Chemical Imbalance Theory: Fact or Fiction?

I would now like to address the next three myths:
"'Antidepressants are not mood-altering, they directly improve the disease of depression.'
'Antidepressants are like insulin for diabetes, they provide essential missing substances.'
'Antidepressants don't cause abnormalities in the brain, they correct biochemical imbalances.'"

I would argue that these three statements are directly connected. Many people believe that a lack of the neurotransmitters that antidepressants affect is one cause of depression. This implies that a chemical imbalance in the brain is involved when people are depressed. Peter Breggin would argue that the chemical imbalance theory is simply false. He says that medicine does not know enough about the brain to determine whether these neurotransmitters are related to depression and thus, that doctors who prescribe antidepressants to combat a chemical imbalance are taking a shot in the dark in fighting depression.

Mood-altering simply means that the drug artificially affects the patient's mood. This is viewed as a negative because it could be argued that this is not treating the disease properly. However, I am of the opinion that facing the grueling cycle of depression to improve the patient's mood, even by artificial means, is treating the disease. The cycle of depression is described many different ways. A good example of the cycle in  practice would be this: John Doe is depressed. Because he is depressed, he does not work as hard and his work is substandard. His work is substandard so he is fired. He is fired so he feels bad about himself and he feels guilt, leading to him being more depressed. Perhaps you are not sympathetic. You may say, John should have used that guilt and self-loathing to find a new job and try harder. That is exactly what a depressed person would have trouble doing. In these cases, a drug that can help elevate mood can result in John doing a better job at work due to him having less depressed feelings. Maybe he would end up getting promoted, at which point, John would begin to feel develop a sense of self worth and pride that might generate a happiness that is not purely deriving from his medication.

What Peter Breggin pictures^^

Breggin's second and third claims are more similar. The first compares depression and diabetes, both diseases that we suppose to cause a chemical imbalance. In this case, the antidepressants, in fixing that imbalance, would clearly be doing a good thing. The third claim states this explicitly. If there is  not chemical imbalance, then Breggin is right, these drugs are being marketed under false pretenses and may not be helpful to depressed patients. However, the research I have read makes me wonder if Breggin's eighteenth book will be a retraction of his attacks. There are studies available that strongly support the chemical imbalance theory. According to a study done by the Canadian-based Centre for Addiction and Mental Health (CAMH), monoamine oxidase A, an enzyme that would break down the neurotransmitters doctors claim to be imbalanced, is more prevalent in people with untreated depression than those who are not depressed. More of this enzyme means less of the neurotransmitters which clearly results in a chemical lack. The study goes on to discuss the significance of monoamine transporters, which are specialized by neurotransmitter. These take the monoamine neurotransmitters away from active sites, creating further imbalance. This would explain the variety and varying severity of depression symptoms. If one had an excess of serotonin transporters, then less serotonin would be in their active sites, while they may have a normal amount of dopamine transporters. These differences would affect symptoms and severity and also which drugs would be effective on which individuals.

This blog post may seem extra long, but this particular topic will most likely be a defining point of my overall project. The validity of the biochemical imbalance theory is extremely significant and I will discuss it's implications in my later posts.


Nauert, Rick. "Depression's Chemical Imbalance Explained | Psych Central News." Psych Central.com. Web. 02 Mar. 2012. <http://psychcentral.com/news/2006/11/09/depressions-chemical-imbalance-explained/398.html>.
 

Breggin, Peter Roger. The Antidepressant Fact Book: What Doctors Won't Tell You about Prozac, Zoloft, Paxil, Celexa, and Luvox. Cambridge, MA: Perseus Pub., 2001. Print.