"Chemical Imbalance Theory" and Paxil, Zoloft, Prozac, Celexa, Effexor, Xanax etc

Anyone who is prescribed psychiatric medication (Paxil, Zoloft, Prozac, Celexa, Effexor, Xanax etc) is thought to have a chemical imbalance.

This chemical imbalance theory implies that our minds have fixed amounts of these chemicals which have well-defined normal levels.

Notice how this fits the usual medical understanding that there is a simple physical malfunction which can be fixed using drugs/surgery etc. But even before the Prozac Revolution, it was obvious to those pioneering scientists that this implication is far from reality.

Since these chemicals have similar structures to well known drugs, we know that changes in the levels of these chemicals have dramatic effects on how our body works. Just as these chemicals can profoundly influence our state of mind, our state of mind can also influence our neural chemistry. Drugs that make us euphoric either directly or indirectly stimulate the same receptors that get stimulated when we are naturally euphoric.

So while we accept that psychoactive medications can help the mentally ill, can we really deny that profound learnings can do the same thing?

As yet, there is only one way of detecting levels of these chemicals in someone's brain, which involves waiting until they are dead, slicing their head into into thin slices etc
Even then you can only measure those levels at time of death, and then they are going to be strongly influenced by the cause of death!

The levels aren't the whole picture though. There are thousands of these information chemicals which are constantly being produced, reabsorbed and stimulating receptors inside synapses.. A piece of your brain the size of a grain of sand contains a billion of these synapses, belonging to 100,000 neurons, each of which having a unique function. All of which amounts to easily the most complex system known to mankind.

When it comes to influencing this system, how do doctors and psychiatrists know which chemicals to boost? DSM-IV of couse!

DSM-IV is a manual full of sets of symptoms. Regardless of any underlying mechanism, if you match a particular set of symptoms, you are given a nominalisation to describe them. Each nominalisation is treated with a particular drug (although analogues of the same drug are often used for a wide range of these "diagnoses").

The only scientific evidence supporting the "chemical imbalance" theory are the clinical trials of these drugs (which barely distinguish them from placebo). After Prozac had sewn-up the "depressed" market, the other drug companies quickly manufactured Prozac analogues (Seroxat, Zoloft, Effexor, Luvox, Anafranil) to trial for the other DSM categories.

There is one sure-fire way to get a chemical imbalance - and that's getting addicted to any neurological medication. If you stop taking it and get withdrawal symptoms, then that's a chemical imbalance. And just like any other chemical imbalance, it's temporary -- unless it creates further psychological/physical problems:

I recently had a client who was misdiagnosed as clinically depressed, was prescribed increasingly large doses of Paxil up to 80mg (more than quadrule the current recommended) with no improvement. When he tried to stop taking them, he immediately went into through terrible withdrawal symptoms, which, combined with his pre-existing problems, lasted 6 months.
It was then lifted slightly by his next medication, Cipramil. Not surprising really, since both Paxil and Cipramil are SSRIs and the Cipramil just substituted for the Paxil his body had become habituated to.

Yet it is considered perfectly acceptable that those seeking treatment might have to go through several drugs before finding settling on one that makes them feel slightly better, even though their judgement may be based on satisfying their new addiction.

There is no need to blame anyone for this situation. Doctors and psychiatrists do their best with the training and information they are given. They can only go on what medical research has shown to be most effective in clinical trials. The drug companies probably blame their shareholders.

If this system is to be improved, new diagnosis methods need to find the best treatment for each patient, rather than matching drugs to arbitrary classification of mental problems. Research needs to be done to precisely establish what makes some patients respond better than others to the exact same medication.

As drugs get more sophisticated, we'll be able to precisely alter neurotransmitter levels in each part of the brain at particular times. But the drugs will still never be able to respond directly to the changing needs of the individual, not even using nanotechnology.

The only machine that can do that is our very own mind.

Doctors Speak Out Against "Chemical Imbalance"

Critique of Chemical Imbalance theory - Simon Sobo, M.D.

There is no evidence that any psychiatric or psychologial disorder is caused by a biochemical imbalance. - Peter Breggin M.D.

First, no biological etiology has been proven for any psychiatric disorder (except Alzheimer's disease, which has a genetic component) in spite of decades of research.  ...  So don't accept the myth that we can make an 'accurate diagnosis.'  ...  Neither should you believe that your problems are due solely to a 'chemical imbalance.' - Edward Drummond, M.D., Associate Medical Director at Seacoast Mental Health Center in Portsmouth, New Hampshire

...those who take these drugs, and their children who take them, are being transformed. - Fred A. Baughman Jr., M.D. Neurologist

I am constantly amazed by how many patients who come to see me believe or want to believe that their difficulties are biologic and can be relieved by a pill. This is despite the fact that modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness.
However, this does not stop psychiatry from making essentially unproven claims that depression, bipolar illness, anxiety disorders, alcoholism and a host of other disorders are in fact primarily biologic and probably genetic in origin, and that it is only a matter of time until all this is proven. This kind of faith in science and progress is staggering, not to mention naive and perhaps delusional.

- Dr David Kaiser, M.D. Psychiatrist