“Is Depression a Mental or Physical Illness?”


In The Conversation, two Australian scientists discuss historical and current research into tentative links between inflammation, immune response and depression.

“The idea that the activation of the immune response may trigger depression in some people is by no means a new one,” they write. “Early descriptions of post-influenza depression appeared in the 19th century in the writings of English physician Daniel Tuke.”

They also provide a broader context for their exploration of the theme: “The recent enthusiasm to embrace inflammation as the major culprit in psychiatric conditions ignores the reality that ‘depression’ is not a single condition. Some depressive states, such as melancholia, are diseases; some are reactions to the environment; some are existential; and some normal. Such separate states have differing contributions of biological, social and psychological causes. So any attempt to invoke a single all-explanatory ’cause’ should be rejected. Where living organisms are concerned it is almost never that simple.”

Is depression a mental or physical illness? Unravelling the inflammation hypothesis (The Conversation, June 30, 2015)

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  1. Cancer is a heterogenous disorder, yet it has a recurrent theme of a disinhibition of cell division (among other things). Inflammation may in fact be a recurrent theme in all types of depression-or it may one day proven to be not. Note the wonderful work of the …..psychologist Naomi Eisenberger on the initiation of an inflammatory cascade as a result of social rejection.

    This is yet another mostly useless commentary based upon misinformation and crankiness. Inflammation may have nothing to do with depression, but until someone connected to this site posits a science based theory, those involved will and should be seen as having the same hubris commonly seen in the field of psychiatry .

    Having spent over 20 years studying inflammation and mood disorders, I don’t recognize anyone associated with this site as having done credible research to dispute the inflammatory hypothesis. It is easy to blow up a building, it is harder to build one.

    Build a building, and then the scientific community may listen.

    • Hi Thelonius,

      I agree with you here. I think that functional medicine in general is very promising for depression and many other issues. I often point people to this video that I like


      where Mark Hyman discusses this in a way that I find very convincing. He points out that depression may be caused by vitamin B12, Omega 3, vitamin D deficiency, gluten allergy, infection, heavy metal toxicity, hypothyroidism and many other issues, and the right thing to do is to find and fix any such underlying problem rather than saying you have a thing called “depression” and, thus, you get an “antidepressant”. I am really expecting that if someone made Clinical Practice Guidelines that were actually aimed at giving people the best care, this is going to be the first step.

      I personally think that the above issues mainly trigger depression rather than directly cause it and that depression as a mental phenomenon can be understood to be caused by one underlying habitual unconscious thought pattern that is basically the same for at least most people that have depression. That’s why, I believe, things like various therapies and meditation can help, and can sometimes help a huge amount.

      – Saul

      • Hi Saul,

        Thank you for your thoughtful reply. I taught clinical neuroscience in a major teaching institution. After 15 years I left due to the pressure posed to teach algorithms instead of a measured, thoughtful approach.

        The railing against psychiatry is often justified, the lack of an intelligent attack on psychiatry, and psychology is rather sad.

        Dr. Whitakers book is a prime example of substituting one mythology for another. Only science in its purest sense attempts to be apolitical, and forever questioning.

        Mad in America pretty much sums up the problem with this site, and the book it is based upon. Science? Has shown angry people preferential scan the environment for hostile cues.

        • Hi Thelonius,

          I’m surprised by your comments. I have learned many things from this site and I think that R.W.’s books have made a huge contribution in exposing an entire field that is thoroughly, shockingly corrupted. I don’t see how he is promoting any sort of mythology.

          Most important of all, for people who are being victimized even now, it is very hard to come to the truth on your own – that many of those people in the white coats, from the best universities, with recommended treatments backed up by long lists of publications in prestigious journals, with the NIMH grants and great bedside manners are, in fact, totally wrong and are harming you severely, not helping you.

          – Saul

          • Whitaker’s book has exposed many things that needed to be exposed, and in that sense served a good purpose.
            What he did not do, nor do followers of him and this site, is replace their polemics with something positive-thus MAD in america.
            Whitiker cherry picks data, the same way the field of psychiatry often does. I spent 25 years as a neuroscience research, having apprenticed under Eric Kandel.

            Really smart people ask more questions then they ever answer. Whitaker’s book has that in reverse in my opinion, and has little if any credibility as a brain researcher.

            Does he know anything about the brain or mind from a science perspective? No.

