A few years ago I visited my primary doctor because of chest pains and after a few tests he confirmed that I had an anxiety disorder and not heart disease. After the test he spoke to me for about 5 minutes, prescribed Prozac, and told me to have a great day.
At first I really didn’t think much about this, but for reasons unknown to me, I stuck the little bottle of pills in my pocket and vowed to never ingest any of it. In retrospect it may have been my natural suspicion and anxiety about things I knew nothing about but over time it is clear that this was a good move on my part.
I won’t beat around the bush I don’t think that anxiety disorder(s) or any other mental illness is caused primarily by a “chemical imbalance” in the brain and I’m also not convinced that antidepressants work as advertised ( I didn’t say that they don’t work for some). Nowadays it seems that people rely on buzz words as reference material and I think that this practice has lead to a warped view of what is and is not causing mental malfunction in people.
So what does cause anxiety disorder(s)? The jury is still out on this question, but suffice to say the causes are complex, multifaceted, and poorly understood by science as of today. The reason that this matters is because if the actual cause of anxiety disorder, OCD, social anxiety, panic disorder, agoraphobia, and PTSD are not known then why are doctors prescribing psychotropic drugs to cure and or manage these conditions?
This I think is a fair question, which when reviewed carefully will reveal that not only are the reasons not good but border on the unethical. When this question is reviewed closely the very efficacy (effectiveness) of antidepressants can also be called into question.
You and I, and millions of others, have seen all the commercials before. Sad girl sitting at the base of a wall, lying in bed, hands plastered all over face, you can chose the sad position. The scene is usually shot in black and white until the voice over comes on and says “Are you sad? Nervous all the time?” And you perk up and say “yea, yes I am”.
The voice over than offers a solution in the form of a pill, Que bright colors and cheerful music, to make you happy. The ad, and by direct connection the pharmaceutical companies, argue that depression and anxiety disorders (among other mental conditions) may be related to a chemical imbalance in your brain. A what?
The idea of a chemical imbalance causing havoc in people’s brains all started in the 1950’s and culminated in a scientific paper written by Joseph Schildkraut in 1965. His paper called “The Catecholamine Hypothesis of Affective Disorders” basically argued that neurotransmitter imbalances in the brain (a.k.a. brain chemicals) were the main cause of psychiatric conditions, like anxiety disorder for example.
But was Schildkraut right? Are the drug companies using sound science when promoting their products? Let’s review a few bits of information and you can make up your own mind.
The principle argument made by the chemical imbalance theory is that if there is an imbalance of certain brain “chemicals” then things go array. However studies have shown that “depleting serotonin (brain chemical) levels in the brain reaped no consistent results” 1. In other words getting rid of serotonin from the brain did not cause anxiety, depression, etc on a consistent basis.
In addition “contemporary neuroscience research has failed to confirm any serotonergic lesion (chemical based reason) for any mental disorder, and has in fact provided significant counter evidence to the explanation of a simple neurotransmitter deficiency” 1. As of today there is simply no solid scientific evidence to support the notion that anxiety and other mental conditions have anything to do with chemical imbalances.
So if the existence of a chemical imbalance is questionable how do antidepressants work? The answer is no one is absolutely certain, but again let’s take a closer look. Ever heard of broad spectrum antibiotics? Essentially these are antibiotics prescribed to battle a wide range of bacteria in the body. This sounds great but sometimes this type of antibiotic targets good bacteria and can also cause sickness.
It’s like carpet bombing. When loads of bombs are dropped from an aircraft and it’s hoped that the intended target gets hit. But this leads to collateral damage and this is a risk you take when shooting into the dark. You may hope to take an antidepressant to relieve depression but this can have unintended consequences.
In other words, if you target a wide range of chemicals in the brain your bound to hit something. But should serotonin really be the target? Or should it be some other chemical? This is simply unknown.
Some might argue that antidepressants helped them, even saved their life, possible. But there are also many other instances of people becoming more anxious, more depressed, more suicidal. This is what makes antidepressants problematic.
Moreover “the fact that aspirin cures headaches does not prove that headaches are due to a low level of aspirin in the brain” 1. Recently I reviewed a blog that was thrashing anyone that contested the effectiveness of antidepressants. This caused me concern for a few reasons.
