5 ms·

That whole "chemical imbalance" thing is a myth.

by 69132 8y ago

jrs95 8y ago
Yup. Just to get rich selling pills that barely make a difference. As someone who’s probably had a prescription for every major anti-depressant, the only difference I never noticed from taking them is that my dick didn’t work. Not saying that depression isn’t a serious issue and that it can just be “thought away” though. But the drugs are really only helpful to some people, and there’s not much evidence to substantiate that this is just a chemical problem. There may be a chemical element, but IMO this is being exaggerated for profit. Meanwhile we aren’t dealing with any of the underlying social problems that probably play a much larger part.
- ianai 8y ago
  Funny, I’ve known several people who clearly were depressed through physiology. Nothing to do with being able to “think it away”
  - jrs95 8y ago
    Physiology and “chemical imbalance” aren’t exactly the same thing. Just because you’re physiologically predisposed to depression doesn’t mean that you can fix that by ingesting chemicals, which is usually what’s implied by that phrase.
- 4183821747 8y ago
  The drugs can be really, really helpful to some people though. There is no doubt in my mind that Prozac saved my life 25 years ago.
  - JshWright 8y ago
    Yep, my wife was on Zoloft for ~18 months after a pregnancy (postpartum depression), and it absolutely made a massive difference.
    - ianai 8y ago
      I first felt the genuine desire to seek out and socialize with strangers after a dose of kava. I now can’t take it as it conflicts with other medication. But before then and after then, I genuinely experience discomfort around all people.
- simongray 8y ago
  I recently read the book "Lost Connections" by Johann Hari which covers this issue. In fact, it's a really a book about some deeper problems of Western society (where depression, anxiety, etc. has been on the rise for a long time), so the pharmaceutical pill-pushing and the fairly debunked "chemical imbalance" explanation of depression really just sets the backdrop of the story. He emphasizes - like you mention - social changes in modern Western societies as major causes of depression. I really recommend the book. If you're not convinced or just want an audio version, then I recommend the episode of the Ezra Klein Show podcast where Johann Hari is a guest - that's what convinced me to read the book.
  - hellofunk 8y ago
    I’m curious, if depression doesn’t have some basis in chemical roots, then why is it often hereditary? Like other forms of mental illness which are chemical and hereditary, depression also exhibits these characteristics.
    - simongray 8y ago
      The current mainstream view is that depression is partly physical, so you're not wrong. (edited for clarity) Some say that depression is a chemical imbalance, but this is not a mainstream view any longer (I think, although it's often mentioned in comments on the Internet), although treatment is still very much based on chemicals like SSRI drugs, which have very little proven effect, require constant upping of dosages to gain the small effect they provide, and also having several undesirable side-effects.
      - ianai 8y ago
        I did not equate the two.
        simongray 8y ago
        I did not say you did, sorry if it seemed that way, but others further up this tread are indeed saying that.
- JshWright 8y ago
  > there’s not much evidence to substantiate that this is just a chemical problem > we aren’t dealing with any of the underlying social problems that probably play a much larger part. I assume your concern for evidence applies to your pet theory as well, are you able to share any?
  - jrs95 8y ago
    It’s just my opinion based on personal experience, from my own struggles and those of people that I’ve known. It seems to make a lot of sense that we like the chemical imbalance narrative because it allows us as a society to wash our hands of this and pretend it has nothing to do with us.
  - ThrowawayP 8y ago
    While I don't directly agree with jrs95, the fact is that the pills just plain don't work a lot of the time. Google the medical term "treatment-resistant depression". The very first link says "Despite advances in the understanding of the psychopharmacology and biomarkers of major depression and the introduction of several novel classes of antidepressants, only 60%–70% of patients with depression respond to antidepressant therapy." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/) Presumably, the odds were worse before. Consider, too, that that probably doesn't even include those that develop tolerance effects afterward; with that, the numbers likely climb much closer to 50%-50% or worse.
gr33nman 8y ago
“Rather than some embarrassingly reductionist, one-deficiency-one-illness-one-pill model of mental illness, contemporary exploration of human behavior has demonstrated that we may know less than we ever thought we did. And that what we do know about root causes of mental illness seems to have more to do with the concept of evolutionary mismatch than with genes and chemical deficiencies.” http://kellybroganmd.com/depression-serotonin/ http://kellybroganmd.com/depression-serotonin/
- turingcompeteme 8y ago
  Kelly Brogan is an anti vaxxer and a HIV/AIDS denialist. It's very sad to see her getting linked here.
  - gr33nman 8y ago
    I’m also wary of accepting controversial opinions at face value, and fully support your skepticism here. She’s not my favorite messenger, either. I don’t think ad-hominem attacks are fair, though. The article is full of references to evidence outlining her position. Do you have any critique of her arguments you can share?
    - seattle_spring 8y ago
      Calling out why a doctor is a quack is not an ad hominem when questioning their qualifications as a medical reference.
      - gr33nman 8y ago
        Yes, but only if evidence is provided to justify calling the doctor a quack.
hellofunk 8y ago
Entirely untrue and offensive. Propagating this is dangerous and fuels the stigma that makes treatment harder. Not all mental illness is chemical, but a lot very much is.
- jdietrich 8y ago
  Chemical imbalances may possibly play some role in depression, but we have no idea of which chemicals or what the "correct" balance is. Antidepressant drugs do work, but we don't really know why. Selective serotonin reuptake inhibitors appear to work. So do monoamine oxidase inhibitors. So do selective norepinephrine and dopamine reuptake inhibitors. We used to think that tianeptine was a serotonin reuptake enhancer, but we now think it's a mu-opioid agonist; either way, it seems to work as an antidepressant. Opipramol is a stone cold whodunnit of a drug. Nobody really knows what causes depression. We know that there are certain risk factors, we know that there are useful treatments, but we don't really have a clue what's going on inside the brain. The chemical imbalance hypothesis isn't particularly accurate or particularly helpful. Psychiatrists see some patients who are severely depressed for no apparent reason, but most see far more patients who just have lives that would make anyone miserable. Depression is emphatically not randomly distributed - prevalence rates are vastly higher in certain groups, for reasons that can only plausibly be psychosocial. The chemical imbalance hypothesis lets society abrogate responsibility for the fact that a lot of people are justifiably downtrodden, despondent and hopeless. We need to recognise depression as a complex, multifaceted disorder with neurological, cognitive and social components. Antidepressant drugs have life-changing effects for some patients, but psychotherapy and lifestyle interventions are also enormously valuable. Some patients achieve complete remission within weeks of starting antidepressant drug treatment; others have tried four or five drugs with no noticeable benefit. If you're suffering from depression, you'd be foolish not to try drug treatments, but you'd be equally foolish to only try drugs.
  - deleted 8y ago
    [deleted]
- daxorid 8y ago
  I'm going to defend 69132 here. 1. We know that the symptoms of many different varieties of mental illness have been helped by the administration of SSRIs and other drugs that alter brain chemistry. 2. But what we most assuredly do not know is that mental illness patients have detectably different brain chemistry from baseline. We assume from (1) that (2) follows, but we have no actual evidence of (2). Herein lies the problem. We cannot make a scientific statement on (2) predicated only on (1). In this specific sense, OP is correct. And the downvotes are unfair. And more research is needed.

