How to Take the News That Depression Has Not Been Shown to Be Caused by a Chemical Imbalance

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From Joanna Moncrieff: “So if depression is not caused by low serotonin, what is it caused by? I have been asked this question by TV and radio presenters on several occasions over the last few days. Many psychiatrists assume that there must be some brain processes that cause depression that we haven’t fully discovered yet. This might be the case, but at the moment, it is merely speculation. A paper from 2019 reviewed research on all the main biological theories of depression, and concluded that ‘there is a lack of evidence for leading biological theories for onset and maintenance of depression.’

So maybe thinking about depression as a brain disease is the wrong way to think about it. Maybe we need a different sort of framework. Maybe our common-sense understanding of depression is more helpful than a medical one. Although our brain is involved in everything we think and do, of course, our moods and emotions are almost always reactions to events in our lives. We feel good when things go well, and sad, anxious, angry or frustrated when things go badly. Our large human brain is what gives us the capacity to reflect on our circumstances and to evaluate whether we like them or not, and it enables us to experience emotions, but the brain is not the cause of these emotions. In contrast, we know that adverse life events such as poverty, debt, divorce, child abuse, loneliness etc strongly predict whether someone will get depressed or not. This is not to suggest that depression cannot sometimes be very severe and the events that may have caused it hard to identify.

The British Psychological Society’s report on depression published in 2020 argues that ‘depression is best thought of as an experience, or a set of experiences, rather than as a disease. The experience we call depression is a form of distress. The depth of distress itself, as well as the contributing events and circumstances, can be life-changing, and even life-threatening. However, calling it an illness is only one way of thinking about it, with advantages and disadvantages.’

International bodies such as the United Nations and WHO (World Health Organisation) have also expressed concern that thinking about depression and anxiety as medical problems is not appropriate or useful and is leading to ‘an over-reliance on psychotropic drugs to the detriment of psychosocial interventions’ (WHO, 2021).”

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3 COMMENTS

  1. I am not convinced by black and white thinking, or right and wrong thinking. Post natal depression has a hormonal aspect and depression has a vegetative effect on sleep and other bodily aspects. Stress affects the body in subtle and profound ways. I feel that consciousness, body, brain, spirit, brain waves, aura, hereditary and many other factors of material and cosmic existence ARE ALL INTERWOVEN. The biomedical model has worked for so long because it includes “comforts” like a warm bed, fresh sheets, a dozen nurses and doctors; three hot meals, concerned inquiry, family visits, and these fripperies are very soothing to those who see no point in carrying on living. These things affect the conciousness, body, brain, aura and so on. A placebo lift for downing beer or a magic pill for two months has saved lives. I have experienced that myself. In monastic eras the body was treated as though the four humours affected the whole kit and caboodle of the person who felt sick. But, I am with anyone who says that THE WAY the body and brain has been treated has been, in modern times, blithly stupid, due to the human love affair with the religion of scientism. But one stupid is not made better by another stupid. To say that the brain, which has umpteen things going wrong with it daily is okay always is daft. The brain does have seizures via its many thousands of reactions and hormones and chemicals. The brain is is pristine and fine much of the time is something I agree with mostly, and so we should leave the brain alone and only treat it with balanced herbal monastic smoothies. However, I am not one hundred percent, black and white or right and wrong about viewing the brain as NEVER having anything go awry with it. It does! Even severe premenstral tension is a nightmare for some women.

    I hope that a form of medicine will develop that returns to the holsitic appreciation of our monastic herbalist humourous forebears. The conciousness needs the body and brain whilst gadding about in Earthly splendor. The term “Lex Talionis” means being proportionate and balanced in seeking justice, but it is also good, going forth, in how we may soften and mend the medical path to align more holistically with other ways of caring for the sick.

    The angels want me to come away from being provocative and I am not sure why. I feel that the individual must be their OWN doctor, lawyer, priest, going forward. None can have trust in anything but your own free choice to believe what you believe is true whilst society is being shaken up. I believe I do have a problem in my physical brain. I feel my hallucinations are like phantom limb pain. My brain is misreading reality. I cannot stop it or help it or control it. It is not distress. It is not trauma. Although these make matters worse for sure. I have real schizophrenia and I am master of my own free choice of knowledge. But..

    I DO believe the world is soaked in psychiatric poisons and children should never be medicated in any way while their brains are growing. I am mostly not for medical drug treatment UNLESS someone is completely desperate to try a pill in a hospital emergency setting and only short term. I am in hospital as I write this and I feel well looked after. I am totally against forcing any pill on anyone. I am totally against flimsy informed consent. My fear is that these will be enforced on people in the future. A regime is coming and it will be forcing everyone to agree to all sorts of things that go against holistic care. For that reason I am going to applaud this article Joanna. The dismantling of the pill for every ill is a good campaign. Drugs should never be forced on people. And never on children. And drugs should be only used with great care.

    I have to stop going on about this though as I have other interests in life. I will simply say whether I personally agree or disagree as I dont want to stand in the way of the bigger picture.

    • Some time later…

      Never say I am dishonest. Let me give you reason to smirk at me. After writing the first comment I went for a wander in the ward. Along comes a male nurse to give me my pills. I study the four pills and ask not to take pill number three….

      “You have to obey the doctor’s decision for you to have the four pills but if you want changes ask him later”.

      Now I happen to be a voluntary patient. I came here willingly. I went back on pills willingly. So what part of the word “obey” is necessary?

      This farcical comedy sketch will not change my mind about how I believe being here is needed by me. There are no wistful Soteria houses near me. And I know not the friend who would cook three meals a day for me without them having to neglect their own troubles. But I am HONESTLY startled by how oafish can be the way some nurses regard all the various different patients as one generic rowdy patient, a factory made “patient A” needing muscled in on in the decision making skill. However, not ALL nurses are the same either and I have met many with fondness and consideration bordering on masochism. Those good nurses are tirlessly helpful and affectionate. I have never been called so many versions of darling in all my life.

      I just want to be clear and HONEST that there are good people and imbalanced people everywhere.

      It matters to the future to be HONEST to oneself at least. Your own knowingness is what is right for you. I am for you having the choices that you want, not the choices that I want.

      If you want no pills or professionals or room and board in your wellness plan then do not have those. If you do want those then have those. NO ONE should be forced. I bid a goodbye for now as I need to be away, to take a long holiday psychologically.

      Love from Diaphanous Weeping.

  2. I don’t want to be overly dismissive about this. But the idea that emotional reactions are caused by various stimuli has been floating around at least since 1950, and we are all familiar with this basic mechanism, as it is so obvious.

    By the mid-1950s at least one researcher had worked out all the basic mechanisms behind these reactions and a theoretical model explaining how that worked and how to treat it. This work was dismissed or ignored by both Psychology and Psychiatry, as they were already hellbent on a biological model, regardless of its unworkability.

    Most people today are still ignorant of that work and of the rather amazing spiritual realizations that it disclosed. The mind-body-spirit model IS workable, but is only studied and discussed by a few theologians and those who have studied that research that started in the 1950s and practice its results today. For us, then, many answers worth looking at are right under our noses. We should at least study them and discuss them. Our continued ignorance of them is extremely frustrating for someone like myself.

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