Updated: Sep 29
We want you to have all the facts so that you can make informed decisions about how you think about your emotional wellbeing and your healthcare. So, here it goes: According to Dr. Andrew Weil (with a critical eye), "The biomedical model explains depression as the result of a chemical imbalance in the brain, specifically neurotransmitters affecting our moods…[even more specifically] a deficiency of serotonin at synapses in key areas of the brain; therefore, boosting the activity of this neurotransmitter with drugs that block its reuptake will treat or cure your problem.” He and other experts in psychiatry and mental health care note that there is, however, NO solid proof that this is the case.
The “chemical imbalance” theory was popularized by the pharmaceutical industry, after one company came out with Prozac in the 1970s, and to this day, billions of dollars from the sale of antidepressants and anti-anxiety meds are at stake, so pharma companies continue to pump money into promoting the chemical imbalance theory. They count on people believing that they have "disorders" that only medication can treat, and in turn, they need to continue to take them endlessly. This has become so ingrained in our culture that people speak about mental illness/mental health this way, as though it's obvious. As if a person who struggles has a flawed psyche. It's also an external that western medicine can point at that makes the field (and us) feel more in control and able to "fix."
The reality is that research shows that SSRIs yield very similar results as placebo pills, and sometimes, placebos work even better! And the American Psychiatric Association's official statement in 1978 was: “Psychiatric disorders result from the complex interaction of physical, psychological, and social factors, and treatment may be directed toward any or all three of these areas." So, when it comes to pervasive depression, anxiety, PTSD, and other mood and psychological "disorders"--basically, presentation and duration check the boxes of the clinical diagnosis list--yes, there is an "imbalance," but NOT a proven imbalance of neurotransmitters. It's an imbalance of many facets of LIFE--it's when we live in extremes, when there's too much or too little in our various buckets, and when we have unhealed trauma wounds continuing to get pinched so they surge through our bodies and keep negative self narratives on repeat. It's not likely that psychological struggles will ever be tied solely to brain chemistry, isolated from the rest of human experience--it's a multifaceted problem that can be influenced positively by attending to unresolved trauma (body-based neurological rewiring techniques), automatic thought patterns, one’s sense of belonging and connection to a community, social engagement and healthy/satisfying relationships, movement and exercise, nutrition and hydration, vitamins, hormones, exposure to nature and the sun, among other things.
The other things is, both uncomfortable and comfortable emotions and moods are simply part of being human. Our society doesn't like discomfort so we push sadness, hurt, disappointment, embarrassment, shame, anxiety, fear, anger, resentment, and so much more, down, sweep them under the rug, distract ourselves from them...we do whatever we can to try to make them stop for the moment! And, they don't go away when we do that. They stay in our bodies, in our muscles, in our gut, in our heart, and in our beliefs about ourself. We feel things because we're supposed to, not because there is something wrong with us. Emotional responses tell us something about our situation and about how we're treating ourself. Depression and anxiety are feelings that are never going to be eliminated from human experience--you are going to feel them at various points, and they look different for different people. And this topic deserves the attention of its own article...stay tuned.
Pathology-Focused Society + Diagnoses
Because of chemical imbalance theory and our pathology-focused society, the whole way we look at psychiatric diagnoses is backwards. Major Depressive Disorder, Generalized Anxiety Disorder, Panic Disorder, and ADHD, for example, are compilations (lists!) of common patterns of mood, behavior, and presentation, grouped together for easy labeling among care providers, researchers, and for insurance purposes; these patterns of experience are not CAUSED BY a disorder itself. We look to point at a disorder like it's a tumor we can remove or an infection we can fight, and then the label that made us feel more in control initially, ends up feeling like something out of our control again. This theory puts us in a no-win situation. Try to think about mental health as a larger, whole system concept, fed and taken care of by all of the different layers of your life, past and present, not chemicals.
Disclaimer + Some
We do not have an anti-medication stance, nor do we judge anyone's decisions to take or not take medication! We believe there is a time and place for medication, especially when your mood or psychological challenges are paralyzing, totally destabilizing your life, health, and relationships, or putting you or some else in danger. And yes, they can bring people relief.
That said, most psychotropic medications were designed and intended for short-term use (YES, really), as a temporary aide so that a person can access the energy, focus, or relaxed state required to learn about their needs, gain self-awareness and tools, and take action in their lives so they don't feel the need to or have to stay on medication indefinitely. While they can impact your mood when you’re taking them, psychotropic medications won’t solve the problems in your life keeping you stuck–the challenges in your home, in your beliefs about yourself, in your relationships, in your workplace, in your self-care, in your moving or not moving your body, in your traumas. In fact, taking medication that changes your mood can actually mask the problems that deserve to be addressed for lasting relief, as they lead your mood and focus away from the discomfort. The distress is likely actually functional anxiety telling you something—that something in your life and the way you’re managing it isn’t working. And, if you eliminate that meaningful human instinct, you’re stuck yet again. This is why if you’re engaged in psychiatry, psychiatry AND therapy yields the best and most lasting outcomes for people.
You are a Member of Your Care Team
You are entitled to do what you feel is best for you, AND you are allowed to have the goal of eventually getting off the meds, if you want, even though western medicine seems to say you must stay on them. If you see a psychotropic medication prescriber, DO ask questions, be honest with them, and advocate for yourself and your goals. Another point to know about discontinuing meds is that many psych medications have withdrawal and rebound effects when you stop taking them, that rev you up or cause a mood crash, and that can alarm people and make them feel totally out of control. Because of this uncomfortable and sometimes, scary reaction, you might then be convinced that you do in fact NEED this medication, and so you start back up again. This is a cycle that can be prevented. Any medical professional prescribing these kinds of medications should be providing education about this potential reaction, helping you to understand it, and facilitating a specific process of weaning you off a medication, with a very particular tapering down of the dosage, according to the medication in question. Please do not just stop taking a medication without consulting with your prescriber and coming up with a plan together.