Friday, March 7, 2008

Is depression caused by chemical imbalance? Um, maybe not.

"Biochemical roots of depression challenged," says the headline in an article on the Psych Central web site.

Ideally this should be a headline blazed across every mainstream web site and TV news show. This is a big big deal and it will probably get very little attention because marketplace economics are dead set against it.

Scientifically what's going on here is no new news at all. There has yet to be any conclusive, clinical proof that chemical imbalances "cause" depression. None. It was a theory that gained footing in the '60s but 40 years later, the Diagnostic and Statistical Manual of Mental Disorders, continues to tell us, in no uncertain terms, that the cause of depression and anxiety is "unknown."

Authors of a study quoted in the Psych Central article suggest that the media has played a large role in passing the chemical imbalance theory along as fact, fueled in large part by how apparently successful certain drugs were in alleviating depression.

Only--uh oh--it turns out the drugs don't work so well after all. Some recent studies have questioned how effective these drugs actually are. One study published last month suggests that most of the perceived effectiveness of several of the most common SSRIs (Selective Serotonin Reuptake Inhibitors, often prescribed for depression) is due to the placebo effect.

All of this, to me, relates to an incredible, largely unexamined bias in our day and age towards treating our bodies reductively, particularly when it comes to biochemistry and genetics. It's like every Valentine's Day when there are articles in the newspaper about the chemistry of love, quoting scientists talking about whichever chemicals that get secreted in the brain when we are in love. And the underlying presumption much of the time is that the chemical is somehow causing the feeling of love.

Western scientists truly have an irrational faith in the fact that the chemicals cause the emotions. That's how the "chemical imbalance causes depression" arose so naturally.

It rarely seems to occur to clinicians that the emotions may be causing the chemicals. That's because western scientists have such a hard time accepting the idea that the mind can impact the body so flagrantly. (Once again, I would ask: hasn't any of them ever blushed? Or seen someone blushing? Of course the mind can affect the body!)

And so with depression. No doubt a depressed individual does in fact have some chemical imbalances associated with that physical state. But all these years later there is no evidence to show that the imbalance comes first.

And here's the crazy dead-end of reductivist thinking anyway: even if the imbalance *did* come first, what then? We still wouldn't know what caused the imbalance. So the chemical imbalance theory is pointless before it even starts.

Yet it lives, and this small notice on a psychology web site is probably not enough to alert the world about how naked this particular emperor truly is.

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