The Science and Pseudoscience of Mental Health Podcast

The pseudoscience of the ‘chemical imbalance’, and the ‘bad gene’ fuels the psychiatric/pharmaceutical industrial-complex which has wrought such grave harm to so many. Taken together, these toxic fictions comprise the chemical imbalance theory which claims that people with emotional or cognitive challenges are genetically predisposed to have chemical imbalances in their brains which must then be treated with drugs that correct these imbalances, in the same way that diabetic patients need insulin. With no scientific evidence to support it, this belief is nonetheless relentlessly promulgated by the pharmaceutical industry and it has been a wildly successful marketing strategy. So much so, in fact, that the chemical imbalance theory dominates the cultural conversation about mental health.

The Medical Model of Mental Illness; An Inglorious History

The chemical imbalance theory is the preeminent lens through which psychiatry is practiced in the US. It is the latest incarnation of the medical model of mental illness; a model that is rooted in the very inception of the discipline of psychiatry in the late 19^thcentury.¹ The German physician Emil Kraepelin (1856 – 1927) who is widely regarded as the father of modern psychiatry, brought the discipline into alignment with other medical specialities by claiming that psychiatric patients had disordered or diseased brains and speculating that these conditions were often hereditary. Kraepelin also created the antecedents of psychiatry’s symptom-based diagnostic system. Just as a fever or rash are not conditions per se but indicators of a viral or bacterial infection, so too he claimed, experiences such as depression, elation, or hallucination are not relevant in and of themselves but symptoms that reveal underlying disease processes of manic-depressive illness or schizophrenia.² As such, he believed that assigning meaning to patients’ thoughts and feelings was futile, and he anticipated a time when science would usher in more effective medical treatments for these alleged conditions.³

From the 1930s through the mid-1960s, psychoanalytic approaches to patient care, which encouraged non-pharmacological treatment methods, enjoyed a brief ascendancy. While the blind spots of classical Freudian psychoanalysis are well rehearsed, beginning in the 1930s, a creative and productive synergy among the disciplines of psychoanalysis, anthropology and sociology took place.⁴ The resulting cross-cultural and cross-disciplinary research of analysts such as Erik Erikson and Erich Fromm led to a reconceptualization of human suffering as a psychosocial problem, resulting from unmet existential needs for community, self-expression and identity. This catalyzed the development of psychotherapies that were the antithesis of the medicalized approach; ones in which the universal human condition on the one hand, and the uniqueness of each individual’s mode of being in the world on the other, were given primacy.

By the 1970s however, these humane and impactful approaches were largely buried by a resurgence of the medical model bolstered by powerful special interests of the pharmaceutical and technology industries. And whereas in Kraepelin’s day, the medical model was only deemed relevant for hospitalized psychiatric patients, with its resurgence in the 1970s, it was applied even more indiscriminately to outpatient populations as well. The tentacles of the medical model extend their reach with each iteration of the DSM (Diagnostic and Statistical Manual – often referred to as psychiatry’s bible), now in its 5^th edition. Each new version of the DSM includes more diagnoses, while at the same time, the criteria for existing diagnoses are reworked, ensuring that increasing numbers of people will meet them.⁵ Consequently, many traits that were formerly understood to be personal idiosyncrasies or universal human experiences such as transient feelings of unhappiness or restlessness, now qualify as psychiatric illnesses! As a result of this new culture of colonization, it has never been easier to get a prescription for a psychiatric med simply by telling our PCP that we’re having some difficulty focusing or that we’re a little bit blue. It is no coincidence that the majority of DSM panel members responsible for creating and revising the criteria for new and existing diagnoses are consultants to drug companies. The expansion of the DSM legitimizes and facilitates the pharmaceutical industry’s relentless search for new markets. The success of this unholy alliance can be measured by the fact that today, millions of children in the U.S. some of whom are toddlers, are being medicated with psychotropic drug cocktails and the use and abuse of psychiatric drugs is ubiquitous on college campuses.

