is. The sun , the moon and the billions of stars have the power to heal so many issues we all share. The very world we live in is so astounding and awe inspiring that we have no choice but to clear our minds of our complicated multi faceted and possibly self created issues. Between these amazing places is another wonderful and healing benefit ……. thought. The opportunity to think things through and gain a better understanding or maybe an acceptance during this entire journey is worth more to me than any book , any drug or any amount of money.
              I wish everyone the best the world and heavens have to offer. I hope many of you may receive what I’ve received and your life improves with every beautiful moment in life.
              Remember , we are not humans having a spiritual experience but spirits enjoying a human experience.

              • Ah John W….

                I love spiritualism I have come to believe we are indeed spirits in human form after all the brain is physical but the mind is not.

                No emotion can be bottled, seen, weighed, measured nor proven as actual fact physically but, we all know emotions exist because we have felt them.
                From anger to rage, sadness to despair, from frustration to hate.

                It must be a bummer for science to admit it cannot dismiss emotion as hard evidence despite being unable to see, hear, touch.taste and smell it.

                Science tells us we only have 5 senses, neglecting non physical instinct and intuition.

                We are spiritual beings because much of what makes us who we are is the non physical mind and non physical emotional traits we have.

                Morals dont come from pills to make us good, better and mentally healthy , nor does empathy nor compassion.

                but apparently, according to pharma happiness does, as does reversal of anxiety, stress etc.

                I really should leave this forum but, subscribed I always read the follow up comments.

                John W You made my day, it`s nice to have a different take on it all – My life is usually ranting anti pharma rants, with good reason of course when pharma trolls come by and post drivel – it`s been nice to not have to.

                • Miss Diagnosed, I couldn’t have said it better myself. My niece was a beautiful girl. She went off to college, Duke, and started messing with the boys. Then, during a vacation, she lost her mind and went nuts. I guess she was oversexed. But the doctors “diagnosed” her with depression, bipolor disorder etc. Her mother seriously believed in her “illness” at first. But years later, my niece is still dishing out over $300 a week to talk to a shrink. Her mother rolls her eyes at the whole behavioral illness myth. But the doctors and Pfizer are happy.

                • I’m on a different track here but I have to make some comments. I am 68 years old and have never been able to take anti-depressants. I’ve tried two with the same results and will not try any more. Anxiety attacks bordering on panic, heart racing, all-over body pain and a pressure in my system I can’t describe. My real problem is anxiety so why give an anti-depressant that is going to make the anxiety worse? My son is going through this now although it appeared for some time that he might have the same problem. I know what he is going through and I feel for him. You feel like you are losing it. He is stopping the antidepressant and going back to a very low dose of the one he knows he can take. Unfortunately, depression is strong in our family on my mother’s side. I don’t know if anyone has any input but I sure would appreciate it. I am so hoping my son pulls himself out of this soon although knowing what I know about myself I am sure it is chemical with him as well. Thank you!

      • I relate to what you had to say completely,I suffer from anxiety and panic attacks as have other members of my family,have tried everything under the sun,the only thing that works for me is anti-depressants so I KNOW without a shadow of a doubt that that my condition is physically based,whether serotonin,chemical balance or whatever.

Leave a Reply