            I have written and worked on inflammation, the mechanisms of antidepressant action and the dangers of psychotherapy. I have written 3 papers in 25 years-because that is how hard it is to understand these things.

            I can tell you, I found no evidence the Dr. Whitaker understands anything about mental illness, its diagnosis, how to treat it or whether such a thing even exists-as a scientist. He can write as a philosopher if he chooses, but should label himself as such. What he contributed was very valuable, what he has done to improve things has been very limited at best, and very destructive at worst.

            Thanks kindly for the thoughts.

        • You might, instead of just criticizing, point out exactly where you disagree. I see all your comments on this thread and they are just ad hominem attacks. You might also read “answering the critics” first so you don’t start naming the same critiques that have been thoroughly debunked elsewhere.

          So start, name three things incorrect with Whitaker’s stuff. Not just that you don’t like it, what three thinks do you think are inaccurate?

    • I am confused by your post. I thought the proposed theory of depression being caused by inflammation was questionable and not proven according to this article. If something isn’t proven, I thought it was up to scientists to come up with theories showing something is true vs. MIA having to show that the theory of inflammation is false.

      Additionally Oldhead makes a great point about the common practice of assuming all depression is either a physical or mental illness. I will bet if someone is depressed such as having a horrible boss who all of a sudden gets a new job with a great supervisor, my guess is the alleged inflammation immediately disappears.

    • Have you seriously just compared depression to cancer? You mean an actual disease characterized by malignant tissue overgrowth to persistent low mood? Wow…

      Btw, you’re saying you’ve spend 20yrs studying inflammation and in another post you claim to have worked under Eric Kandel who has never touched inflammation with a long stick.

    • Note that it says “in some people.” The huge mistake that people studying this field make is assuming that “depression” is an entity that can be “treated,” rather than a bodily response to what could be any of a huge number of potential provocations, both physiological and psychosocial. Trying to “treat depression” is about as dumb as trying to “treat soreness.” If you could isolate causes, you would probably find that SOME depression is caused by vitamin deficiencies, SOME is caused by inflammation, SOME is a result of prenatal drug insults, SOME is caused by early childhood abuse and neglect, SOME is the result of sensitive personalities interacting with a very insensitive world, etc., etc. “Depression” does not have a single cause, and all efforts to treat “depression” are therefore doomed to failure absent concerted effort to search for the real problem that caused the person to become depressed.

      —- Steve

      • True that there are so many things that cause one to feel depressed. Still, what is the most influential factor in how we address our issues in life? I’d say that it’s the examples around us which model perspective, behavior and response to others.

        Some people are quite focused and self-responsible in how they go about addressing and resolving issues, including inflammation, depression, etc., while some people are not grounded nor centered, and become rather victimized by their own issues, which is what drains energy in individuals and communities.

        Regardless of whatever issues of health or otherwise we experience in life, it is how we respond to them which determines our own sense of integrity and social harmony. This makes or breaks whether or not the problem being addressed will be resolved or remain chronic.

  2. A typical case of thinking with blinders on, and in such a way to guarantee a predetermined set of responses. No thought given to whether “depression” is assumed to be an illness at all, it’s just a question of what type, physical or “mental” — with the medical model being another assumed.

    Substitute the word “sadness” for “depression” and note how stilted these discussions seem.

    Psychiatry is so similar to alchemy in its techniques and assumptions.

    • Hi Oldhead,

      After reading “Psychiatry Under the Influence” I probably share with you a near 0% trust level for academic psychiatry and the APA. In this case, though, I strongly suspect that the issue is going to get investigated by real scientists, not fake scientists. Inflammation as explained above seems to me to be a reasonable, promising hypothesis that you can make without defining “depression” – Does having inflammation in your brain have a bad effect on your mental state? In the hands of honest biologists and neuroscientists, we will find out if it is true or if it is not true.

      I think really, it’s an interesting and promising area and shouldn’t be thrown out with the fake “chemical imbalance”/psychotropic drug story. The fake story also started with reasonable hypotheses: low serotonin causes depression and too much dopamine causes psychosis. These turned out to be false. The unforgivable sin of psychiatry is propagating the false story anyway, as if it were true, while giving drugs that harmed their patients severely in the long run.

      Have a look at that link in my previous post. Notice that the treatments proposed are just good food and supplements aimed at root underlying problems and not toxic drugs treating the end symptoms (which they think include at least some mental problems).

