Critical Psychiatry Textbook, Chapter 4: Are Psychiatric Disorders Caused by a Chemical Imbalance?  

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Editor’s Note: Over the next several months, Mad in America is publishing a serialized version of Peter Gøtzsche’s book, Critical Psychiatry Textbook. In this blog, he discusses the way textbooks refer to the imbalance of various neurotransmitters as causing psychiatric disorders, and whether there is any evidence to support this notion. Each Monday, a new section of the book is published, and all chapters are archived here.

When I lecture for psychiatric patients, half or more say they have been told by their doctors that they are ill because they have a chemical imbalance in their brain.

My colleagues who work with the patients therapeutically have the same experience. But when confronted with this, leading psychiatrists are quick to deny that any psychiatrist ever said this to anyone, or they say they abandoned the idea decades ago. This is not correct.

Illustration of a brain in a test tube against a black backgroundEven today, hospital-based psychiatry in one of the five regions in Denmark mentions it on its home-page:81

“Schizophrenia is a disorder in the brain … People with schizophrenia have disorders in certain areas of the brain where the neurotransmitter dopamine is active. Other disturbances in the brain are also seen.”

“Antidepressant medication acts on some of the chemical processes that are out of balance in the brain in depression. The medication normalises, among other things, the level of the stress hormone cortisol and the brain’s neurotransmitters serotonin and norepinephrine.”

“Affective disorders are mental illnesses related to a chemical imbalance in the brain. It leads to mental health problems like depression, mania or a combination of both.”

“Scans have shown that people with ADHD have changes in several places in the brain … in the area that is responsible for planning, impulse control and attention. The cells of the brain use different neurotransmitters to communicate with each other. If you have ADHD, you will see disturbances in these substances … the levels of the neurotransmitters dopamine and norepinephrine are low. Medical treatment of ADHD increases the amount of the two neurotransmitters in the brain. It improves brain function.”

“The medicine acts on some of the chemical processes in the brain related to anxiety disorder … antidepressant medication normalises the amount of the brain’s neurotransmitter serotonin.”

The text about ADHD was particularly misleading. It indicated that we know exactly where in the brain the problems are and that they can be fixed like a key fits into a lock.

The drug industry also propagates the false narrative. A 2007 survey of US university students found that 92% had seen or heard that depression is caused by a chemical imbalance in the brain, and 89% of these had seen it on TV.82 TV channels in USA are full of ads for prescription drugs, and this indoctrination is very effective.

Schizophrenia and related disorders

The information in the textbooks was often very detailed: The abnormalities in psychosis include changes in neurotransmission and hormonal signals;18:27 they include neuron migration and synapse formation, which in turn lead to structural and functional changes in the brain, including enlarged ventral ventricles, as an expression of atrophy;18:94 PET scans found dysfunction in the prefrontal cortex and in the hippocampus;18:94 PET and SPECT scans have shown increased dopamine synthesis and liberation in many psychotic patients, primarily located to the associative striatum (the head of the caudate nucleus);16:562 and symptom complexes are well correlated to dysfunction of certain cerebral areas on PET scans.18:90

We are also told that there is pathology of the synapses,19:228 and that the findings are robust that there is increased synthesis and liberation of dopamine in the associative striatum.16:215

However, one book noted that not all patients have changes in the dopamine system.16:221 This speaks against the hypothesis that people become psychotic because they have too much dopamine in their brains, and the truth is that it has never been documented that any of the large psychiatric diseases is caused by a biochemical defect in the brain. Furthermore, there is no biological test that can tell us whether someone has a particular mental disorder.

The dopamine hypothesis has been accepted as the basis for using psychosis drugs,18:17 but it is the other way around. Psychosis drugs decrease dopamine and therefore the psychiatrists have claimed, heavily pushed by the drug industry, that the disease is caused by too much dopamine. They have published a huge array of poor studies that purportedly showed this. But the fact is that the studies that have claimed that a common mental disorder like psychosis or depression starts with a chemical imbalance in the brain are all unreliable.7:247

In 2003, the huge deception became too much for six psychiatric survivors. They were so angry about the stories they had been told by their psychiatrists that they sent a letter to the American Psychiatric Association and other organisations stating that they would begin a hunger strike unless scientifically valid evidence was provided that the stories the public had been told about mental disorders were true.5:331

They asked for evidence that major mental illnesses are biologically-based brain diseases and that any psychiatric drug can correct a chemical imbalance. They also required the organisations to publicly admit if they were unable to provide such evidence.

