that 'chemical imbalance' myth

I do think AD's are very over prescribed, our surgery is very very prescription happy, agree with everything carnardtheduck put so eloquently. The drugs are meant to be used judiciously and with care, not dished out like smarties and people like me left to deal with the consequences of not being able to get off. No one ever offered to measure my chemical imbalance, no tests were conducted, I was just "told" I had a chemical imbalance, how did anyone know?

hello - interesting to see some discussion based on my article! Mental illnesses are extremely complex and the causes will vary somewhat between individuals. Obviously, mood, cognition, and behavior have a biological basis and thus extremities of these facets of mental life will also have a biological basis. However, much of what people are told - e.g. depression is due to low serotonin is just not true. There are no way of actually measuring levels of serotonin in the brain, although we are now able to look at neurotransmitter function. The notion of chemical imbalances in the brain being responsible for mental illnesses is such a gross oversimplification and a reduction of horrific mental pain taken out of the context in which it occurs that is a myth and one that seems to make people feel sick. My patients who have a non-biological explanation tend to do better that those who have an exclusively biological explanation, and be more optimistic about there illness. This is not just a facet of the severity of their problem.

I think the question of chemical imbalances and psychiatric drugs are separate. I prescribe (judiciously) antidepressants, antipsychotics and other psychiatric medication where I think it will benefit the individual. If it has the possibility to help, where nothing else has, or the suffering too great, then medication can be helpful. But let's not conflate that with believing these meds, all of which were accidentally discovered to have an effect on the problems they treat are getting at the root cause. That is what my objection is. When we start narrowly displacing the problem onto the imagined 'broken brain', we ignore the wider determinants of mental health. Whilst genes influence how we think and feel, and a number of genetic polymorphisms and other genetic variations have been found to occur more often in those with 'schizophrenia' and bipolar illness, there are no 'genes for' these conditions insofar as the same genetic variations also occur in people who never experience mental illness.

I think the OP is correct to highlight that the notion of chemical imbalances causing depression, has detracted us from looking at how the structure of a patriarchal society has contributed to depression, which occurs twice as frequently in women as in men in the community (so not related to help-seeking behavior).

canardtheduck

Alameda - a close family member of mine has bipolar. My views are that with bipolar there is a biological or maybe genetic propensity. That propensity can be triggered by environmental factors e.g. stress, abuse, but without the biological propensity, it would never happen.

My personal experience with 1 close peson with bipolar is that she does forgerty how horrendous the manic or depressive episodes were - I don't.

That lithium is crucial, but other things can help as well. For example not having as far as you can manage it, a very stressful live. Avoiding over stimulation, getting enough sleep, etc. So no its not all about drugs, but drugs are part of it.

I dunno, Alameda. What you say is fascinating and I think there's truth in it. (Majority of my bi-polar friends had horrendous episodes in their childhoods.)

But my own experience is that the chemical imbalance suggestion fits best. I've had depression since childhood. For agonising years upon years I cringed in various therapists rooms while they overplayed the importance of the tiniest misdemeanours of my parents or boyfriend as causes of my illness. I tried SSRIs and they didn't work. They stifled the depression and everything else too. I thought I was destined to an entire life of this battle. It felt like walking uphill into a wind that pushes you backwards, forever.

Then I hit a really bad phase with PND which I tried to self-manage for four years with very little success (surprise) I went to the doctor and tried a different SSRI. It was like someone had waved a wand over my life. I felt happy and normal, energetic and capable. And I've felt that way for the whole time I've been on this medicine. If something bad happens I feel sad. If something really awful happens I feel low and cry. Just like people who don't have depression. After time I start to feel fine again. Nothing is out of proportion any more. Sad events don't trigger a vertiginous spiral. I don't ever feel sad for no reason. I feel like I owe my life to the SSRI I'm on now.

One of my DC is low by nature. I've done everything I can think of to teach him positive thinking, to feel good about himself, and he is certainly deeply loved in a stable, secure and very happy family. But I keep my eye out because I think he might have inherited the illness from me. He and I both know we can feel deeply sad for no reason, or bad about life even when it's good. No one has shoved him aside socially or personally. He's just wired that way.

None of what I am saying is meant to discredit what you're saying. I just think there is a vast range of reasons why people have mental illness. Chemical imbalance is, IMO, one. Social pressures and life experiences are certainly two others.

As you pointed out, not nearly enough research is funded into the vast range of illnesses known as mental health. Imagine if research into 'physical health' was lumped together in that way.

Alameda - Sorry don't know names of them. Newer drugs that are given as an alternative to lithium. Newer ones are pushed by the drug companies, but yes lithium has the research behind it because it has been used for so long. But there is not much money to be made out of it for the drug companies.

Lithium and other mood stabilisers save lots of lives for people with bipolar. The risk of death either through suicide or psychotic behaviour e.g. believing you can fly, for those who refuse to take mood stabilisers, is high.

Thank you for that, Alameda.

Sorry rubbish at doing links!

I don't often stray in feminism but this caught my eye. I think the "chemical imbalance" thing didn't work for me, I blog about my years struggling to get off of Sertraline/Prozac: Withdrawal Blogspot I actually hated the side effects of Sertraline (libido) and felt totally trapped by being hooked on Sertraline, and the thing that trapped me was my doctor and husband telling me I had a "chemical imbalance" and "if you had diabetes you'd take insulin wouldn't you?".
I understand that that SSRI's work for a lot of people, and the "chemical imbalance" theory works for a lot of people, but for me it left me feeling totally inadequate and like I was fundamentally flawed in some way.
That's just my experience and I'm just one person here.

Garlic - I agree that bipolar has a biological cause. Not so sure with depression.

Although some feel this way, I actually think believing bipolar is biological is worse than thinking it is environmental. Generally people have bipolar for life. If it was environmental, then surely it could be cured.