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The "chemical imbalance" theory has been losing steam for quite some time. The British Psychological Society has issued this consensus statement: There is act

The "chemical imbalance" theory has been losing steam for quite some time. The British Psychological Society has issued this consensus statement: There is actually no evidence for the current view – and we agree with many senior psychiatrists in saying that – we do have an overwhelming amount of evidence that even severe psychiatric breakdown is actually the end result of a complex mix of social and psychological circumstances. People who have suffered things like bereavement, loss, discrimination, poverty, trauma, abuse, domestic violence, in other words things that have happened to you. From my experience, and many others, we have a script running in the background of our minds. Nonstop. This script is brutal, telling us we're worthless, unable to do this, will always be alone, etc etc. It gets etched in our mind and we become it, and likely impacts all aspects of our brain chemistry. (Depressed patients are often deficient in many key areas Omega 3, Magnesium, Vitamin B, etc) https://www.scientificamerican.com/article/is-depression-just-bad-chemistry/ https://www.scientificamerican.com/article/is-depression-jus...

mistermann 10y ago
Wait, so are you saying it is or is not a chemical imbalance?
- tbrownaw 10y ago
  It exists at a different level of abstraction. There might be a correlation, but there's no simple causation (or at least, not going in that direction).
- costcopizza 10y ago
  I think depression is a beast with many intersecting roads. The chemical imbalance seems like it could be more the result of something than the root cause.
  - marxidad 10y ago
    Even if that is the case, if the root cause is just some triggering event, then the chemical imbalance can still remain even if the cause is no longer present.
  - perfectfire 10y ago
    I'm just one person, but it really doesn't seem like that to me. There was no awful situation or experience that brought on my depression or continues to make me depressed. I call that situational depression. You aren't clinically depressed. You're just feeling really crappy because your situation is really crappy. Remove the crappy situation or improve it in some meaningful way and the depression goes away too. With clinical depression there is no trigger or "something" that makes you depressed. You could be in a great situation with nothing bad happening and you're still depressed. Right now I'm in a situation that really weighs heavily on me. Yet I'm not depressed.
    - deleted 10y ago
      [deleted]
  - sundarurfriend 10y ago
    What you're referring to is, I believe, proximal causes and distal causes. Distal causes in depression's case maybe stuff like sleep deprivation, overstressed immune system, gut biome issues, etc. (and possibly genetic elements, who knows!) with little known about how they cause it or how they interact/overlap with one another. The immediate proximal cause is, of course, the "chemical imbalance", which is popsci speak for neurotransmitter issues (among possibly others), a higher level proximal cause might be a life event that somehow causes some 'critical mass threshold' leading a spiraling avalanche (though again, little is known at the biological level about why this is so, assuming it is so.)
mcguire 10y ago
The "get up and fix yourself" theory lost all its wheels long ago, though.
- costcopizza 10y ago
  No, no, no, I'm not advocating for that at all. Rather, trying to be the slightest bit aware of what the sewage of thoughts in your head consists of.
  - sundarurfriend 10y ago
    > trying to be the slightest bit aware of what the sewage of thoughts in your head consists of. That's a pretty useful thing for a "normal" person as a preventative measure to reduce the probability of depression (although there's tons of biological causes including things about gut biome, overstressed immune system, etc., and it's not clear if this 'awareness' would help in those cases). But to a person in the middle of depression, that's like asking them to fire up a debugger and inspect the issue, when their very problem is that their OS barely boots up and refuses to run any program whatsoever. The first paragraph about the 'preventative' aspect might be what you had in mind, with the second para's content implicit in it, but I feel it's important to make it explicit given how widely misunderstood an illness depression is.
amp108 10y ago
One thing, please, for anyone on this board, or anyone who intends to advise anyone about whether or not they should take medications: Unless you are a doctor, you have no advice to give. Unless you are a doctor and have examined a patient, you have no advice to give except to that patient. I don't care what good or bad experience you personally had with medication; people respond differently, and it does not qualify you to give advice to anyone about any drug they are considering taking.
- strictfp 10y ago
  Unless you are a professional author, you have no message to communicate. Unless you are an author and have interviewed your reader, you have no idea how he or she will personally react to the words you write. /s
- perfectfire 10y ago
  I respectfully disagree. I would agree that someone-that-isn't-your-doctor shouldn't tell people what they should do, but hearing the personal experiences of numerous people that have taken certain medications or had certain therapies is invaluable. This is quite different than "regular" diseases and maladies. The drugs and therapies for psychological diseases aren't well understood and are very hit-and-miss. Like you said people respond differently, so hearing the experiences of multiple people can be just as, or much more valuable than your doctor's recommendation which may be based solely on a datasheet they read and maybe tried on a few patients. You may hear experiences of drugs that your doctor has never prescribed before or has never even heard of before. It's not uncommon for a psychiatrist to have certain go-to medications that they use almost exclusively. If those don't work for you, then getting advice from other patients can be a lifesaver. The medication that helped me the most by far was not recommended to me by my doctor. I recommended it. And I found the medication through an ad in the lobby of the doctor's office plus I was considering that class of medication based on the experience of my mother. People rail on prescription medication advertising, but I might not be alive today if not for that ad. And that ad could have easily been a recommendation by a handful of random internet strangers (in fact I would trust the internet strangers more because it's less likely they have an agenda whereas the ad definitely has an agenda).
joesmo 10y ago
Losing steam? You mean the theory was discredited because there isn't any proof whatsoever of it being true and we don't have the means currently to prove or disprove it (measuring said chemicals while the brain is alive). I'd say that's a little more than losing steam. That's on par with the anti global warming campaign as far as science goes. But it's a nice story (think fiction) so people like to keep regurgitating it, including psychiatrists and psychologists who all should know better. But hey, it does sell a ton of drugs, so its primary purpose has been achieved.
ap22213 10y ago
How do they explain the genetic factors that cause predisposition? Just as the humans who eat too much sugar can more easily get type 2 diabetes, some humans who are exposed to 'X' can get mental diseases. (X is unknown or it varies). What if some humans are just more 'evolved' to live in the modern world than others? 10-12,000 years of living within dense populations, under despots, with periodic plagues, and in near constant war probably applies a lot of evolutionary selection pressures. Some of us whose ancestors were assimilated later probably have more genes that haven't been 'weeded out'. I've read some research that human brain size has decreased over the last 100,000 years. The theory is that as humans began to become less independent, they had less need for certain types of brain functions. Since the brain is an extremely resource intensive organ, less brain means less energy requirements. So, humans quickly lose areas of the brain that are less necessary. There are correlations between intelligence and depression. There are correlations between intelligence and sensory and spatial abilities. Maybe some of these things are related.
sundarurfriend 10y ago
Scott Alexander ('Slate Star Codex') wrote a very good post on how to think about the "chemical imbalance theory", where it's useful and where it's not. Here it is: http://slatestarcodex.com/2015/04/05/chemical-imbalance/ http://slatestarcodex.com/2015/04/05/chemical-imbalance/ I also remember reading another article by someone in the field which explained it in terms of proximal and distal causes, which is basically about "different level[s] of abstraction" as tbrownaw in this thread puts it. Will link to it if I manage to find it.

