I can’t even count the number of times someone gravely informed me they were on antidepressants for a “chemical imbalance.” Now, I can’t blame them for believing their doctors, but come on, use your brain! For most people, these drugs seem to make people worse:
In Anatomy of an Epidemic, you also discussed the pseudoscience behind the “chemical imbalance” theories of mental illness – theories that made it easy to sell psychiatric drugs. In the last few years, I’ve noticed establishment psychiatry figures doing some major backpedaling on these chemical imbalance theories. For example, Ronald Pies, editor-in-chief emeritus of the Psychiatric Times stated in 2011, “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend – never a theory seriously propounded by well-informed psychiatrists.” What’s your take on this?
The “disease model,” as a basis for making psychiatric diagnoses, has failed.
This is quite interesting and revealing, I would say. In a sense, Ronald Pies is right.Those psychiatrists who were “well informed” about investigations into the chemical imbalance theory of mental disorders knew it hadn’t really panned out, with such findings dating back to the late 1970s and early 1980s. But why, then, did we as a society come to believe that mental disorders were due to chemical imbalances, which were then fixed by the drugs?
Dr. Pies puts the blame on the drug companies. But if you track the rise of this belief, it is easy to see that the American Psychiatric Association promoted it in some of their promotional materials to the public and that “well informed” psychiatrists often spoke of this metaphor in their interviews with the media. So what you find in this statement by Dr. Pies is a remarkable confession: Psychiatry, all along, knew that the evidence wasn’t really there to support the chemical imbalance notion, that it was a hypothesis that hadn’t panned out, and yet psychiatry failed to inform the public of that crucial fact.
The low-serotonin theory of depression has been so completely discredited by leading researchers that maintaining the story with the public has just become untenable.
By doing so, psychiatry allowed a “little white lie” to take hold in the public mind, which helped sell drugs and, of course, made it seem that psychiatry had magic bullets for psychiatric disorders. That is an astonishing betrayal of the trust that the public puts in a medical discipline; we don’t expect to be misled in such a basic way.
But why now? Why are we hearing these admissions from Dr. Pies and others now? I am not sure, but I think there are two reasons.
One, the low-serotonin theory of depression has been so completely discredited by leading researchers that maintaining the story with the public has just become untenable. It is too easy for critics and the public to point to the scientific findings that contradict it.
Second, a number of pharmaceutical companies have shut down their research into psychiatric drugs [see Science, 2010], and they are doing so because, as they note, there is a lack of science providing good molecular targets for drug development. Even the drug companies are moving away from the chemical-imbalance story, and thus, what we are seeing now is the public collapse of a fabrication, which can no longer be maintained. In the statement by Dr. Pies, you see an effort by psychiatry to distance itself from that fabrication, putting the blame instead on the drug companies.
If you or anyone you know takes psychiatric drugs, go read the rest.