The Myth of Serotonin-Imbalance
As early as 1998, professor emeritus of psychology and neuroscience at Michigan University Elliot Valenstein shared research in his book, Blaming the Brain, that showed serotonin levels in the brain did not correlate with feelings of depression. He found that it is just as likely for people with normal serotonin levels to feel depressed as it is for people with low or high levels of serotonin to feel depressed. His research concluded that “there is no convincing evidence that depressed people have serotonin or norepinephrine deficiency.” Yet, the theory debunked and discarded by research scientists remains a mainstay of psychiatry’s toolkit in prescribing psychiatric medications. In my experience from listening to members of my Facebook Group and other forums and groups, and even to my psychiatrist, there is still widespread belief that something is amiss in our brains and that the only way to relieve our symptoms is to start taking psychiatric medications.
Additional research continues to bear this discovery. Yet, it took until 2011 for psychiatry to officially declare that the imbalanced brain chemistry theory is indeed incorrect. Psychiatrist Ronald Pies wrote in the Psychiatric Times that “…the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.” Sadly, these well-informed psychiatrists Dr. Pies mentions appear to be few and far between. Every day, people on my Facebook group and other groups dedicated to supporting people on antidepressants, switching antidepressants, or trying to stop share how frustrating, lonely, and disabling it is to have their doctors deny their personal experiences for the standard tropes of psychiatric medicine. Such as, you need these medications because your brain is imbalanced, and you will likely need them for the rest of your life.
Why it Matters
For historical context, the 1960s saw the start of the antidepressant era. During that time, experts in depression wrote that depression was an episodic disorder, meaning it could be expected to clear up with time. As Dean Schuyler, head of the depression department at the NIMH, wrote in his 1974 book, The Depressive Spectrum, that the majority of depressive episodes “will run their course and terminate with virtually complete recovery without specific intervention.” In 1969, George Winokur, a psychiatrist at Washington University, wrote in The American Journal of Psychiatry that “Assurance can be given to a patient and to his family that subsequent episodes of illness after a first mania or even a first depression will not tend toward a more chronic course.” Yet today, we see more and more long-term users who claim that they are worse than when they started psychiatric medication and experience many side effects and drug-induced illnesses that they are told are all in their heads. Many share they have been cut off from medical help because they question this paradigm.
Robert Whitaker, an award-winning writer and journalist who specializes in covering medicine and science and author of three books on psychiatry and pharmaceuticals, cites three studies in his Psychology Today article, “Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria: New research on why antidepressants may worsen long-term outcomes,” that support the premise that antidepressants are causing a “chronification” of depression. One such study by Giovanni Fava states that “psychiatric drugs perturb neurotransmitter pathways in the brain, and in response to that perturbation, the brain undergoes a series of compensatory adaptations in an effort to maintain the normal functioning of those systems. Fava calls this compensatory process to a psychiatric drug “oppositional tolerance.”
If we can’t rely on medication to give us the long-term outcomes we need, what will?
Bruce Levine, Ph.D., Bruce E. Levine, a practicing clinical psychologist often in opposition to the mainstream of his profession, writes and speaks about how society, culture, politics, and psychology intersect. In his article for Mad in America, “Depression: Psychiatry’s Discredited Theories and Drugs Versus a Sane Model and Approach,” he suggests that there needs to be a more common-sense approach to mental health. One that includes “[a]ctivism to change societal policies," including “eliminating, reducing or at least mitigating the effects of financial poverty, [...a]nd the effects of unemployment. Preventing unnecessary involvement with the criminal justice system [and] recognizing that alienating jobs that are vulnerable to layoffs are among the many reasons why so many people experience ever-increasing anxiety, powerlessness, resentment, and rage, […and i]mplementing policies at every level of society that build and maintain community.” These are the basic human biological drives we need to feel we belong and flourish.
Lifestyle changes such as how we eat, exercise, and commune with the world outside our doors, as our neurobiological connections require, are also important. The current belief system that medication is the first line of defense against mental illness clearly does not serve us. We need human connection at its most basic biological drive, which I will share more about in subsequent newsletters.