Revealing the Truth Behind Depression and Chemical Imbalance

Young Asian woman looking thoughtful or sad as she stares out a window.
Uncomfortable situations have the potential to transform us and propel our growth, and it brings out our enormous capacity for coping with and surviving them. (Image: Ocusfocus via Dreamstime)

Through no fault of their own, there are many uninformed individuals when it comes to what’s happening within the modern-day medical industry. It’s an unfortunate fact that medical science has been overwhelmed with scientific fraud and has fallen under pharmaceutical company influence.

When we hear the words “big pharma,” we instantly think of conspiracy theorists. The small group of people and the corporations they hide behind control tremendous amounts of power. However, there have been many physicians and doctors holding influential positions trying to let us know just how deep the betrayal goes.

The betrayal

Close up of a handshake between two Caucasian men wearing business suits.
‘The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research.’ (Image: 드림포유 via Flickr)

Dr. Marcia Angell, a physician and longtime Editor-in-Chief of the New England Medical Journalwrote in PLoS Med that she believed that half of all the published literature could be false, adding:

“It’s simply no longer possible to believe much of the clinical research that is published, or to rely on the judgement of trusted physicians or authoritative medical guidelines.”

Now, don’t get me wrong, depression is a very real condition and remains a major problem. It’s the methods that are commonly used to treat the condition that are being called into question.

Arnold Seymour Relman (1923-2014), Harvard Professor of Medicine and Former Editor-in-Chief of the New England Medical Journal, wrote in a paper titled Who pays for the pizza? Redefining the relationships between doctors and drug companies:

“The medical profession is being bought by the pharmaceutical industry, not only in terms of the practice of medicine, but also in terms of teaching and research.

“The academic institutions of this country are allowing themselves to be the paid agents of the pharmaceutical industry. I think it’s disgraceful.”

Depression: Is it a chemical imbalance?

Of course, there are brain events and biochemical reactions occurring when someone feels depressed, as there are all the time, but no research has ever established that a particular brain state causes, or even correlates with, depression.
‘Of course, there are brain events and biochemical reactions occurring when someone feels depressed, as there are all the time, but no research has ever established that a particular brain state causes, or even correlates with, depression.’ (Image: Gloria Williams via Flickr)

It must be said from the onset that the chemical imbalance theory is just that — a theory — it has never been proven. So with that said, has this theory been pushed as fact? If so, is it being used to push more drugs into the market?

In a blog by National Public Radio’s Alix Spiegel, Joseph Coyle, a neuroscientist from Harvard Medical School, was quoted as saying:

“Chemical imbalance is sort of last-century thinking. It’s much more complicated than that.”

Saying that depression results from a chemical imbalance just simplifies it, and doesn’t tell of just how complex the disease really is. There are many studies that show depression is much more than simply having too much or too little of certain brain chemicals.

It’s understood that there are several forces that interact to bring on depression; these include faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems, just to name a few.

Dr. Joanna Moncrieff, a British Psychiatrist and author, wrote on her blog:

“Of course, there are brain events and biochemical reactions occurring when someone feels depressed, as there are all the time, but no research has ever established that a particular brain state causes, or even correlates with, depression.

“Alongside biochemical theories numerous findings have been trumpeted as indicating the disease-basis of depression, including variations in cortisol (stress hormone), brain volume abnormalities and neurotrophic factor. In all cases studies yield inconsistent results, and none have been shown to be specific to depression, let alone causal.

“The fact that more than 50 years of intense research efforts have failed to identify depression in the brain may indicate that we simply lack the right technology, or it may suggest we have been barking up the wrong tree!”

The evidence supporting the theory

Illustrated slice through the human serotonin transporter structure illustrating the binding sites for serotonin reuptake inhibitors (SSRIs) showing the chemical structure of the drug Citalopram at the central site in purple and at a second, “allosteric,” site in yellow.
‘Theories such as low serotonin only came about because scientists observed the effects of the drugs on the brain. It was simply a hypothesis that attempted to explain how the drugs could be fixing something. However, whether or not people actually had lower serotonin levels has yet to be proven.’ (Image: NIH Image Gallery via Flickr)

The most common evidence used to support the theory is simply that some drugs have either increased or decreased the mood in human and animal models. While this is true, just because the antidepressants increased and decreased certain chemical levels in the brain still does not prove the chemical imbalance theory of depression.

With today’s technology, we simply cannot determine whether a human has a chemical imbalance or even be able to say what neurotransmitters are involved. It is for this reason that the chemical imbalance theory remains a theory. However, the general public accepts the chemical imbalance theory as fact.

In a feature article, Jonathan Leo & Jeffrey R. Lacasse wrote:

“The cause of mental disorders such as depression remains unknown. However, the idea that neurotransmitter imbalances cause depression is vigorously promoted by pharmaceutical companies and the psychiatric profession at large.”

Theories such as low serotonin only came about because scientists observed the effects of the drugs on the brain. It was simply a hypothesis that attempted to explain how the drugs could be fixing something. However, whether or not people actually had lower serotonin levels has yet to be proven. The feature article added:

“The idea that depression results from a chemical imbalance in the brain was first proposed in the late 1950s and early 1960s by several different scientists.