      – Saul

      • An inflamed brain sounds depressing indeed. But consider:

        Understanding depression and its causes

        Depressive disorders often co-occur with anxiety or substance abuse and are a leading form of disability in the United States. Depression may strike any time without warning. Researchers have identified the five primary causes of mild, moderate and severe clinical depression:
        1. Imbalance of key chemical neurotransmitters in the brain;
        2. Chronic low-grade hopelessness generated by early childhood trauma;
        3. Marriage to the wrong person;
        4. Sudden realization of the essential absurdity of life;
        5. Ecological catastrophe on a scale never before seen in human history.

        Other factors which might trigger a depressive episode include:
        * having either too much or not enough of something;
        * being trapped in an utterly hopeless situation with no way of escape;
        * remorse, guilt, shame, failure, disappointment, frustration, grief, heartache, pain or loss of some kind;
        * infestation of household pests such as termites or rodents;
        * omega-3 deficiency from not eating sufficient quantities of cauliflower and other vegetables;
        * leaky faucet, clogged drain or similar plumbing problem;
        * global economic collapse, thermonuclear war, mass starvation, genocide, etc.

        From “Asymptomatic Depression: Hidden Epidemic and Huge Untapped Market”

  3. Heah ! Theloniousmonk I love the original the genius jazz piano man . I suspect he suffered from mercury poisoning from dental amalgam which can effect negatively any part of the body creating inflammation among other things . Mercury is the second deadliest element on the periodic table just behind liquid plutonium .Dr. Marilyn Hamberger was appointed head of the FDA for a time during President Obama’s first term just when anti- mercury attorney Charlie Brown , as a dental material or as a substance added to vaccinations was asking the courts to ban the use of this mercury at least in and for children . Well Marilyn was there in a position to ensure the status quo remained in tact . She sits on the board of directors for Henry Schein corporation which is the main manufacturer of so called silver amalgams which are really 53% mercury. Heah its not a conspiracy its a business plan within the confines of the Therapeutic State . What does Theloniusmonk the psychiatrist say now ? G-d bless Robert Whitaker a great investigative writer who has helped among other things validate the experience of psych-survivors and has helped expose psychiatry as the gestapo pseudo science it basically is . Thank g-d for old head and the other commenters . (anti-psychiatry and health freedom, all the way).
    You want some science on inflammation go here http://www.whale.to/b/blaylock.html

    • Thelonius Monk was able to play music when he took his medication.When he was off it he only could play one song over and over in one key and was non functional. The same held true for Bud Powell. Monk was grateful for what his psychiatrists did for him. You may want to read a bit before you write.

      • There is no substitute for understanding psychiatry then the lived experience of 44years at the point of it’s spear . You may be talking about Monk at the end of his career . Lived experience and pattern recognition say certainly he was tragically affected by mercury poisoning by 53% mercury amalgam. Toxic metal poisoning undiagnosed by the psychiatric pseudo-science.
        Did you fully read ? http://www.whale.to/b/blaylock.html Russell Blaylock MD retired decorated neurosurgeon has actually seen with his eyes inflammation of the brain many times in autopsy’s he’s done . Why not read about it and learn what he has to say . And I agree none of us know everything but certainly psychiatry is pseudo science and can be the final accurate arbitrator of nothing as it has and continues to cause humungas damage to so many human beings from the cradle to the earlier grave , however often it’s true believers try to take the high ground and resurrect it as something valuable . Uruguay a poor country does quite well without psychiatry . Just give people free access to drugs herbs “meds” if they choose let them share experience about them freely among each other and you don’t need psychiatrists or psychiatry. Straight to hell for those that want to lord it over another human being or deny them necessaries for living, or put stumbling blocks before their fellow human being for profit for themselves or poison other peoples children. Psychiatry is the modern day Spanish Inquisition supported by neo-feudalistic people in power and must be crushed and tossed into the dustbin of history. HEALTH FREEDOM MUST BE ESTABLISHED WITHOUT A DOUBT or the therapeutic state will eat us all.

      • This defamatory claim that Thelonious Monk “off his meds” was able to play only one song in one key warrants a rebuttal. In The Atlantic, Robin D.G. Kelley (his biographer who actually had access to Monk’s medical records), describes Monk as “a man who suffered more from prescription drugs and bad diagnosis than he did from illicit drugs and bipolar disorder. He received very bad medical treatment, bad advice and bad prescriptions for a very long time. The impact that had on his ability to function shocked [Kelley].”