The medical director of the American Psychiatric Association (APA) tried to get off the hook by saying that, “The answers to your questions are widely available in the scientific literature.” In his book, The Art of Always Being Right, philosopher Arthur Schopenhauer calls this deplorable trick “Postulate what has to be proven.”83

The hunger strike ended when people started getting health problems, but the APA bluffed. It stated in a press release that it would not “be distracted by those who would deny that serious mental disorders are real medical conditions that can be diagnosed accurately and treated effectively.”

Schopenhauer says about this trick: “If you are being worsted, you can make a diversion—that is, you can suddenly begin to talk of something else, as though it had a bearing on the matter in dispute and afforded an argument against your opponent … it is a piece of impudence if it has nothing to do with the case, and is only brought in by way of attacking your opponent.”

This is one of many examples that psychiatry is more of a religion than a science. Religious leaders couldn’t have invented a better bluff, if people had required proof that God exists: “We priests and cardinals will not be distracted by those who would deny that God exists and knows about people’s problems and can treat them effectively.”

It is important to realise that a difference in dopamine levels between patients with a schizophrenia diagnosis and healthy people—even if it existed—cannot tell us anything about what started the psychosis.

If a house burns down and we find ashes, it doesn’t mean that it was the ashes that set the house on fire. Similarly, if a lion attacks us, we get terribly frightened and produce stress hormones, but this doesn’t prove that it was the stress hormones that made us scared. It was the lion.

People with psychoses have often suffered traumatic experiences in the past, so we should see these traumas as contributing causal factors and not reduce suffering to some biochemical imbalance that, if it exists at all, is more likely to be the result of the psychosis than its cause.

One textbook16:238 listed a study showing that nine people at ultra-high risk of psychosis who later developed psychosis had greater dopamine synthesis capacity in the striatum, with a huge effect size of 1.18, than did 29 healthy volunteers.84 There was a positive correlation between dopamine synthesis capacity and symptom severity, but such studies cannot tell us what starts a psychosis. These people were already ill (they had already seen the lion) when they were recruited for the study even though they did not yet formally fulfill the criteria for what constitutes a psychosis.

Affective disorders

According to the textbooks, depressive conditions are associated with an influence on the hypothalamic-pituitary-adrenal cortex axis (HPA axis);19:210 likely disturbances in the central nervous system and neurotransmitters;17:357 and elevated cortisol.17:357,18:122

However, I also found alternative views. Three psychologists called it a hypothesis that depression should be due to a chemical imbalance—insufficient monoaminergic transmission—and that improvement was due to re-establishment of normal synaptic levels of serotonin and norepinephrine.20:430 They noted, with references, that this does not agree with the observation that the effect comes after weeks of treatment, and that there are other reasons to consider the hypothesis insufficient.

The hypothesis that depressed patients lack serotonin has been convincingly rejected.2,85,86 Some drugs that decrease serotonin (e.g. tianeptine) or do not increase serotonin (e.g. mirtazapine) also seem to work for depression,2,5,87 and mice genetically depleted of brain serotonin are not depressed but behave like other mice.88 Further, it would be difficult to explain why these drugs seem to work in social phobia, which is not considered a lack-of-serotonin disease.86

When I said in my lectures for psychiatrists and other doctors that many patients had been told they had a chemical imbalance, I was met with angry responses demanding that I documented my so-called allegations. My colleagues obviously didn’t like to admit that they misinformed their patients. I referred to what patients, health professionals, and others had told me, and to websites where patients share their experiences, but this was taken to mean that I didn’t know what I was talking about, as if it didn’t have any value to listen to patients’ testimonies.

When I argued that the documentation on the internet is very convincing because patients rather consistently have had the same experiences, I was told that these were just anecdotes which, moreover, had not been published in a peer reviewed journal. As if that would make any difference.