mistermann 10y ago

Wait, so are you saying it is or is not a chemical imbalance?

tbrownaw 10y ago
It exists at a different level of abstraction. There might be a correlation, but there's no simple causation (or at least, not going in that direction).
costcopizza 10y ago
I think depression is a beast with many intersecting roads. The chemical imbalance seems like it could be more the result of something than the root cause.
- marxidad 10y ago
  Even if that is the case, if the root cause is just some triggering event, then the chemical imbalance can still remain even if the cause is no longer present.
- perfectfire 10y ago
  I'm just one person, but it really doesn't seem like that to me. There was no awful situation or experience that brought on my depression or continues to make me depressed. I call that situational depression. You aren't clinically depressed. You're just feeling really crappy because your situation is really crappy. Remove the crappy situation or improve it in some meaningful way and the depression goes away too. With clinical depression there is no trigger or "something" that makes you depressed. You could be in a great situation with nothing bad happening and you're still depressed. Right now I'm in a situation that really weighs heavily on me. Yet I'm not depressed.
  - deleted 10y ago
    [deleted]
- sundarurfriend 10y ago
  What you're referring to is, I believe, proximal causes and distal causes. Distal causes in depression's case maybe stuff like sleep deprivation, overstressed immune system, gut biome issues, etc. (and possibly genetic elements, who knows!) with little known about how they cause it or how they interact/overlap with one another. The immediate proximal cause is, of course, the "chemical imbalance", which is popsci speak for neurotransmitter issues (among possibly others), a higher level proximal cause might be a life event that somehow causes some 'critical mass threshold' leading a spiraling avalanche (though again, little is known at the biological level about why this is so, assuming it is so.)