The Pseudoscience of the Chemical Imbalance Theory

Despite decades of drug industry funded research that tried but repeatedly failed to prove that psychiatric disorders are caused by chemical imbalances in the brain, this narrative continues to inform the practice of a majority of American psychiatrists.⁶

To be fair, many psychiatrists are aware that the ‘chemical imbalance’ is an unsubstantiated trope, but they use it anyways to buttress patient compliance with medication protocols, often the only tools in their toolbox. As is the case with ‘chemical imbalance’ research, the fervent hunt for the ‘bad gene’ that predisposes us to a discrete mental illness (such as depression, bipolar disorder, or schizophrenia) came up empty.

The Human Genome Project, tasked with mapping the entirety of the human genome, was launched in 1990 with great fanfare. It inspired an enormous sense of optimism that its findings would usher in a new era of individualized medicine; one in which the genetic origins of disease would be revealed, and ‘bad genes’ would be spliced away through fantastic feats of genetic engineering. Our species’ genome was fully mapped by 2003, well ahead of schedule, because researchers discovered that humans have a paltry 20,000 genes.⁷ To put this into perspective, a flea has 30,000 genes! ⁸ It became quickly apparent to serious scientists that our genes play a far less central role in shaping us than was previously believed. Our exquisitely complex brains and bodies require the manufacture of 200,000 different proteins, so the long-held belief that each gene has a singular purpose and codes for only one protein was revealed to be false.⁹ The field of genetics has largely moved past the simplistic notion that a given gene is a blueprint for a narrowly defined trait or disease state. And yet, like the myth of the chemical imbalance, the ‘bad gene’ conceit lives on in the public imagination, in spite of the fact that after decades of concerted effort, not a single psychiatric disorder has been successfully tied to a specific gene.

Psychiatry’s desperate bid for legitimacy as a medical discipline has created a shameful series of pseudoscientific rationales to justify the use of inhumane, and often barbaric treatment protocols such as insulin coma therapy, lobotomy, shock therapy, and most recently, the prescribing of antipsychotics and anticonvulsants to millions of children for a range of questionable diagnoses. The chemical imbalance theory preempts the search for the root cause of patients’ suffering and undermines access to impactful therapeutic interventions. It also encourages facile diagnoses and harmful treatment protocols. As Robert Whitaker’s exhaustive review of the literature makes all too clear, not only are psychiatric medications largely ineffectual, they have a multitude of serious, sometimes dire adverse effects. ¹⁰ Furthermore, if patients decide to stop taking their medications, they frequently experience severe withdrawal effects which more often than not, they will have to endure without support from a health care provider. In the U.S., psychiatry has not developed protocols for safely withdrawing from psychotropic drugs. To do so would be to admit publicly that most of these drugs are highly addictive and that many if not most patients were wrongfully prescribed in the first instance.¹¹ In light of this inglorious history, it is hardly surprising that the medical model of mental illness is regarded with suspicion at best and often with disdain by millions of victims of pathogenic drug cocktails, and by many principled practitioners who ‘think outside the box’, and jeopardize their livelihoods by offering humane care that eschews the treatment guidelines mandated by their disciplines.

The Loss of Community and Identity: An Existential Crisis

Humans are not machines whose software needs an occasional chemical adjustment. The roots of human suffering are often located in traumatic personal histories of abandonment and neglect, larger social forces such as poverty, racism and misogyny, and thwarted existential needs. With their wildly disproportionate access to and flagrant manipulation of the media (as illustrated by the recent Facebook debacle), corporations have ushered in a global culture which concentrates wealth and power in a handful of individuals, leaving the rest of us struggling to secure basic amenities such as affordable health care and housing. Significantly, the corporations enjoying the greatest success today are those that alienate us from our own human nature; tech companies that seduce us to replace lived experiences with virtual ones, and pharmaceutical giants whose drugs alter our personalities and blunt our emotions. Increasingly, deep human experiences are replaced by shallow commodified ones; Facebook ‘friends’ replace realtime relationships, and the curated selfie is more valued than authentic self-expression.

