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The chemical imbalance theory posits a belief there is a simple chemical or physical malfunction of the brain, causing mental disorders, which can be fixed using psychotropic drugs, electroconvulsive therapy, or psychosurgery. The term 'chemical imbalance', used extensively as a tagline by drug companies in the United States after deregulation of pharmaceutical advertising, is not a medical or scientific term, and in this respect, is not the basis for any scientific theory. The term 'chemical imbalance theory' is most frequently used by critics of the drug industry.
Research in neuroscience, notably neurochemistry, implicates changes in levels of neurotransmitters in certain structures of the brain with a role in some mental disorders, notably clinical depression. However, such a role has not yet been proven for any common mental illness: "No single reproducible abnormality in any neurotransmitter or in any of its enzymes or receptors has been shown to cause any common psychiatric disorder. Indeed it is not longer considered likely that one will be found, given the complexity of psychiatric diagnosis and the profound interaction of environmental factors with genetics in psychiatric disorders."[1]
Chemical imbalance diagnosis
The chemical imbalance theory is not strictly defined, and there are virtually no useful laboratory tests available for diagnosing mental illness via testing for chemical imbalances, though Alzheimer's disease and Parkinson's disease are among the few disorders affecting mental health where symptomatic pathologies, rather than underlying causes, can be reliably identified. Instead, psychiatric diagnoses, predicated upon presumed chemical imbalances, are routinely arrived at by psychiatrists based on algorithmic (DSM-IV) criteria outlined in diagnostic manuals, primarily through reference to the Diagnostic and Statistical Manual of Mental Disorders (DSM). In practice, psychiatric diagnoses rely upon a physician's judgments about a patient's medical history, clinical evaluation of symptoms, and from patient response to psychiatric drugs.
A chemical imbalance is typically described as a deficiency or an overabundance of certain neurotransmitters causing abnormal brain chemistry. Some of the major hormones associated with 'chemical imbalances', said to result in mental illnesses, include serotonin, norepinephrine, and dopamine. Pyschiatric drugs are said to work by restoring normal levels of these neurotransmitters. Certain anxiety disorders as well as bipolar disorder (manic depressive disorder) and schizophrenia also involve disturbances of brain function, possibly related to chemical imbalances.
Based on the chemical imbalance theory, doctors and psychiatrists typically rely on the DSM-IV to determine which drugs will restore a balance closer to an optimum. The evidence said to support the chemical imbalance theory derives from the clinical trials of these drugs. Medical professionals are trained to comply with what these clinical trials have shown to be most effective.
Cautionary measures
An important consideration with regard to chemical intervention is the potential for relapsing into depression or other psychiatric conditions when medication is discontinued abruptly or without medical supervision. Aside from malnutrition, the only certain means of creating chemical imbalances in the brain is the use of psychiatric drugs, and side effects from psychiatric drugs can be significant. Great care must be taken to prevent severe withdrawal symptoms after engaging in psychiatric drug use.
Controversy
Critics of the chemical imbalance theory contend brain chemistry levels are not an adequate gauge of neurochemical processes affecting mental health, noting the enormous number of different chemicals and their unknown interactions. Moreover, critics assert, the psychiatric establishment assumes patients having a ‘mental illness’ must have a ‘chemical imbalance’ in their brain, as subjective diagnostic checklists are used in lieu of actual medical tests.
The chemical imbalance theory, according to critics, is routinely presented as ‘fact’ so often it has become widely accepted as fact, despite having never been proven. The Pfizer drug company has been promoting its drugs for years, in print, on television, and on the radio, with statements asserting mental illness may be due to a chemical imbalance in the brain. According to Jaelline Jaffe and Jeanne Segal, "The misconception the commercials foster is that the brain somehow develops a chemical imbalance and the result is depression, occurring in a single directional process. In fact, the relationship between brain chemistry and experience is a two-directional phenomenon: Life experience affects brain chemistry at least as much as brain chemistry affects life experience. The 'chemical imbalance' hypothesis is not wrong. It's just not entirely correct.'
Psychiatric diagnostic practices in the United States have come under sharp criticism for reliance upon the chemical imbalance theory rather than actual medical testing. For example, in a Florida psychiatric hospital study, one hundred patients diagnosed with a mental illness were subsequently given a complete medical exam, after which it was discovered nearly half of the patients’ psychiatric problems were secondary manifestations of an undiagnosed medical problem.[2]
See also
External links
Critical views
- 23NLPeople.com - 'Ritalin: Role Models in a Bottle, Social Discipline in a Capsule'
- Deep-Trance.com - '"Chemical Imbalance Theory" and Paxil, Zoloft, Prozac, Celexa, Effexor, Xanax etc: Anyone who is prescribed psychiatric medication (Paxil, Zoloft, Prozac, Celexa, Effexor, Xanax etc) is thought to have a chemical imbalance'
- ETFRC.com - 'There are no "Chemical Imbalances"', Eaton T. Fores Research Center Against Psychiatry
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- PsychForums.com - Online discussion of ETFRC's 'There are no "Chemical Imbalances"'
- HappinessOnline.org - 'I'm O.K. You're O.K. We're Not O.K. Some psychiatrists want to start treating "relational disorders." Are they nuts?', Walter Kirn, Time (September 16, 2002)
- Keirsey.com - 'The Great A.D.D. Hoax', David Keirsey
- MindFreedom.org - 'Debate Between Pfizer, Inc. and MindFreedom continues: Three Rounds, So Far: MindFreedom Calls for Congressional Investigation of Psychiatric Drug Company Undue Influence and Corruption in Federal Agencies'
- Oikos.org - 'History of the Fraud of Biological Psychiatry', F. Baughman
- StopShrinks.org - 'Logical Errors in Mental Health', Rob Ryley
- ThomHartmann.com - 'The Gift of ADHD: ADHD and ADD Home Page', Thom Hartmann
- ZMag.org - 'Psychiatric Medications, Illicit Drugs, & Alcohol', Bruce Levine (2002)
Proponent views
- Anxiety-and-Depression-Solutions.com - 'Understanding Chemical Imbalance: What is a Chemical Imbalance?', Jake Van Der Borne (June 14, 2004)
- BMA-Wellness.com - 'Frequently Asked Questions About Psychiatry and Mental Health', Floyd P. Garrett, MD
- HelpGuide.org - 'Medications for Treating Depression and Anxiety: Making Informed Choices', Jaelline Jaffe, PhD, Jeanne Segal, PhD
- MHSource.com 'Ask the Expert: Chemical Imbalance' (February, 2001)
- Zoloft.com - 'Zoloft (Sertraline HCl): #1 For Millions of Reasons'
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