        Kellly also writes, “What’s far more important to Monk’s story than his diagnoses or misdiagnoses . . . is pharmacological history. Thelonious was given large doses of thorazine by one set of doctors, and another who was giving him large doses of amphetamine under the guise of ‘vitamins’. You can see how that might have created the conditions for strange behavior.”

        About Lithium, Kelley writes that it “acts like a blanket on the brain for many people. When Monk eventually was prescribed it, later in life, it contributed to an unwillingness or a lack of desire to play. . . . he suffered from an increasing number of health problems, some of which had to do with the thorazine he was taking.”

        Here’s the link to the Kelley interview:

        • Having had Thorazine forced upon me in the private mental hospital ,Ridgeway Hospital in Illinois for 2 1/2 months straight at a dose of 800 mg. a day at the age of 16 plus artane and cogentin I can vouch by way of lived experience what a crazy making chemical lobotomy abomination Thorazine even by itself really is . It falls in the category of crimes against humanity.
          I suspect also that Mercury poisoning was a factor in what happened in Vincent Van Gogh’s life. You always must ask “What dental work a person has and infection from bad teeth .” Poverty and pseudo science dental care. Also Van Gogh spent time preaching in coal mines . My dental work made me crazy and when it was removed mainly amalgam Mercury all symptoms dramatically subsided. See the work they do at the Paracelsus Klinic in Switzerland. Afordable by the ultra wealthy.
          Check out Dr. Rau http://www.TheRauWay.com

        • Thank you, Susan! I had a sense that this was at least a distortion of what really happened, but it sounds like almost the opposite was true of what TM claimed above. It is always easy to make someone a poster child for a cause after they’re no longer alive to defend themselves. They even did it to John Nash while he was still alive.

          —- Steve

          • You’re welcome, Steve!

            I find myself getting fairly incensed over the ridiculous and defamatory practice of psychological autopsy. Ugh.

            This notion that when Thelonious Monk was off his psych drugs “he only could play one song over and over in one key and was non functional” is simply too ludicrous to be believable. If Robin Kelley’s research is accurate, then I agree with you that it does seem that the opposite situation is true. Psychiatric drugs had a very detrimental effect on Thelonious Monk.

            And I also agree with you that it’s time to get back to the original topic of Rob’s post.

        • 1950s, when his manic-depressive episodes really began to be a problem. But for the purposes of discussion, if he had been treated that way, I actually think his creative output would have been diminished. Lithium acts like a blanket on the brain for many people. When Monk eventually was prescribed it, later in life, it contributed to an unwillingness or a lack of desire to play.

          Really? Lithium acts like a “blanket” and “it contributed to an unwillingness to play”-really?

          1-Thank you for the article-had not read it.
          2. Ask the many people who take lithium, even at the expense of its bad side effects-of which there are many-and still they refuse to change
          3.Did this person have access to Monks medical records? No. Nellie and TMjr have valid opinions, but they are opinions.

          Your comment does little to enlighten, is uninformative other than to introduce me to an article I had not seen. I have read the book.

          Why not READ TOM HARREL’S ACCOUNT OF WHAT LIFE IS LIKE OFF HIS MEDICATIONS? Terrible and he would not be able to play “as long as I take my medications I can stay on the bandstand”.

          I will be fascinated by your opinion to this brilliant trumpet players testimony that his playing would be impossible to do without this anti psychotics. His band mates attest. See the Charlie Rose interview with Tom.

          Your comment is yet another reason why this site is not taken seriously. I found a pearl on the beach-the beach is thus made of pearls..

          • What of the fact that his psychiatrists were providing him with stimulants prior to his development of manic episodes? I am sure an educated person like you is aware that stimulants can cause mania even in “normal” people? And that stimulants increase dopamine while antipsychotics decrease dopamine?

            Diagnosis on a live person who can give immediate feedback is an extremely subjective and dicey operation. I find post-hoc diagnosis on the deceased to be particularly odious and disrespectful. You can believe what you want, but none of us really know what happened, and there are certainly a range of possible explanations for his behavior that prevent a blithe statement that he couldn’t play without his medication.