mcguire 10y ago

The "get up and fix yourself" theory lost all its wheels long ago, though.

costcopizza 10y ago
No, no, no, I'm not advocating for that at all. Rather, trying to be the slightest bit aware of what the sewage of thoughts in your head consists of.
- sundarurfriend 10y ago
  > trying to be the slightest bit aware of what the sewage of thoughts in your head consists of. That's a pretty useful thing for a "normal" person as a preventative measure to reduce the probability of depression (although there's tons of biological causes including things about gut biome, overstressed immune system, etc., and it's not clear if this 'awareness' would help in those cases). But to a person in the middle of depression, that's like asking them to fire up a debugger and inspect the issue, when their very problem is that their OS barely boots up and refuses to run any program whatsoever. The first paragraph about the 'preventative' aspect might be what you had in mind, with the second para's content implicit in it, but I feel it's important to make it explicit given how widely misunderstood an illness depression is.

amp108 10y ago

One thing, please, for anyone on this board, or anyone who intends to advise anyone about whether or not they should take medications: Unless you are a doctor, you have no advice to give. Unless you are a doctor and have examined a patient, you have no advice to give except to that patient. I don't care what good or bad experience you personally had with medication; people respond differently, and it does not qualify you to give advice to anyone about any drug they are considering taking.

strictfp 10y ago
Unless you are a professional author, you have no message to communicate. Unless you are an author and have interviewed your reader, you have no idea how he or she will personally react to the words you write. /s
perfectfire 10y ago
I respectfully disagree. I would agree that someone-that-isn't-your-doctor shouldn't tell people what they should do, but hearing the personal experiences of numerous people that have taken certain medications or had certain therapies is invaluable. This is quite different than "regular" diseases and maladies. The drugs and therapies for psychological diseases aren't well understood and are very hit-and-miss. Like you said people respond differently, so hearing the experiences of multiple people can be just as, or much more valuable than your doctor's recommendation which may be based solely on a datasheet they read and maybe tried on a few patients. You may hear experiences of drugs that your doctor has never prescribed before or has never even heard of before. It's not uncommon for a psychiatrist to have certain go-to medications that they use almost exclusively. If those don't work for you, then getting advice from other patients can be a lifesaver. The medication that helped me the most by far was not recommended to me by my doctor. I recommended it. And I found the medication through an ad in the lobby of the doctor's office plus I was considering that class of medication based on the experience of my mother. People rail on prescription medication advertising, but I might not be alive today if not for that ad. And that ad could have easily been a recommendation by a handful of random internet strangers (in fact I would trust the internet strangers more because it's less likely they have an agenda whereas the ad definitely has an agenda).

joesmo 10y ago

Losing steam? You mean the theory was discredited because there isn't any proof whatsoever of it being true and we don't have the means currently to prove or disprove it (measuring said chemicals while the brain is alive). I'd say that's a little more than losing steam. That's on par with the anti global warming campaign as far as science goes. But it's a nice story (think fiction) so people like to keep regurgitating it, including psychiatrists and psychologists who all should know better. But hey, it does sell a ton of drugs, so its primary purpose has been achieved.

ap22213 10y ago

How do they explain the genetic factors that cause predisposition? Just as the humans who eat too much sugar can more easily get type 2 diabetes, some humans who are exposed to 'X' can get mental diseases. (X is unknown or it varies). What if some humans are just more 'evolved' to live in the modern world than others? 10-12,000 years of living within dense populations, under despots, with periodic plagues, and in near constant war probably applies a lot of evolutionary selection pressures. Some of us whose ancestors were assimilated later probably have more genes that haven't been 'weeded out'. I've read some research that human brain size has decreased over the last 100,000 years. The theory is that as humans began to become less independent, they had less need for certain types of brain functions. Since the brain is an extremely resource intensive organ, less brain means less energy requirements. So, humans quickly lose areas of the brain that are less necessary. There are correlations between intelligence and depression. There are correlations between intelligence and sensory and spatial abilities. Maybe some of these things are related.

sundarurfriend 10y ago

Scott Alexander ('Slate Star Codex') wrote a very good post on how to think about the "chemical imbalance theory", where it's useful and where it's not. Here it is: http://slatestarcodex.com/2015/04/05/chemical-imbalance/ http://slatestarcodex.com/2015/04/05/chemical-imbalance/ I also remember reading another article by someone in the field which explained it in terms of proximal and distal causes, which is basically about "different level[s] of abstraction" as tbrownaw in this thread puts it. Will link to it if I manage to find it.