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The "Chemical Imbalance" Myth

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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.

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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.

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256 Comments

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  1. 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.

  2. 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?

  3. 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?

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. @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.

  10. 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.

  11. 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.

  12. 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,
    Froscha

  13. 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.

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

  15. @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.

  16. 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.

  17. 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.

    Warmly,
    Chris

  18. 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!

  19. 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,
    Chris