            I would add that there are plenty of folks who will give positive testimonials about the benefits of these drugs, and there are plenty who will give equally negative testimonials for the same drugs. While both constitute data of a sort, this kind of story does little or nothing to illuminate the real issues facing psychiatry today. Let’s say for the sake of argument that Monk really did feel he couldn’t play without his medication. That is one person’s experience. I am much more interested in the collective experience, which I would have to say is very nuanced and politically charged, but is on the whole much more honestly reflected by the articles and data here than those put forward by the psychiatric community as a whole. Namely, that drugs can suppress symptoms in the short run, but IN THE COLLECTIVE, they do not appear to lead to better outcomes for those exposed to them, and in fact, can lead to significantly worse outcomes (like drug-induced mania and early death) in some of the drug categories.

            It seems foolish to spend a lot of time arguing about an individual case of a person who is unable to clarify the facts for us due to his having moved on to a better world. It certainly does nothing whatsoever to answer the question as to whether depression is a physical or mental illness. Perhaps we should get back on topic.

            — Steve

          • Also I spent 3 months on lithium and couldn’t stand the flat straight line effect denying me the emotional joy I was able to feel at times before I took it . Couldn’t stand the blood monitoring and dealing so much with the psych authority control people who by that time I realized definitely did not know what they were doing. Looking forward at the deadly side effects , I wanted to live long and healthy so I stopped taking that crap. If TM wasn’t so full of himself I could teach him more of value in one day then all the pseudo science delusions that have carried him away for most of his life. I guess financial reward , power and titles can make a delusional framework appear to be real science . The gestapo even made profit for themselves for a while . And the psychiatric gestapo still does today. And if that isn”t depressing I don’t know what is .

          • Your comment is yet another reason why this site is not taken seriously.

            By whom? You seem to take it seriously enough to try to make us take you seriously.

  4. I appreciate the comments by theloniusmonk as well as the other comments. We should all be trying to understand the complexities of emotional life, and be hoping to build up helpful resources and approaches for people, and not just tearing things down. None of us, ( or anybody) knows enough about mental health to make definitive statements about etiology. We do know that taking simplistic approaches, and interpreting research in superficial ways, whether to agree with it or debunk it is dangerous.
    My own opinion on the topic on the topic of this essay is that “depression” is neither a physical or emotional “illness” as it can not be simply categorized as an illness. A significant part of the problem with modern psychiatry has been because of the misinterpretation of the DSM word “disorder” as meaning “disease” or “illness” I have assessed and treated over 5000 people in my career., and few fit well into any DSM diagnosis. There is no such thing as “depression” as a singular entity. The real life reality of what one sees in practice are individuals who have some life-long emotional issues, who have made certain life choices partially because of those issues, and then have some critical life events that leaves them in distress of one kind or another. Most people will show a mix of symptoms with some sadness, anxiety, ruminations or relationship difficulties. It is the role of a psychiatrist or psychotherapist to help people deal with their life problems, their traumas, predisposing emotional issues, and their symptoms. No single diagnosis or modality of intervention can address all the factors that need to be addressed in any individual. Nor should we, as theloniusmonk points out, just throw away certain modalities because they’ve been overused or misused. We always have to keep our minds on the most important aspect: the helping of people in distress. Part of this is being aware of the resources people are able to access, their financial abilities to afford certain treatments, and of course the possible short term and long term gains and problems with any modality offered. Various people who are encouraging these debates have different backgrounds. Robert Whitaker is a journalist. His work has been very valuable, but I wouldn’t expect him to be an expert clinician, nor would I criticize him fro not having clinical expertise. Many clinicians have not had the time or opportunity to explore all areas of writing. I wouldn’t expect them to. We all have something to offer to the debate, and we all have limitations. Lets value our various perspectives, the same way we hope the mental health field could eventually value the perspective of all individuals.

    • Wait, your response is basically, “Bob Whitaker is nice, but he’s a journalist and I know more than him because I’m a clinician.”

      So I challenge you, what three areas are you right about where he is wrong? Just three areas. Go, if your clinical based evidence is so strong.

      • That is not at all what I said. You are taking things out of context. I’m not sure why you are looking for an argument. Everyone has different areas of expertise and different perspectives. What I clearly stated is that we need to have respect for various perspectives. I also directly implied that it would be unfair to expect Bob to be an expert in all areas.

        • Dr. Hoffman,
          May I offer some words from experience?
          It is useless to try to convince angry people by logic. They need to be accepted, not engaged.

          My hope is that my occasional comments on this site lead perhaps one person to actually think rather than to rail with vitriol about things they know little about. If I was misdiagnosed or mistreated by a psychiatrist, perhaps given thorazine and had permanent TD I would be pissed off ,too. Hopefully I would be able to eventual realize that that is not an indictment of a therapy that has not only harmed, but helped many.

