Last week, the Wall Street Journal has an article titled The Medication Generation by Katherine Sharpe which questioned the fact that a large number of teenagers are currently taking antidepressants. In several respects the article was a bit of a refreshing change from how the topic has often been presented as it raises important questions about what it means for a generation of teenagers to grow up on medications. It also has some refreshing quotes from experts who point that there are no easy answers. Of course, all this is nothing new to the readers of this website. But at least some of the major newspapers are beginning to publish skeptical articles. (The article never brings up the efficay problem with the SSRIs but that is another story).
However, one aspect that stands out in the current paper is the author’s discussion about the chemical imbalance theory of depression. Sharpe is on the fence about the theory and can’t quite decide if it is a good thing or bad thing that people have been told that depression is caused by low serotonin. On one hand she points out a potential problem with biological theories: “there are the consequences of teaching young people to think about their problems in biomedical terms.” But then on the other hand she sees a silver lining because the chemical imbalance theory has supposedly removed any negative stigma: “the acceptance of depression as a biological illness has been hailed for removing shame and stigma from the condition.”
But rather than discuss the theory’s utility shouldn’t the questions focus on the accuracy of the theory? If it is not scientifically accurate, isn’t it misleading to portray it as a scientific fact? Several years ago we monitored the media for mention of the chemical imbalance theory. Whenever an article in the main stream media mentioned the theory as a well-established proven fact an email was sent to the author asking if they could supply a reference in support of their statement. None of the reporters provided any citations that could be considered sound evidence to support the theory. Many of the responses seemed to equate this request with asking for a citation that the world was really round. Some of the organizations supplied citations which were little more than similar statements from another organization.
As just one example, consider the following. In the Philadelphia Inquirer, a reporter wrote that “mental illnesses are simply chemical imbalances.” For her reference she supplied a statement made by the President of the Society of Neuroscience, which was part of a request made to a congressional panel for more funding. He said: “mental illnesses were due to a chemical imbalance.” When it was pointed out to the reporter that this was not a scientific reference, she replied, “I did not conduct an extensive literature search, as I assumed that if an individual such as the president of the Society of Neuroscience, among others, stated that a mental illness represents a chemical imbalance, there must be some evidence to that fact.” In the published paper there are many more examples like this.
What would probably come as a surprise to many of these reporters that we talked to is that some leaders in the field have even stated that the psychiatry profession never accepted the theory in the first place and that the chemical imbalance theory is really nothing more than a straw man argument developed by scientologists.
Any discussion about too many teenagers taking SSRIs needs to examine the role of a now largely discredited theory about depression. The presentation of a false scientific theory cannot be excused by some sort of utilitarian argument that ultimately the public is well served by a falsehood.