I wondered why these folks were so sure that antidepressants worked as advertised? That chemcial imbalances were the culprit. Were they basing it on commercials or scientific findings? Even the president of the American Psychiatric Association has stated that there is no test to determine if someone has a psychiatric condition 2. There is no blood test or other lab test to confirm that someone is “off balance”. Yet powerful drugs are administered to combat the ‘disease’.
So then if you can’t test for it how can one treat it effectively? Again, some say that it has worked wonders for them but what of a placebo effect? It is very possible that many people feel better because they feel like they are treating their condition and not necessarily because the drug is effective.
“using the freedom of information act researchers were able to gain access to all clinical trials of antidepressants submitted to the Food and Drug Administration (FDA) by the pharmaceuticals companies. When the published and unpublished trials were pooled (combined), the placebo duplicated about 80% of the antidepressant response” 1.
Ultimately the scientific literature currently available simply does not confirm that chemical imbalances cause mental ailments nor does it confirm that anti depressants treat any brain imbalances.
In my view the causes of mental ailments are most likely spread among biologic, genetic, social and environmental reasons. Being that mental ailments are so complex I find it hard to understand why some are so sure about chemical imbalances being the primary cause of mental disorders.
Moreover how can a single drug, whether it’s Prozac, Zoloft, Lexapro, etc treat all six anxiety types and depression, and male sexual dysfunction?
I am not a fan of using drugs to treat anxiety however I also understand that they do help some people. The fact that this happens is great but that does not mean that it is ethical for any company to mislead people and make them believe that what they are selling is proven to work when it is not.
Just because a substance may help does not make it safe or well understood. Antidepressants can be harmful and even dangerous. You might ask well why do doctors prescribe such drugs? Doctors are smart, dedicated professionals, but this does not make them experts in what is yet to be completely understood.
The point of this article was to open the eyes of anxiety and depression sufferers. Make sure that you ask questions about what is prescribed to you. Make sure that you are properly diagnosed and not simply providing your own diagnosis visa via a 5 minute conversation with a family doctor.
Like all things we buy and consume we should be as informed as possible so we can also be empowered to make decisions based on facts and not be emotionally sold on something. Drugs are simply handed out too easily and not looked at with a critical eye by the general public.
And although drug therapy may help some people this does not excuse you from weighing your options and being well informed. Your attention to this matter is demanded because your health could be on the line.
Let me know what you think and don’t forget to check out the podcast that I included below.
1. It is not known if mental disorders are caused by chemical imbalances in the brain. This is an unfounded theory.
2. It is not yet known if or exactly how antidepressants work.
3. The media plays a large role in informing the public about ‘facts’ regarding mental illness and effective treatments.
4. Drug companies are misleading the public to believe that the chemical imbalance theory is fact and that antidepressants are safe and effective. These two things are yet to be fully known.
5. You should be an informed consumer and protect your health by educating yourself and asking questions when speaking to your doctor.
6. There is no test that can determine if someone is serotonin deficient or mentally ill.
Thanks for telling it like it is about antidepressants and the "chemical imbalance" advertisements. 10 years ago I tried 3 antidepressants to no avail. One of them packed on the pounds that left me even more down. I stopped when my psychiatrist had me go for one more. I know others who found their bouts with antidepressants gave them little or no benefit and ran up their pharmacy bills. A few years ago I saw a report in the New England Journal of Medicine that said bleakly that some of the pharmaceutical companies actually fudged on their antidepressant studies.They kept the negative studies from being published in peer reviewed journals. About the same time I saw resesearch analysis that showed that most antidepressants were little better than placebo. Yikes! I also saw that aerobic exercise, cognitive behavioral style thought change, activities, and social networking helped people more than antidepressants. I can testify to that because brisk walking, a better diet, and thought monitoring helped me out of those dark corners. I have been depression free for 9 years and love it. Here's some articles on depression and antidepressants that verify what you wrote. One's from Dr. Mark Hymen (The UltraMind Solution Doc). Another's from Self-helpapedia on depression by Steve Mensing "Your Emotional Power" which shows ways out of depression which don't resort to ineffective and overhyped antidepressants. Dr. David Burns (The Feeling Good guy) wrote a whole chapter on the failure of antidepressants in "When Panic Attacks".