I remember once as a teenager I was very sad for something that I now cannot remember and I asked my mom for a pill of those that the doctors gave her to cure her chronic sadness. She told me: “Oh, my little girl. It is not that easy… If so, I would have been cured for a long time”. My mother was diagnosed with almost every mental illness that was trendy in the 80s and 90s. She knew by that time, the late 90s, that medication was not exactly the cure for depression or the often claimed chemical imbalance of the brain.
As it happens with many ideas, they remain in common knowledge as if they were sacred truth for mankind. Chemical imbalance is one of the most repeated lies related to mental health. It is rather a convention believing that depression is caused by a chemical imbalance in the brain. The idea is that depression is caused by reduced levels of serotonin, a neurotransmitter responsible for happiness and self-confidence. In that sense, you can take medication to “correct” it and you are done. However, it is not that easy.
The Myth of Chemical Imbalance
Historically, people have been looking for an answer to that state of sadness that seems to have caught some people forever. Apparently, they have not exactly been searching causes but the effective cure for this ailment. Humanity has even blamed demons for causing depression. The current discipline in charge of depression is psychology.
The idea of depression being caused by a chemical imbalance was widely spread among psychology. It was perfect for explaining depression as a brain disorder and not as a mental illness. Back in the 60s, pharmaceutical companies started to develop new psychiatric drugs, for boosting serotonin, which worked along with therapy. These drugs became very popular in the 70s and 80s but since the cause of depression remained unknown, psychiatrists prescribed different drugs to people with similar symptoms. They had no scientific evidence of these drugs working for any psychiatric problem. For a time, they were just looking for the specific drug that caused fewer side effects to a specific patient.
Fighting Depression with Drugs
Nevertheless, insurance companies and public health programs continuously affirmed that drugs were the fastest treatment for depression, as they correct the chemical imbalance. Certainly, it seemed to be the fastest, but not the definitive, treatment for depression. Curiously, after 4-6 weeks of antidepressant treatment not everyone feels better, and after months many still have the symptoms, as it has been shown in Michael Gitlin’s article of 2009. This psychiatrist of the University of California found that one-third of the patients treated with antidepressants do not improve, and a significant proportion of the remainder get somewhat better but remain depressed.
Furthermore, the risk of relapse is surprisingly high. If it were a matter of just correcting a chemical imbalance in the brain, once it is “fixed,” the problem is solved. But, this is not the case. According to the American Psychiatric Association, at least 50% of the people who have suffered from depression will suffer from it a second time. And about 80% of the people who have suffered from depression twice will suffer from it a third time.
Chemical Imbalance: Studies are Inconclusive
Despite what everybody thinks about depression being caused by a chemical imbalance, there are very few peer-reviewed articles about it and they do not present conclusive findings. In fact, Irving Kirsch, associate director of the Program in Placebo Studies at Harvard Medical School, has revealed that the difference between antidepressants and placebos is not significant. Antidepressants are more effective than placebos but of no clinical importance. Studies show that although antidepressants are as effective as therapy in the short term, people using these drugs are more likely to have a relapse than the ones who do not.
Generally speaking, psychology claims to be a science but these medical doctors, the psychiatrists, perform no biological tests to get a diagnosis. It seems to be that there are no means to measure serotonin or any neurotransmitter in a living person. However, psychology does research. Antidepressants have passed through different processes of research before being approved by the FDA, while alternative treatments have not. There are many alternative treatments and many people fiercely trust them because they have been working for them. However, there is not enough evidence of effectiveness and how accepted these treatments can be. For example, doing exercises might be a good option as an alternative treatment but many depressed people would not even attempt to do exercises.
Even though now we know that the so-called chemical imbalance is not real, avoiding antidepressants is still not recommended. For years, they have been “helping” people to get along with depression, but we do need a lot more research to get out of this status quo and find a better treatment.
Apparently, the correct path to get better is having both medication and therapy, favoring therapy and encouraging people to gradually leave medication as symptoms disappear. In the end, we know that depression has been surrounding human beings from day one and it’s not going to vanish soon.