That whole "chemical imbalance" thing is a myth.

by 69132 8y ago

That whole "chemical imbalance" thing is a myth.

Yup. Just to get rich selling pills that barely make a difference. As someone who’s probably had a prescription for every major anti-depressant, the only difference I never noticed from taking them is that my dick didn’t work. Not saying that depression isn’t a serious issue and that it can just be “thought away” though. But the drugs are really only helpful to some people, and there’s not much evidence to substantiate that this is just a chemical problem. There may be a chemical element, but IMO this is being exaggerated for profit. Meanwhile we aren’t dealing with any of the underlying social problems that probably play a much larger part.

ianai 8y ago
Funny, I’ve known several people who clearly were depressed through physiology. Nothing to do with being able to “think it away”
- jrs95 8y ago
  Physiology and “chemical imbalance” aren’t exactly the same thing. Just because you’re physiologically predisposed to depression doesn’t mean that you can fix that by ingesting chemicals, which is usually what’s implied by that phrase.
4183821747 8y ago
The drugs can be really, really helpful to some people though. There is no doubt in my mind that Prozac saved my life 25 years ago.
- JshWright 8y ago
  Yep, my wife was on Zoloft for ~18 months after a pregnancy (postpartum depression), and it absolutely made a massive difference.
  - ianai 8y ago
    I first felt the genuine desire to seek out and socialize with strangers after a dose of kava. I now can’t take it as it conflicts with other medication. But before then and after then, I genuinely experience discomfort around all people.
simongray 8y ago
I recently read the book "Lost Connections" by Johann Hari which covers this issue. In fact, it's a really a book about some deeper problems of Western society (where depression, anxiety, etc. has been on the rise for a long time), so the pharmaceutical pill-pushing and the fairly debunked "chemical imbalance" explanation of depression really just sets the backdrop of the story. He emphasizes - like you mention - social changes in modern Western societies as major causes of depression. I really recommend the book. If you're not convinced or just want an audio version, then I recommend the episode of the Ezra Klein Show podcast where Johann Hari is a guest - that's what convinced me to read the book.
- hellofunk 8y ago
  I’m curious, if depression doesn’t have some basis in chemical roots, then why is it often hereditary? Like other forms of mental illness which are chemical and hereditary, depression also exhibits these characteristics.
  - simongray 8y ago
    The current mainstream view is that depression is partly physical, so you're not wrong. (edited for clarity) Some say that depression is a chemical imbalance, but this is not a mainstream view any longer (I think, although it's often mentioned in comments on the Internet), although treatment is still very much based on chemicals like SSRI drugs, which have very little proven effect, require constant upping of dosages to gain the small effect they provide, and also having several undesirable side-effects.
    - ianai 8y ago
      I did not equate the two.
      - simongray 8y ago
        I did not say you did, sorry if it seemed that way, but others further up this tread are indeed saying that.
JshWright 8y ago
> there’s not much evidence to substantiate that this is just a chemical problem > we aren’t dealing with any of the underlying social problems that probably play a much larger part. I assume your concern for evidence applies to your pet theory as well, are you able to share any?
- jrs95 8y ago
  It’s just my opinion based on personal experience, from my own struggles and those of people that I’ve known. It seems to make a lot of sense that we like the chemical imbalance narrative because it allows us as a society to wash our hands of this and pretend it has nothing to do with us.
- ThrowawayP 8y ago
  While I don't directly agree with jrs95, the fact is that the pills just plain don't work a lot of the time. Google the medical term "treatment-resistant depression". The very first link says "Despite advances in the understanding of the psychopharmacology and biomarkers of major depression and the introduction of several novel classes of antidepressants, only 60%–70% of patients with depression respond to antidepressant therapy." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/) Presumably, the odds were worse before. Consider, too, that that probably doesn't even include those that develop tolerance effects afterward; with that, the numbers likely climb much closer to 50%-50% or worse.