This organised denial is disturbing. In a Danish study of 493 depressed or bipolar patients from 2005, 80% agreed with the sentence: “Antidepressants correct the changes that occurred in my brain due to stress or problems.”89

The myth about a chemical imbalance in the brain being the cause of depression and other psychiatric disorders won’t go away. In 2018, my deputy director at the Institute for Scientific Freedom, Maryanne Demasi, and I collected information about depression from 39 popular websites in 10 countries (Australia, Canada, Denmark, Ireland, New Zealand, Norway, South Africa, Sweden, UK, and USA). We found that 29 websites (74%) attributed depression to a chemical imbalance or claimed that depression pills could fix or correct such an imbalance.90

The psychiatrists use this myth to convince their patients that they should continue taking drugs they would rather avoid because of their harmful effects. In 2013, the chairman of the Danish Psychiatric Association, Thomas Middelboe, described the term chemical imbalance as a metaphor psychiatry had grasped to explain diseases whose causes are unknown.91

As illustrated above, cognitive dissonance also plays a role. In 2014, I debated with Poul Videbech—an editor of the textbook without references18—at a public meeting arranged by medical students. After I had documented that far too many people are in treatment with depression pills and had suggested that we tapered off the drugs, Videbech said, in front of 600 people including patients and their relatives: “Who would take insulin from a diabetic?”7:249

A year later, when I published my first book about psychiatry7 and was interviewed in a newspaper,92 Videbech said on the same page that he had known for 20 years that the theory of the chemical imbalance was too simple, and that it was outrageous that I had said that he and his colleagues still believed in it.

Well, the myth about the chemical imbalance is only a thing of the past when challenged. Psychiatry professor Birte Glenthøj was also interviewed and confirmed that the myth was alive and well: “We know from research that patients suffering from schizophrenia have, on average, increased formation and release of dopamine, and that this is linked to the development of the psychotic symptoms. Increased dopamine activity is also seen before patients are first given antipsychotic medication, so it has nothing to do with the medication.”

In 2017, Videbech postulated again that when people are depressed, there is an imbalance in the brain.93 Furthermore, he and another psychiatry professor, Lars Kessing, had written in their two contributions to the Handbook for Patients, which has official status in Denmark and is available on the Internet, that depression is caused by a chemical imbalance.94,95

I complained to the editor but got nowhere. Kessing and Videbech changed a few minor things and introduced new claims that made their articles even worse. I complained again, and again to no avail, and the misinformation about the chemical imbalance continued. In his update, Kessing added, “It is known that antidepressant drugs stimulate the brain to make new nerve cells in certain areas.” Videbech wrote the same, but there were no references. If this is correct, it means that depression pills are harmful to brain cells, as the brain forms new cells in response to a brain injury. This is well documented, for example for electroshock therapy and psychosis pills.11

Some leading psychiatrists, including Kessing,89 consider their patients ignorant, but I must say that the level of ignorance among themselves about their own specialty is astounding. When a hypothesis has been rejected, again and again, no matter how much people have manipulated the research design and the data, it is time to bury it for good.

This won’t happen. The chemical imbalance myth is not a question about science but about money, prestige, and guild interests. Can you imagine a cardiologist saying, “You have a chemical imbalance in your heart, so you need to take this drug for the rest of your life,” when she doesn’t have a clue what she is talking about?

The textbooks did not use the term chemical imbalance directly, but many statements were made about drugs correcting what was claimed to be over- or underproduction of chemical messengers in the brain.

The myth about the chemical imbalance might be the most harmful of the many myths in psychiatry. It tends to keep the patients locked in the role of passive receivers of harmful drugs for years or maybe for life. It is obviously more difficult for patients to opt out of drug therapy if they believe they get a drug that corrects something that is wrong with them. The patients often say that they are afraid of falling ill again if they stop taking their drug because of this myth.

In 2014, the APA wrote on its website, “Antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain. These medications are not sedatives, ‘uppers’ or tranquilizers. Neither are they habit-forming. Generally antidepressant medications have no stimulating effect on those not experiencing depression.”7:276

This is an amazing act of lying to the public. All of this is wrong, and healthy people can develop both numb­ness and mania and can become suicidal on depression pills.2:179 Until January 2021, the website of the APA still claimed that psychiatric medications can help correct imbalances in brain chemistry.96

A 2022 article demonstrated the extent to which the psychiatrists still propagate the myth about chemical imbalances.97 All six influential US and UK textbooks published from 1990 to 2010 that the authors examined supported the theory, at least in some sections, and devoted substantial coverage to it, and most of 30 highly cited reviews of the aetiology of depression supported it, as did most of 30 research papers on the serotonin system.

