In 1997 Eli Lilly’s anti-depressant drug Prozac was considered “one of the most widely prescribed drugs in history,” and in 2021 it is 40 million users strong accounting “for a quarter of Lilly’s $10.8 billion in sales and more than a third of its $3 billion profit last year.”
“Surveys suggest that 80% or more of the general public now believe it is established that depression is caused by a ‘chemical imbalance”Moncrieff, J., Cooper, R.E., Stockmann, T. et al. via Molecular Psychology
I remember the first time I heard the chemical imbalance theory. It was in the old Zoloft commercials, remember them? A blob bouncing around on green grass with a voice in the background saying that depression may be a chemical imbalance in the brain.
Chemical imbalance theory was introduced in the 60s with “little scientific evidence to support it,” and suggests that depression is caused by a lack of serotonin in the brain.
“Serotonin can be measured in blood, plasma, urine and CSF, but it is rapidly metabolised to 5-hydroxyindoleacetic acid (5-HIAA)….two meta-analyses of a total of 19 studies of 5-HIAA in CSF (seven studies were included in both) found no evidence of an association between 5-HIAA concentrations and depression.”Moncrieff, J., Cooper, R.E., Stockmann, T. et al. via Molecular Psychology
For companies like Eli Lilly, their record-breaking success rests on one thing, the theory that depression is a chemical imbalance in the brain.
This is likely why you have not heard that the chemical imbalance theory is now being called a myth and also likely why you have not seen the massive amount of articles and research discussing how we have been mislead, like this one from Florida State University…. we will get to that in a moment.
But first let me share my experience with depression and medication.
Actually, first let me make a disclosure
Some people suggest that because I have this approach to anti-depressants I must be anti-vax or anti modern medicine. This is definitely not the case. I had brain surgery that saved my life and LOVE modern medicine—without it I would literally be dead.
Medication is an individual choice. If you are on anti-depressants don’t change your approach because of an article on the internet. But do look at the research and talk to your doctor if you feel the need to change your approach.
In my mid twenties I finally found the courage to go to therapy. There I learned my childhood was not normal, that not all children pissed their pants in fear of daddy, and not all parents gave their children the silent treatment for months on end.
A therapist told me it was one of the worst cases of abuse they have seen. Another told me she was surprised I was able to function and have a career. I’ve asked multiple therapists to please not cry when I disclosed what I thought were normal childhood occurrences. When asked why, I said that her crying showed me it wasn’t normal. I felt stupid and sad I didn’t stand up for myself.
It was shocking and heartbreaking. Even now, 10 years later and in remission for high functioning depression, high functioning anxiety and c-ptsd I still feel a deep sadness in my heart that I am not sure will ever go away.
One therapist thought I was suffering from a broken heart (that’s actually a thing you can read about it here).
The chemical imbalance
Finding a therapist who can help with depression and complex trauma is a very lonely and difficult process. While I searched for a therapist I read books and studied subjects on my own, so when I found an amazing therapist I already had some knowledge under my belt.
She suggested I had a chemical imbalance and that I should take a daily medication. I said that I could not find enough substantial evidence to prove that depression and anxiety were caused by a chemical imbalance. (This was 10 years ago before the current articles and information discrediting the chemical imbalance theory.)
I do not remember the exact references I used back then, but Dr. David D. Burns outlines it beautifully in the intro to his book “When Panic Attacks.”
It was suggested that I didn’t want to take medication out of shame. And while I appreciate the support and reminder that there is no shame in taking medication, there was no shame here.
For me, it wasn’t about shame. I didn’t take a daily medication for depression because I didn’t see enough evidence to prove it would be beneficial. And the for profit pharma companies and business men saying the pill they had was the treatment I needed just didn’t feel right to me. I followed my intuition.
“Andrew Hotchkiss, Lilly group brand leader, said that “because Prozac is the leading antidepressant, if more people come into treatment, we will benefit from that.’” (Ref)
The middle ground
Even though, due to research of scientific studies and articles, I did not believe that depression was a chemical imbalance and that medication would not cure it, I was suffering and I still needed help.
My doctor prescribed me an “only as you need” sleep aid. It helped me get the rest I needed in order to do the work (changing dysfunctional thought habits) to overcome depression. I do not know where I would be without it.
She still heavily encouraged me to take a daily anti-anxiety medication, and she told me I was doing things the hard way, but “the hard way” felt like the right path for me.
We agreed that if I was not making progress and if things got worse, I would go on a daily medication. It never got to that point.
Before therapy I tried all the things people say to try to reduce depression. Yoga, exercise, meditation, journaling, eating health, you name it. And while I was 40 pounds lighter and had a nice, rounded ass, I was still depressed. Luckily, my therapist introduced me to two things that would change my life forever: CBT and Melody Beattie.
CBT, or cognitive behavioral therapy, focuses on thought patterns and the fact that depressed people have similar dysfunctional thought patterns.
I became obsessed with CBT and its founder, Aaron T. Beck. I find him and his research truly magnificent and it’s a regret of my life that I did not write him a letter of thanks before he died.
And Melody Beattie showed me that while I feel lonely in this process, I can read a book and find a friend. After reading “Codependent No More” all bets were off. Already an avid reader who wanted to be a psychologist as a kid, I would get a book delivered and read it in one night.
