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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. 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.

  2. “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.

  3. 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.

  4. 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 radiantrecovery.com

  5. 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.
    http://psycheducation.org/depression-is-not-a-moral-weakness/chapter-12-putting-it-all-together/

    • 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.

  6. 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.

  7. 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!

    https://www.psychologytoday.com/blog/theory-knowledge/201403/depression-and-the-disease-pill-model-mental-health

    https://www.psychologytoday.com/blog/charting-the-depths/201009/the-disease-model-depression-has-not-lifted-depression-stigma

    • 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 fly.it 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]

  8. The link between depression and biochemistry has been proven. 1) See MensahMedical.com–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.

    • Hitler was depressed. Thanks to your comment now I understand why he did what he did. Poor guy.

    • Why on Earth would he take this down? This 5+ year old article is still getting comments on a regular basis and bringing traffic to his website.

  9. 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 them.you never know,one day depression might hit you.I have a great life,
    Wonderful husband,wonderful children.great family and a great God.

    • Thank you he doesn’t suffer from it. So he doesn’t know. If it’s not true how come it makes feel better.

      • 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

  10. 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.

  11. 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!!

  12. 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.

  13. 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
    Anthony
    http://www.wholelifecc.com

    • 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

  14. 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)…

      /rant

      • 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…

  15. 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!

  16. 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?!?!

        HA.

        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.

          • The fact that recreational drugs work show that the ‘mind’ and ‘brain’ are the same thing.

      • 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.

  17. 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.

  18. 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.

    • Check Datis Kharrazian’s book “Why is my brain not working?”, I’m sure you will find strategies to deal with it

    • 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.