ADHD

The textbooks noted that the psychopathological development in ADHD is assumed to involve epigenetic changes and early acquired biochemical and hormonal dysregulation;19:52 that a dys-regulation of dopamine and noradrenaline in the brain is likely very important for the change in brain function;19:113 and that disturbances of certain areas of the cortex and basal ganglia are in areas mainly controlled by dopamine.18:229 None of this can be substantiated.

Anxiety disorders

A textbook mentioned that serotonin is important for the pathogenesis of OCD.19:162 There were no references, but this has never been shown to be correct.

Inflammation, one of the latest fads in psychiatry

Inflammation is one of the latest fads in psychiatry.7:289 A textbook noted the role of inflammation for the development of depression but did not explain what the significance of this was.17:911

Two of the editors of one of the textbooks16 co-authored a 2014 systematic review of 14 trials of celecoxib, a so-called non-steroidal anti-inflammatory drug (NSAID), that showed an effect on depression, with an effect size of 0.34.98

However, many of the patients had arthritis.98 It is not surprising that painkillers might seem to reduce the depression. Even if we ignore this, and tentatively assume that NSAIDs have an effect on depression, the effect size of 0.34 is so small that it is not clinically relevant (see Chapter 8).

There is another, little known reason why the meta-analysis cannot document that inflammation plays a role in depression. It is that, despite their name, non-steroidal, anti-inflammatory drugs do not have anti-inflammatory effects.

When the newly synthesised cortisone was first given to 14 patients with rheumatoid arthritis in 1948 at the Mayo Clinic in Rochester, Minnesota, the effect was miraculous.99 The results were so striking that some people believed a cure for rheumatoid arthritis had been discovered, but the serious harms of corticosteroids quickly dampened the enthusiasm.

By calling the new painkillers non-steroidal, anti-inflammatory drugs, the companies created the illusion that their effect was similar to that of steroids but without their serious harms. This marketing trick was highly effective and NSAIDs are used so much that they are one of the most important reasons why our prescription drugs are the third leading cause of death, after heart disease and cancer.46:8

I have asked many rheumatologists about the documentation that the drugs are anti-inflammatory but I received no useful answers. I therefore studied the issue myself.

With orthopaedic surgeons, I did a placebo-controlled trial in 173 patients with acute ankle distortions where we measured the oedema by volumetry, using the healthy foot as control for the displaced amount of water.100 Using a factorial design, we randomised the patients twice: To a group that was instructed to immobilise the foot and was given crutches and to a group that was instructed to walk as normally as possible despite the pain; and to naproxen and placebo.

Mobilisation quickly reduced the oedema. After 2-4 days, the volume difference was 42 mL when the patients were mobilised compared to using crutches (P = 0.01). In contrast, there was no significant effect of naproxen (P = 0.42; difference 11 mL compared with placebo). Thus, mobilisation was anti-inflammatory, which naproxen wasn’t, and it also led to much faster recovery.

The minor non-significant effect of naproxen could be real and simply a consequence of the drug’s effect on pain, which would increase mobilisation. The company selling naproxen, Astra-Syntex, had provided the blinded trial medication but did not like our results, which were bad for marketing. Its statistician ensured that the most important results did not get published and that the trial report was unintelligible gobbledygook for the average doctor. But I spared a copy of the statistical report, which is why I am able to tell the true story.

