Chemical imbalances do not exist; dying brain cells do

Researchers have never been fully confident in the chemical imbalance theory, yet the media continue to purport it as fact. Dr. John Grohol over at PsychCentral recently wrote:

We’ve all heard the theory — a chemical imbalance in your brain causes depression.

Although researchers have known for years this not to be the case, some drug companies continue to repeat this simplistic and misleading claim in their marketing and advertising materials. Why the FTC or some other federal agency doesn’t crack down on this intentional misleading information is beyond me. Most researchers now believe depression is not caused by a chemical imbalance in the brain.

How did we come to this conclusion? Through years of additional research. But now some are jumping on the next brain bandwagon of belief — that depression is caused by a problem in the brain neuronal network.

Grohol cites Jonah Lehrer's article in the Boston Globe in which he posits that researchers now think depression comes from "brain cells shrinking and dying." Lehrer writes:

Neurons
The effectiveness of Prozac, these scientists
say, has little to do with the amount of serotonin in the brain.
Rather, the drug works because it helps heal our neurons, allowing them
to grow and thrive again.

In this sense, Prozac is simply a bottled version of other
activities that have a similar effect, such as physical exercise. They
aren't happy pills, but healing pills
.

If that's the case, why pay money for something that you can get for free (like exercise)? Grohol wisely counters:

It’s
another love letter to the brain scientists studying in this field, but
ignores the decades’ worth of research showing that non-medical
treatments are also effective in treating depression. Like, you know,
psychotherapy.

The obvious answer is that psychotherapy also helps in some way
to help “heal our neurons.” Which begs the question — if healing our
neurons is key, there are likely dozens of possible ways to do so. Why
only focus and mention the medical cures?

(I can't help but think here of Gianna at Beyond Meds who encourages her readers to find alternative treatments that do not involve medication.)

But Grohol is correct. Psychotherapy is immensely effective on its own. Medication can be helpful combined with psychotherapy, but as I've said before, patients should not solely rely on medication (or even supplements) as the cure-all for mental illness. In most instances, a change in behavior or thinking is required for positive progress.

Antidepressants
On a related note, a
recent report from the Agency for Healthcare Research and Quality found
that prescriptions for antidepressants rose by 16 million within a
3-year span
(2002–2005). While researchers have a new theory on the
cause of depression, the chemical imbalance myth is unlikely to die
anytime soon. The theory is entrenched in American culture, propagated
by the media, and widely accepted as fact among doctors and patients.
Lehrer might argue the rise of antidepressant prescriptions isn't a
problem since the drugs are simply "healing pills."

However, I appreciate the mention of therapy apart from medication at the end of Lehrer's piece:

While antidepressants help brain cells recover their
vigor and form new connections, [Eero Castren, a neuroscientist at the
University of Helsinki,] says that patients must still work to cement these connections in place, perhaps with therapy. He compares antidepressants with anabolic steroids, which increase muscle mass only when subjects also go to the gym.

"If you just sit on your couch, then steroids aren't going to be very effective," he says. "Antidepressants are the same way: if you want the drug to work for you, then you have to work for the drug."

Even neurologist Castren states that drugs — no matter what the
bodily cause — are no quick fix. If researchers know this, why don't
more patients believe this too?

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6 Comments

  1. Gianna said,

    July 31, 2008 at 9:29 pm

    I don’t believe drugs heal. I know you, too, know of many cases of when they cause more damage.
    The positive stuff that is said about prozac making neurons grow…I highly doubt it or people could get off the drugs more successfully. Instead people stay stuck on them and suffer from “poop-out.” If the drug were healing how can you explain “poop-out?”
    Neuroplasticity of the brain, on the other hand is totally right on, but the way to change the brain most mightily in terms of the research that has been done is through meditation.

  2. July 31, 2008 at 10:29 pm

    Which, I think, again points out that recovery from depression is more of a psychic (mind-related, not ESP) thing rather than physical (hormones, etc.). Withdrawal is rough on the body but complete withdrawal also involves the mind, spirit, and soul.

  3. Tim V said,

    July 31, 2008 at 11:35 pm

    I’m beginning to toy with the idea that depression may have some realtionship towards being selfish and self centered.As one who has struggled repeatedly with depression and used to think that I was NOT selfish or self centered, this is not an easy statement to make. Consider though, when our actions and thoughts are focused on helping others we generally are not depressed. One other thought, when we feel helpless to remedy or fix a situation, that can lead to depression. Also if we feel that life in general or God in particular or a loved one is not treating us right-again, depression may follow. Finally, does it all boil down to pride ? I’m only thinking out loud…physical sickness cab certainly cause one to be depress or losing one’s job or getting divorced etc etc

  4. Jack said,

    August 1, 2008 at 11:39 am

    Well, if there’s not a brain chemical imbalance, but these drugs were scientifically formulated and designed to supposedly correct one…. then just what ARE these drugs doing to people and their brains? THAT’s why the truth’s not being told.
    But you’ve succumbed to a similar thing, even as you’ve wisely noted the medical myth — which is that ‘psychotherapy somehow” does…. whatever. Just what is this “psychotherapy’, specifically? That is, out of the hundreds and hundreds of things that are called that?
    And while you’re mentioning research, you might include the research that finds that not-therapists not-doing therapy with depressed people are able to help and benefit them at least as much as therapists doing therapy – and even more so.
    So if the drugs aren’t doing what they’re sold to do, which isn’t even a problem, and therapists aren’t quite as good at helping people as others are… then WHY haven’t we all been told the truth about this?
    Gee… any idea$?

  5. Tamara said,

    August 2, 2008 at 9:28 pm

    I’ve done the drug route so many times over the last 20 years and while I don’t think it has actually done much for my mental health it has sure undermined my physical health. It is still so seductive to want to run back to the drugs when I am in a freak-out over whatever. I hope that I have made that mistake for the last time as I am trying to wean myself off of them yet again after my last moment of weakness when I allowed my doc to talk me into going back on all the meds.

  6. April 8, 2011 at 5:47 am

    It can be confusing to see contradictory research out there that lays out the basic premise, “we have no freaking idea what we’re talking about.”

    However, it’s still good that they are choosing to keep trying. There’s already new forms of treatment that incorporate analyzing your genes to determine the best and worst drug treatments for a person.

    Cheers,
    David
    http://www.allthingsdepression.com


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