          Good luck in your posts.


          • TM,
            Many people on this site are “actually thinking.” Some people here rail with vitriol against things they know little – butsometimes a lot – about. Further, many on “the other side” – i.e. who identify more with the medical model / traditional psychaitric thinking – also know almost nothing about what they are talking about, and rail with vitriol against people they don’t understand. Surely you know this… as others have pointed out, you are not necessarily more right than the other commenters here. Perhaps in some ways your thinking is as distorted and constricted as you projectively imagine theirs to be.

    • Norman Hoffman is a doctor and a clinician.

      Therefore, I would not expect him to know that writing one very long paragraph without breaking up particular groups of sentences into many smaller segments makes for very difficult problems reading blog responses in the discussions.

      In fact, some readers (as noted in other blog discussions) actually avoid completing such responses due to focusing difficulties and the tediousness of sorting out the essential arguments presented in long paragraphs.

      We all want to be heard and understood and appreciated; proper spacing (including double spacing) helps this happen.

      I would like to know what part of theloniousmonk’s criticisms of Robert Whitaker he appreciated and those that he, perhaps, did not appreciate.


      • Hi Richard,

        As you point out, we all have our areas of expertise and we all have things to learn. Thanks for your comments.
        I don’t particularly appreciate any of theloniusmonk’s criticisms of Robert Whitaker. Bob has done a tremendous job of bringing to light and promoting discussions of the horrible state of mental health care. All people who write essays will put foreward a particular view and provide evidence for that view. No one presents in equal balance all the counter arguments. It is not reasonable to expect anyone to do so. Clinicians should be responsible for understanding various sources of evidence and to come up with reasonable approaches to human care. Many clinicians in mental health are failing to do so.
        I do agree with his point that we should not just be trying to tear things down, nor just accepting alternate points of view without adequate evidence.

    • Thank you kindly Dr. Hoffman.
      Interesting that others who disagree with me have disabled my ability to reply to their comments.
      I am still waiting for Ms. Beachy’s comment on her view of Tom Harrell’s documented gratitude for his psychiatrist, and his mediation to allow him to grace us with his genius (see interview w

      I think the lack of reply is a stronger reply upon reflection.


      • Thank-you.

        I think that it is important to have open dialogue and balanced views. I believe that there is a place for good psychiatry. Many of us old school psychiatrists have been practising psychotherapy and using medications appropriately fro many years, with good results. I believe that it is a problem that many people these days aren’t even sure what good psychiatry is or what to expect.

      • A Google search popped up this CBS piece on Tom Harrell.

        According to this account, regarding his affliction, “Harrell overcomes it with music. Yet the moment he stops playing his disorder seizes him. . . . But while Harrell appears in full retreat from the world, the music prevents him from losing his place. And when horn returns to mouth, the voices vanish. It’s the only time you don’t see the signs of his illness”

        Harrell states that the psych drugs help keep him on an even keel, but that even with the drugs, performing is an act of will. And then his wife, Angela, describes “a toxic reaction to a medication that almost killed him.”

        Not exactly what I would call a resounding endorsement of psychiatric treatment.

        This article left me with the impression that it’s mostly Harrell’s wife and his music that keep him together. His story brought to mind a brilliant TED talk by violin virtuoso Vijay (Robert) Gupta about Nathaniel Anthony Ayers (a.k.a. “The Soloist”) entitled :
        “Music Is Medicine, Music Is Sanity”

        Oh, and by the way, nobody has “disabled” your ability to reply to their comments.

  5. Hi Norm, Monk, Else, Old, Steve, B, AA, Corrina, Rob,

    It’s an interesting thread for me. I appreciate everyone’s comments. If we stay honest and open-minded, we’re already vastly ahead of the pretend scientists described in R.W. & C.G.’s new book. I’m trying keeping my eyes on the prize, which, for me, is stopping the ongoing horrible mis-treatments and harms that are happening to so many people.

    I am a scientist myself, and one of the unwritten rules is that there is no such thing as a scientific authority. There is no such thing as “you don’t have enough credentials to question us.” To me, the fact that Robert is consistently attacked for being “just a journalist” is not acceptable behavior as a scientist and it makes me suspect even more that Robert and Lisa are correct. If Robert was wrong, they would not complain that he was just a journalist, they would explain where he made a mistake.