The focus was initially on the neurotransmitter norepinephrine, but by the mid 1960s the focus had shifted to serotonin, another transmitter, which ultimately led to the development of the Selective Serotonin Reuptake Inhibitors (SSRI) such as Prozac and Paxil.

“In spite of the enormous amount of money and time that has been spent on the quest to confirm the chemical imbalance theory, direct proof has never materialized.”

Antidepressants and the placebo effect

Orange and blue medicine in capsule form sitting on a glossy black surface.
‘But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect.’ (Image: Sam-Cat via Flickr)

Pharmaceutical companies have one focus, brain chemistry, even though we know that it is a multifaceted issue that involves many concerns and many chemicals. Focusing on the one chemical imbalance theory, and handing out drugs that actually alter brain chemistry is irresponsible, and has its own dangers.

The irony is that the only thing we know for sure is people who take antidepressants will now have biochemical imbalances without a doubt. That’s right, by telling them that they have a biochemical imbalance and then prescribing them antidepressants, we are actually giving them the biochemical imbalance.

Irving Kirsch, who is a lecturer in medicine at the Harvard Medical School, wrote in a publication:

“Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. 

“But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. 

“Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. 

“The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.”

Kirsch writes how in a 2002 study, it was found that 80 percent of the effect of antidepressants, in clinical trials, could be attributed to the placebo effect:

“I assumed that antidepressants were effective. As a psychotherapist, I sometimes referred my severely depressed clients for prescriptions of antidepressant drugs. Sometimes the condition of my clients improved when they began taking antidepressants; sometimes it did not.

“When it did, I assumed it was the effect of the drug that was making them better. Given my long standing interest in the placebo effect, I should have known better, but back then I did not.

“Analyzing the data we had found, we were not surprised to find a substantial placebo effect on depression. What surprised us was how small the drug effect was. Seventy-five percent of the improvement in the drug group also occurred when people were give dummy pills with no active ingredient in them.”

Drug company connections

Four twenty-dollar bills of U.S. currency fanned out on a wooden surface with a prescription medication bottle on its side and 4 black and yellow capsules on top of them.
‘Our inquiry into the relationships between DSM panel members and the pharmaceutical industry demonstrates that there are strong financial ties between the industry and those who are responsible for developing and modifying the diagnostic criteria for mental illness.’ (Image: Images Money via Flickr)

Antidepressant drugs are the most commonly prescribed drugs in North America, with pharmaceutical companies raking in billions of dollars every year from the sale of antidepressant drugs alone. It should also be mentioned that billions of dollars are also spent marketing and advertising their products.

As a result of Kirsch and his team’s research, the idea that there is scientific literature confirming the benefits of antidepressants has now lost all credibility. By using the Freedom of Information Act, the team was able to access data that pharmaceutical companies had sent to the Food and Drug Administration (FDA) in order to obtain approval for multiple antidepressants.

By doing this, they were able to obtain data on both published and unpublished trials; the team explained:

“This turned out to be very important. Almost half of the clinical trials sponsored by the drug companies have not been published (Melander, Ahlqvist-Rastad, Meijer, & Beermann, 2003; Turner, Matthews, Linardatos, Tell, & Rosenthal, 2008).

“The results of the unpublished trials were known only to the drug companies and the FDA, and most of them failed to find a significant benefit of drug over placebo.

“The data in the FDA files were the basis upon which the medications were approved. In that sense they have a privileged status. If there is anything wrong with those trials, the medications should not have been approved in the first place.”

The data showed only 43 percent of the trials had a statistically significant benefit of drug over placebo; however, the remaining 57 percent had failed. There have been other studies that have also demonstrated the ineffectiveness of antidepressants, and how often this fact is hidden by pharmaceutical companies. The more alarming fact is studies that have shown anti-depressants can cause real harm are often withheld.

In a study that was published in The British Medical Journal, researchers revealed that pharmaceutical companies were not disclosing all information regarding the results of their drug trials. They discovered that the full extent of serious harm in clinical study reports was going unreported.

These reports are relied on by major health authorities like the FDA when determining outcomes. Tamang Sharma, a Ph.D. student at Cochrane and Lead Author of the study, noted that they:

“Found that a lot of the appendices were often only available upon request to the authorities, and the authorities had never requested them.

“[She was] actually kind of scared about how bad the actual situation would be if [they] had the complete data.”

Lisa Cosgrove, a psychologist, and her team investigated financial ties between the Diagnostic and Statistical Manual of Mental Disorders (DSM) panel members and the pharmaceutical industry. What they found was out of the 170 DSM panel members, 95 had one or more financial associations with companies in the pharmaceutical industry.

One hundred percent of the members of the panels on “Mood Disorders” and “Schizophrenia and other Psychotic Disorders” had financial ties to drug companies. The leading categories of financial interest held by panel members were research funding (42 percent), consultancies (22 percent), and speaker’s bureau (16 percent). The team wrote:

“Our inquiry into the relationships between DSM panel members and the pharmaceutical industry demonstrates that there are strong financial ties between the industry and those who are responsible for developing and modifying the diagnostic criteria for mental illness.

“The connections are especially strong in those diagnostic areas where drugs are the first line of treatment for mental disorders.”

“The DSM appears to be more a political document than a scientific one. Each diagnostic criteria in the DSM is not based on medical science. No blood tests exist for the disorders in the DSM. It relies on judgments from practitioners who rely on the manual.”

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