Our core existential needs for human connection, meaning, and a sense of purpose in our lives are foundational for psychological health, but it is an uphill battle to realize the fullness of our humanity when the dominant culture is so antithetical to our efforts. Corporate culture is destroying the complex human tapestry of indigenous cultures, born of millennia of accumulated wisdom, and replacing it with a technology-driven monolithic culture that worships machines and devalues human life. It has set in motion an existential crisis of community and identity. As psychologist Daniel Burston points out; “Technophiliahas displaced the spontaneous sense of awe and reverence for nature, and the intricate interdependence of life-forms that constitute the web of life necessary to sustain a sane society – one rooted in the love of life, and therefore capable of averting self-destruction that is rationalized in the interests of ‘science’, ‘development’, ‘progress’ and ‘profit’.”¹²

In the wake of these developments, many of us feel isolated, worthless, and aimless. It is no wonder that the number of people seeking help for their emotional wounds is soaring. More often than not though, when we do reach out for help, our feelings of despair are numbed with drugs, and the status quo remains unchallenged and unchanged. Rarely are the larger social, cultural and existential issues that are undermining our sanity even part of the conversation in mainstream mental health settings.

The Loss of Community and Identity: A Biological Crisis

And yet, as vital as the psychosocial dimension of human life is, we are not exclusively formed by our personal and cultural identities and our existential longings. We are also biological beings; interdependent on a complex ecosystem that has been decimated by man-made toxicants as a consequence of obscene corporate greed and lax or nonexistent governmental regulations. More than 80,000 industrial chemicals have been introduced into our air, soil and water, 1,000 of which are established brain toxins. This number is most certainly an underestimate because the majority of these 80,000 chemicals have never been tested for safety.¹³ It is hubris to imagine that our own bodies and brains have unique immunity to these harms.

Roundup Ready

The Monsanto corporation, whose signature products are the weed killer Roundup and ‘Roundup ready’ GMO crops, is widely acknowledged as having perpetrated the greatest environmental harm in recent decades. Roundup, whose active ingredient is glyphosate, has arguably wrought more destruction to human and planetary health than any other product on the market today. Glyphosate is now off-patent and manufactured cheaply across the globe. Four and a half billion pounds are used worldwide annually.¹⁴ Roundup was dangerous enough when it was first introduced in the 1970s as a weed killer. But then, in the 1990s, Monsanto developed the technology to genetically modify crops to survive the glyphosate assault so that entire fields could be sprayed with ease, and we began to directly consume glyphosate saturated plants. Unlike most man-made toxins which tend to be fat soluble, glyphosate is all the more pernicious because it is water soluble. This enables it to permeate our soil and water table, and it is distributed throughout our bodies, rather than remaining sequestered in our fat stores. Glyphosate also damages the gut lining and the blood-brain barrier, rendering us even more vulnerable to other toxic exposures such as mercury and lead, causing massive inflammation throughout the body and brain. Among its many harms, glyphosate prevents soil microbes and plants from manufacturing essential amino acids (building blocks of proteins), so called, because the human body cannot produce them. Several leading scientists including Stefanie Seneff, senior scientist at MIT, note that it is no coincidence that the logarithmic increase in incidence of the multiple health epidemics we are witnessing today – everything from cancer and diabetes, to autism – maps seamlessly onto the growing use of glyphosate.¹⁵ Meanwhile, Monsanto was recently purchased by Bayer for 66 billion dollars. What a perfect business model! Monsanto reconstitutes itself as an arm of the pharmaceutical industry to treat the health crisis that Roundup, its signature product created.¹⁶