    – Saul

    • Hi Saul.

      Simple-he is wrong in cherry picking data, and not providing a plausible scientifically testable hypothesis. It took me over 20 years to get a modicum of an understanding of how antidepressants work and had to review over 10,000 papers putting together a model that is still far from complete.

      I am fairly sure Dr. Whitaker has never done anything close to that amount of work as a scientist, nor seen a fraction of the patients I have seen over a 27 year career. He just posits his pondering and panders to angry people-some very justified in their bile, some less so.

      I appreciate your thoughtful prose. This is my answer to you query. He is a journalist just as Kramer was in writing his prozac book.

      • Whitaker never claimed to be doing more than examining the extant research and reflecting on its implications. His great value lies in his ability to contrast the “story” commonly reflected in the media and in most doctor’s offices with the actual data that is to hand. He has not claimed to be a scientist or a physician, or a clinician, but his work has started a vital conversation that has been absent for decades in the mental health field. You have your personal experience, and I would not want to take that away from you, but you seem to be wanting to trash Whitaker’s work for some personal reason that has nothing to do with its real value. It frankly diminishes my respect for your comments when you are unable to recognize and acknowledge that Bob Whitaker has put decades of research into this topic and has radically changed his own views based on what he’s learned. You seem to claim that others are not open to hearing what you have to say, but it seems like the pot calling the kettle black to me.

        Bob’s a journalist and never claimed to be anything different. A journalist deals in stories. He’s called the mental health consensus story into question and proposed an alternate reading of the facts. That’s what an investigative journalist is supposed to do, and he’s done it with tremendous success. I think your scorn is very much misplaced.

        —- Steve

        • Good response Steve.

          And Thelonius Monk, if it took you 20 year and 10,000 papers to understand “how antidepressant works”, that’s bad news for all the psychiatrists out there who haven’t come to your level of understanding. And worse news for their patients who will not be receiving “the right pill.”

  6. Contrary to popular belief, there is no such thing as “scientific proof” –


    With that said, I’m remain unconvinced that study of human behavior is “science” to begin with… IMHO, there are far too many variables; we humans, with our complex and “unpredictable” thoughts, feelings… Right when you least expect it, someone commits a random act of kindness. Go figure.


    • Science is actually never able to prove anything. But it is quite adept at DISPROVING certain things. Scientific truth only lasts as long as it is impervious to vigorous efforts to disprove it through logical contradictions. A lot of my issues with psychiatry relate to their unwillingness to try and shoot holes in their own theory, and their apparent need to attack anyone else who does find those holes. Additionally, psychiatric researchers appear particularly susceptible to the urge to find convenient or comfortable explanations. For instance, when people in third world nations have better schizophrenia outcomes, it must be the culture, or different diagnostic criteria, or the study was flawed in design, because it COULDN’T be that our modern approach is just plain not as helpful as what more “primitive” people do. That ain’t science!

      Real science is ultimately very skeptical, and should be even moreso when dealing with the vagueries of human behavior. Putting any theory under intense and unrelenting scrutiny is the core of good science. Only when it survives a brutal onslaught of attempts to disprove or provide alternate explanations can any scientific theory even approach anything remotely resembling a “scientific truth.”

      —- Steve

      • Neurotransmission in the brain can simply not be adequately measured. Therefore the “chemical imbalance” theory cannot be proven. But it cannot be dis-proven either. Period.

        If I had a dime for every time an MIA author, commenter dismissed the “chemical imbalance” as bogus, while insisting there “is no chemical imbalance” I would be a rich man!

        I think that there likely may be some kind of “imbalance” – because of the fact that stress, trauma, poor diet, and many other things seem to cause “imbalance” in other body parts; why not the brain? I don’t claim to know, but it’s hard to trust those who claim to know: “There is no such thing as a chemical imbalance in the brain…” Really? Says who?


          • I apologize for leaving so many back-to-back comments, but need to clarify. I’m not saying that I believe “mental illness” may be caused by *irreversable( chemical imbalances.

            It seems to me that *if* such a thing exists, it could also likely be reversed, because healing takes place, at many levels, in many ways… and it would seem only logical that if stress or trauma can induce dis-ease, the reverse could also take place, on an emotional; spiritual level.