gr33nman 8y ago

“Rather than some embarrassingly reductionist, one-deficiency-one-illness-one-pill model of mental illness, contemporary exploration of human behavior has demonstrated that we may know less than we ever thought we did. And that what we do know about root causes of mental illness seems to have more to do with the concept of evolutionary mismatch than with genes and chemical deficiencies.” http://kellybroganmd.com/depression-serotonin/ http://kellybroganmd.com/depression-serotonin/

turingcompeteme 8y ago
Kelly Brogan is an anti vaxxer and a HIV/AIDS denialist. It's very sad to see her getting linked here.
- gr33nman 8y ago
  I’m also wary of accepting controversial opinions at face value, and fully support your skepticism here. She’s not my favorite messenger, either. I don’t think ad-hominem attacks are fair, though. The article is full of references to evidence outlining her position. Do you have any critique of her arguments you can share?
  - seattle_spring 8y ago
    Calling out why a doctor is a quack is not an ad hominem when questioning their qualifications as a medical reference.
    - gr33nman 8y ago
      Yes, but only if evidence is provided to justify calling the doctor a quack.

hellofunk 8y ago

Entirely untrue and offensive. Propagating this is dangerous and fuels the stigma that makes treatment harder. Not all mental illness is chemical, but a lot very much is.

jdietrich 8y ago
Chemical imbalances may possibly play some role in depression, but we have no idea of which chemicals or what the "correct" balance is. Antidepressant drugs do work, but we don't really know why. Selective serotonin reuptake inhibitors appear to work. So do monoamine oxidase inhibitors. So do selective norepinephrine and dopamine reuptake inhibitors. We used to think that tianeptine was a serotonin reuptake enhancer, but we now think it's a mu-opioid agonist; either way, it seems to work as an antidepressant. Opipramol is a stone cold whodunnit of a drug. Nobody really knows what causes depression. We know that there are certain risk factors, we know that there are useful treatments, but we don't really have a clue what's going on inside the brain. The chemical imbalance hypothesis isn't particularly accurate or particularly helpful. Psychiatrists see some patients who are severely depressed for no apparent reason, but most see far more patients who just have lives that would make anyone miserable. Depression is emphatically not randomly distributed - prevalence rates are vastly higher in certain groups, for reasons that can only plausibly be psychosocial. The chemical imbalance hypothesis lets society abrogate responsibility for the fact that a lot of people are justifiably downtrodden, despondent and hopeless. We need to recognise depression as a complex, multifaceted disorder with neurological, cognitive and social components. Antidepressant drugs have life-changing effects for some patients, but psychotherapy and lifestyle interventions are also enormously valuable. Some patients achieve complete remission within weeks of starting antidepressant drug treatment; others have tried four or five drugs with no noticeable benefit. If you're suffering from depression, you'd be foolish not to try drug treatments, but you'd be equally foolish to only try drugs.
- deleted 8y ago
  [deleted]
daxorid 8y ago
I'm going to defend 69132 here. 1. We know that the symptoms of many different varieties of mental illness have been helped by the administration of SSRIs and other drugs that alter brain chemistry. 2. But what we most assuredly do not know is that mental illness patients have detectably different brain chemistry from baseline. We assume from (1) that (2) follows, but we have no actual evidence of (2). Herein lies the problem. We cannot make a scientific statement on (2) predicated only on (1). In this specific sense, OP is correct. And the downvotes are unfair. And more research is needed.