Chemical Imbalance: Stone Age Thinking

By Tim Evans and Geri Carter

“Chemical imbalance” thinking is in the dark ages but remains and predominates our training of future counselors and treatment of people who have relational issues, not chemical imbalances.

Donald Jackson, M.D., in his article, “The Myth of Normality,” wrote:

“Again and again, psychiatrists, psychologists, and others concerned with mental health are called upon to decide how ‘sick’ a person is. Their ability to arrive at anything that resembles a sound judgment is hampered because there is no standard of psychological ‘normality’ or ‘good health.’

“In somatic medicine, physicians know that the normal systolic blood pressure will range from 110 to 130. When the read?ing is 160, the physician can readily label?it deviant and recommend treatment for high blood pressure. But researchers in the mental health fields have been so engrossed with the study and treatment of people who are labeled ‘sick,’”they have had neither the opportunity nor the interest to study people who are ‘well.’ One tragic result of the failure to develop a reliable yardstick is the appalling hit-or-miss process by which people are sent to mental institutions.”

More tragic consequences result from prescribing brain-altering drugs and making individuals to believe there is something wrong with their brains.

Alix Spiegel recently reported that despite the current research, which shows a lack of serotonin is not the cause of depression, we continue the backwards practice. In her report (NPR, When It Comes to Depression, Serotonin Isn’t The Whole Story, January 23, 2012), she states,

“When I was 17 years old, I got so depressed that what felt like an enormous black hole appeared in my chest. Every- where I went, the black hole went, too. So to address the black-hole issue, my parents took me to a psychiatrist at Johns Hopkins Hospital. She did an evaluation and then told me this story:

‘The problem with you,’ she explained, ‘is that you have a chemical imbalance. It’s biological, just like diabetes, but it’s in your brain. This chemical in your brain called serotonin is too, too low. There’s not enough of it, and that’s what’s causing the chemical imbalance. We need to give you medication to correct that.’

“Then she handed my mother a prescription for Prozac.

“ That was the late ‘80s, but this story of a chemical imbalance brought on by low serotonin has remained very popular.

“‘I don’t know of any story that has supplanted it,’ says Alan Frazer, a researcher who studies how antidepressant medications work. He is also chairman of the pharmacology department at the University of Texas Health Science Center at San Antonio.

“ ‘It definitely continues to live — absolutely,’ agrees his colleague Pedro Delgado, the chair of the psychiatry department at UT. ‘If you go to your community doctor, you’re likely to hear some version of that.’

“But for many scientists who research depression, this explanation is no longer satisfying.

“ ‘Chemical imbalance is sort of last- century thinking. It’s much more complicated than that,’ says Dr. Joseph Coyle, a professor of neuroscience at Harvard Medical School. ‘It’s really an outmoded way of thinking.’

“Coyle, who is also the editor of the journal Archives of General Psychiatry, says that though serotonin plays a role in depression, low serotonin is likely not the cause of depression. Scientific thinking has clearly shifted, he says.

“Still, the story of serotonin remains. Why does it continue to have such a powerful grip on the popular imagination?

“According to Frazer, to understand how the story of low serotonin came to dominate our understanding of what causes depression, you need to go back to the late ‘50s, to a psychiatric hospital in Switzer- land.

That’s where psychiatrist Roland Kuhn gave a newly developed drug to 10 patients who had been paralyzed by depression for years. Over the course of three weeks, he watched a near-miracle occur.

“ ‘There was this lightening of their mood,’ Frazer says. ‘They became more energized, more interested in things around them.’ “This was the birth of the very first antidepressants, called tricyclics. And with that birth came a question: How could these drugs possibly be working? Researchers had some ideas, but it really wasn’t until the mid ‘60s, when the cause of Parkinson’s disease was discovered, that a real narrative began to take shape.

“It turned out that Parkinson’s — a brain disorder — was caused by a deficiency of a chemical in the brain called dopamine. This discovery influenced the way scientists thought about depression.

“ ‘There is no doubt in my mind that the Parkinson’s story had a strong impact on the way that people were thinking about depression,’ Frazer says. “It became easy?to speculate that depression was due to a deficiency.’

“The question, of course, was what was deficient? Which chemical was too low? For decades researchers argued this question, but no one candidate took the lead. And then came Prozac.

“Almost as soon as it was introduced?in 1987, the antidepressant Prozac, which selectively targets the chemical serotonin, became a blockbuster. ‘Prozac just blew everything else out of the water,’ Frazer says. . . . ‘It was very free of side effects,” says Pedro Delgado. “And so it began to be used very widely, and there was a lot of enthusiasm for it.’

“That understates the case. In a very short time, Prozac became wildly popular, and again, Prozac worked on just one chemical in the brain: serotonin.

“And really, it is because of the popularity of Prozac that the low-serotonin story took hold, even though, Frazer argues, the scientific research has not borne that out.

“ ‘I don’t think there’s any convincing body of data that anybody has ever found that depression is associated to a significant extent with a loss of serotonin,’ he says.

“Delgado also makes this argument. In the 1990s, he carried out a study that showed that if you take a normal person and deplete them of serotonin, they will not become depressed. He says he feels this demonstrates that low serotonin doesn’t cause depression....”

Instead of adhering to an outdated model of medicating clients, come join the Florida Adlerian Society at our annual international conference to learn a different way to heal: to cooperate, improve our relationships, and practice a model of mental health that focuses on strength and encouragement.

To read or listen to Spiegel’s full story, go to and search for the title.