            There is research that seems to indicate that some ulcers may not have stress as their root cause; other research that seems to indicate that some types of ulcers may be caused by stress, or worsened by stress… and around and around we go…

            IMHO, human clinical trials are complex; those that involve studying emotions, (maybe) impossible. What is “stress,” after all? Where does the mind end, and the body begin? The brain and other body parts? There’s complex connection; along with all the variables that involve being human…

            Who knows?


          • Ulcers are usually caused by Helicobacter pylori. The stress hypothesis is another example of “we don’t know what causes it so it must be in your head” or at least caused by what’s in your head. That being said – prolonged stress is known to suppress immune system and can lead to worsening of many diseases.

        • And my point would be that the ONLY thing science could ever prove is that “chemical imbalances” don’t exist. It can’t prove that they do. There is some possibility of proof by induction, namely that if chemical imbalances existed, certain things would be observed, and if they aren’t observed, than they are disproven. For instance, Bob refers to research in the 1980s showing that serotonin metabolites don’t differ between depressed and non-depressed subjects. That alone is enough to disprove the “serotonin theory” of depression, at least temporarily, as the expected outcome doesn’t occur if the condition were true. But as you say, human behavior is quite complex and we know next to nothing about the causes or processes involved.

          I think scientifically, though, that the burden of proof for a “chemical imbalance” lies with those claiming it exists. The evidence doesn’t have to contradict this theory, it just has to not support it. So far, there is essentially no concrete support for the existence of a chemical imbalance, so from a scientific standpoint, it is wrong to suggest that this is the case. We can’t say FOR SURE that no such imbalance exists, but again, science is skeptical. Scientifically, we have to assume there is no such imbalance until evidence suggests this to be the case, while we can still retain the possibility that such imbalances might some day be discovered in some cases.

          Of course, the more fundamental problem with this whole idea is that we’ve lumped “depression” case together without any real knowledge that they belong in the same group. If you study ALL depressed people, you will probably never find anything of use except for the crudest methods of suppression (as we have seen). If some depressed people actually DO have a “chemical imbalance,” you will never find that out by studying all depressed people and treating them as a homogeneous group.

          Good science actually begins with a good definition of the problem, and in this case, the DSM has completely failed to provide one. Even Thomas Insel has recognized that as long as we rely on the DSM diagnostic criteria, we will never discover anything of scientific value.

          —- Steve

      • I agree with these ideas Duane and Steve. Western investigation of “mental disorders” appears to be predicated on the illusion that reality, including human emotions and relationships, can be 100% known and reduced to its component parts. I sense in my reading that some traditional psychiatric writers and scientists are quite disturbed by, or perhaps unaware of, the possibility that there are some things we simply cannot know. In some sense they think about things on a Newtonian reductionist level where everything can be seen and known (as with the most elementary physical particles), whereas human emotions and relationships operate on a level more like Einstein/Heisenberg (relativity/uncertainty) wrote about, where the viewpoint of the observer always changes what is happening.

        I like the quote from Lao Tzu which is something like, “Those who know much, say little, and those who know little say much.” 🙂

  7. Thanks Emmeline
    You know, I think we are all wrapped up in the Depression discussion because in this society we buy into the assumption that we are supposed to be “happy”. Therefore any other emotional experience troubles us. We need to dump the assumptions; the first one being that if you have any emotions other than “happy” there is something wrong with you
    Any comments on this?

    • I agree 100%. And the insidious underbelly of this assumption is the belief that the status quo is completely healthy and functional and any adverse reactions to it must be due to failings in the individual, never the society or institution with which they are interacting.

      A great example is ADHD. The entire “disorder” is predicated on the idea that all kids should be able to do well in a standard classroom. But that has never, ever been the case! And we also have proof that “ADHD” diagnosed kids do much better in classrooms that are designed with more freedom of movement and choice of activity. And yet the “ADHD” label protects schools and society at large from having to examine whether classrooms as designed are effective or need to be re-thought, or whether different kids may need different kind of classrooms or instruction, or whether the whole idea of herding kids into groups of 30 to be taught by one trained professional is just a dumb idea in the first place. No, the institution can have no flaws, so we must diagnose the child who doesn’t like or fit into the mold we’ve created.

      Looking around society today, I’d say a certain level of depression and anxiety is completely to be expected. But those in charge don’t want to face the consequences of that observation, and psychiatry is only too happy to help label any dissidents as “mentally ill,” with the real standard being that we’re all right out of “Invasion of the Body Snatchers,” and anyone who is not “happy” with the current state of affairs is the one who has the problem.

      —- Steve