With all the research I previously did on medication and now CBT and friends who wrote books like Melody Beattie’s “Codependent No More,” Dr. David Burns’ “When Panic Attacks,” Dr. Alice Miller’s “Drama of the Gifted Child,” and Dr. Judith Herman’s “Trauma and Recovery“, I lead my recovery with the belief that depression was a thinking disease.
While others were limiting themselves, believing that there was something fundamentally wrong with them (a chemical imbalance), and that there was nothing they could do, I was working hard to identify and change my dysfunctional thought patterns and core beliefs.
My therapist said I was speeding through the therapeutic process.
Sometimes more painful than having brain surgery and learning to walk again, it’s not something I would want to go through again, but I would if I had to because it was worth it. And after a lot of dedication, research and hard work I am in remission for high functioning depression and c-ptsd since May 2022.
I got my life back. I got me back. And I am very happy.
In the last few years, scientists and medical journals have published articles with evidence supporting the hypothesis I made long ago, that depression is not a chemical imbalance. The most comprehensive one I found here.
Scientists are now studying to find the cause of depression. As someone in remission for over a year, I can tell you, it’s primarily thoughts and dysfunctional thought patterns and the severity is contingent upon the level of self esteem and connection a person has. You heard it here first y’all.
I understand how difficult depression can be so I truly want to help others. I understand the loneliness, pain, frustration, and vulnerability, and I wish I wasn’t the one to tell people they have been misled but someone needs to.
People need to know the fact that depression is not a chemical imbalance. They need to know the full reality they face so they have a chance at overcoming their depression. Just like you get the newest software update, you need to navigate the world with the newest scientific advancements.
The shock of truth
Understandably, it is painful to face the reality that people you trust (doctors) were mislead and in turn mislead you. Even more painful to realize that pharmaceutical companies and doctors will not suffer any consequences for misleading you.
Just like I have a disclaimer at the bottom of this site that I am not a doctor, doctors have protections that their medical advice is advice and you would need to prove there was negligence with intent to harm.
Since people cannot lash at pharma companies, some lash at the people who are trying to help. It is the same idea that the person who lashes out the most actually needs the biggest hug.
And stating this scientific fact is going to get backlash because people have been misguided for so long, but we still need to spread the truth.
So far I have been accused of trying to kill people, of being a liar and called a narcissist. My character has been questioned with someone making up a distorted reality that they think I have millions of dollars somewhere from disingenuous services that they think I provide. This is all telling of how deep the chemical imbalance theory is ingrained in our society, and that people have an emotional connection to it.
The middle ground
With depression people go to extremes, it’s called “all or nothing thinking.” And they may think they need to either take medication or not. But this is not the case. Medication is there to help, and sometimes we need help, and that is OK.
Without the medication I would not be where I am today. I am grateful for the medication and the scientists who worked so hard to make it.
The middle ground here would be acknowledging the scientific fact that depression is not a chemical imbalance and also acknowledge that medication can help ease the symptoms. Then create a plan that works for you with the end goal of adjusting your thought habits so they are more balanced and get to a point where you no longer need the medication.
Maybe get a book about overthinking to help you get started, wink wink.
The move forward
Professor of psychopharmacology at the University of Oxford, Phil Cowen stated “No mental health professional would currently endorse the view that a complex heterogenous condition like depression stems from a deficiency in a single neurotransmitter.” (Ref) Simply put, no mental health professional worth their salt would spread the chemical imbalance myth.
Unfortunately for us, Professor Cowen is wrong. Improperly educated people or people who lack updated information is a sad reality in the mental health field. People who are rigid in their beliefs and do not keep up with a changing, progressive field end up steering their clients wrong by telling them limiting beliefs that keep them stuck.
Depressed people are the ones who suffer. And while I wish I had better news for you, the reality is that therapists and counselors are people too, and not all are created equal. But you can and will find the resources to help when you look for them.
The end… for now
I made a personal choice not to take a daily medication because of the science I researched. And no matter what anyone says, I would never try to steer someone away from making their best personal choice. It’s your life, not mine. But I will encourage you to at least look at or consider focusing on your thought patterns. Here’s a beginners guide to core beliefs and automatic thoughts.
Also, here are references and resources outlining that depression is not a chemical imbalance:
- A chemical imbalance doesn’t explain depression. So what does? – Sciencenews.org
- Onset of depression more complex than a brain chemical imbalance – Harvard U
- Depression Is Not Caused by Chemical Imbalance in the Brain – Dr. Noam Spencer, Psychology Today
- Debunking the Two Chemical Imbalance Myths, Again Ronald W. Pies, MD
- Study: Media perpetuates unsubstantiated chemical imbalance theory of depression – Florida State University
- The serotonin theory of depression: a systematic umbrella review of the evidence – Molecular Psychiatry
- Depression probably not caused by chemical imbalance: Study – Australian College of General Practitioners
- A Popular Theory About Depression Wasn’t “Debunked” by a New Review – Tech Networks
- Why Has the Misleading “Chemical Imbalance” Theory of Mental Illness Persisted for So Long? -Slate.com
- Landmark Study Explodes Chemical Imbalance Myth – Freedom Mag
- The chemical imbalance theory of depression is dead – but that doesn’t mean antidepressants don’t work – The Guardian
- Psychiatry DID Promote the Chemical Imbalance Theory – Mad in America
- Finding a Balance in the Chemical Imbalance Theory – Psychiatric News
- A brief history of the development of antidepressant drugs: From monoamines to glutamate – National Library of Medicine
- The Story of Prozac: A Landmark Drug in Psychiatry – Psychology Today