Among Monsanto’s severest critics, is Zach Bush, a triple board-certified MD, who abandoned his prestigious academic career and conventional medical practice a decade ago, after coming to terms with the fact that not only were his pharmaceutically based research and treatment protocols ineffectual; they were making his patients sicker. He has refocused his research and clinical work on the natural medicinal properties of the plants we consume and the soil microbes in which they are grown. Like Seneff, he has trained his attention on the devastating impact of glyphosate. Bush has come to understand that a key feature of any diseased cell is that it has fallen out of communication with other cells. So, for example, in a healthy body, a damaged cell commits apoptosis, or cell suicide because it is harming the welfare of the organism as a whole. But a cell that exists in isolation is only driven by its own directive to survive, which begets, for example, the virulent cancer cell. He goes on to explain that as glyphosate decimates our gut and brain barriers, our immune system is no longer capable of recognizing what is self and what is other, hence the exponential increase in autoimmune disease in which the body attacks its own tissue. In other words, at a basic, biological level, we are losing our sense of community and identity.¹⁷ These biological and existential crises do not simply stand in as metaphors for each other; they amplify and catalyze each other, and they are making us physically and emotionally ill. Cancer rates have exploded over the last two decades; one in two men and one in three women will be diagnosed with cancer in their lifetime. The incidence of autism has more than doubled in 6 short years from in 1in 84 in 2012 to 1 in 36 today.¹⁸ Depression and anxiety are ubiquitous. The alarming decline of our physical and emotional well-being is driven by both hobbled existential longings, and the neurotoxic soup we are all forced to swim in.

The Science of Epigenetics and the Microbiome

After the sobering findings of the human genome project, which dashed the scientific community’s hopes of finding discrete genetic etiologies for severe mental illnesses (in keeping with the medical model), many genetics researchers redirected their focus to the study of epigenetics which provides a far more compelling framework for exploring our biological underpinnings. Epigenetics put simply, is the understanding that genes are highly responsive to the environments in which they find themselves. Environments, whether they be cellular or social, can up or down-regulate gene activity. In addition, a given environment can direct a gene to code for one of a multitude of proteins, and depending on which protein, the outcome may have diametrically opposite effects. In other words, different environments can cause one and the same gene to behave in dramatically different ways; our genes don’t run the show.¹⁹ Another blow to the pride of place of the human genome is the explosion of international research on the microbiome over the past decade. The microbiome refers to the vast microbial ecosystem – consisting of trillions of bacteria, fungi and viruses, and their collective genetic material – that live in us and on us, primarily in our gut. Our microbial genome is 100 times larger than our human genome and it has a profound impact on our health and well-being. Our microbes influence us through a variety of powerful mechanisms; the production of essential compounds such as vitamins, hormones and neurotransmitters, communication with our brain through the vagus nerve, interaction with our immune system, and epigenetic effects on our human genome. Because we have significant control over the composition of our microbial inhabitants through diet and lifestyle choices, the microbiome – which gives us a far more impressive cache of genes than the ones we inherit from our biological parents – can be shaped to our advantage. The combined science of epigenetics and the microbiome underscore the extent to which we are empowered to shape our very biology through the environments we choose.²⁰

The Science and Pseudoscience of Mental Health Series

As increasing numbers of consumers of mental health services are becoming disillusioned with psychiatry, there is a broader movement afoot eschewing conventional medicine as a whole, because it shares the same weaknesses; broken diagnostic systems that focus narrowly on symptoms rather than upstream systemic issues, and treatments that rely heavily on medications whose iatrogenic effects transform us into chronic patients. In consequence, a growing number of people are seeking an alternative approach to healthcare; one that focuses on achieving and maintaining optimal well-being rather than symptom management, and that views the health of mind, body and spirit as interconnected, and interdependent on the integrity of the ecosystems that live within us (microbiome) and around us. The Science and Pseudoscience of Mental Health podcast will explore insights and innovations from this integrative perspective. While calling out the toxic pseudoscience that pervades the mental health field, I will highlight the work of researchers and practitioners who embrace this holistic approach, with expertise in the science of epigenetics, the microbiome, early brain development, and planetary health. Each podcast will be accompanied by an article that amplifies the themes and explicates the science.

Click here to listen to the interviews.