I also did a meta-analysis of the placebo-controlled trials of NSAIDs. The drugs did not reduce the swelling of finger joints measured by jeweller rings in patients with rheumatoid arthritis.101

We should not treat depression with NSAIDs, some of the deadliest drugs we have.6:155

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26 COMMENTS

  1. I do admire Dr. Gotzsche’s work and his chutz·pah. I won’t pretend to have the ability to critique The Critical Psychiatry Textbook. As usual, I do have questions and also the conviction that my family’s lived experience has afforded valuable and meaningful observations, so I value that here at M.I.A. I can actually log a question and hopefully Dr. Gotzsche will see it.
    A really big question that I have is, “Don’t we have a dilemma as to how to determine what would be a sufficient proof of any claims about how the brain does or does not work? It seems that Randomized Control Trials are only of limited value and that holding patients hostage to RCTs or to the luck of a peer reviewed article is abusive and wrong. I recall that my deceased daughter’s attending physician said that if we wanted to bring in a document to discuss with her, she would only discuss peer reviewed papers with us in treatment team meetings. But on the other hand, it would seem that we need to be fair about not dismissing the real possibilities that important causal relationships exist within individual patients , and that we will never be able to control for the complexity of the brain in order to establish their existence. It would seem that we can sin against the patients’ best interests no matter what camp we are in. ..I have more questions, but now I must pull myself away for a family matter.

    I also want to discuss the issue of inflammation. I refer to inflammation, but perhaps the more accurate term is the activity of the cytokines of the immune system, which result in the symptoms of inflammation. I have observed on multiple occasions that the presence of infections which I have referred to as inflammatory conditions have triggered psychotic manias or hypomanias in both of two daughters. I have made multiple observations of these kinds of events and have wondered that perhaps over time there are multiple opportunities to disrupt or resolve the manic or psychotic process. With all the complexity of interconnections, perhaps that also allows for multiple points of intervention to resolve the manic process, in the sense that there are perhaps many micro-pillars for stability. The emotions are important, and the manic process itself appears to be a volatile energy. My observations of these different infections , inflammatory conditions, and their resolution , are consistent with what the literature says about the importance of “inflammation” and infections perturbing the HPA axis , and also that antibiotics can perturb the HPA axis. I’ve seen it “all” . I also think that when patients do improve in hospital it is probably due more to the exended period of better nutrition, the resolution of infections, the eventual benefit of restored sleep, and possibly therapeutic connections, etc. I think the more resilient patients may get better despite the psychosis drugs, so I think there is sometimes fraud to claim that the psyhosis drugs helped the patient. The more sensitive and less resilient patients are the ones who are then labeled Treatment Resistant and they are then delivered to ECT. So, the neediest are treated the worst. Putting the patients through failed, toxic, drug trials, protects the hospital from liability for damage from ECT, don’t you think? It’s impossible to prove what specifically caused the ruin of the patient. What a hell hole for anyone’s child.

    I think I am not a material-secularist-reductionist re: the activity of mind, emotions, and spirituality; but I do believe that the physical matter of our neuroendocrine system is subject to genetically encoded differences that make some of us more fit for survival than others, some more resilient to inflammatory injury, altered neuronal signalling, cell death and apoptosis. The literature about this seems reasonable to me and is exactly what I would expect to read based on what I’ve seen, despite that so much of what afflicted my daughter was kept shrouded in mystery by the doctors who withheld information from us and seemed to be waiting patiently for our naive efforts to advocate for our daughter to fail and for their neutralization of our agency as guardians to be completed.

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    • Daisy Valley writes: “I recall that my deceased daughter’s attending physician said that if we wanted to bring in a document to discuss with her, she would only discuss peer reviewed papers with us in treatment team meetings.

      Urgh. This reminds me so much of psychiatric institutions. I understand why that mentality exists. But I also know why that makes me want to stay away from the world of psychiatry, doctors and some of its slave mentality patients included.

      Not everything in life will have a study associated with it. If the only thing in life that convinces you of anything is a study, then life would be impossible. You should ask for a study every time someone says to you on the street “the florist’s shop can be found there, in that corner”. How do you know that? Will you open Google Maps and check it out? How do you know Google Maps is correct in that instance? Will you ask 10 random people that same question before going to the florist’s shop? Will you submit it to an agency that fact checks the addresses people on the street give? How do you know the agency in that case is giving you the right information? You could do that endlessly till you never go to the florist at all, or till the florist and/or you are dead.

      No. Most people in life rely on the common courtesy of people that they will usually tell you the right address. They could tell you the wrong address (and in that case, further investigation may be necessary), but they usually don’t.

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      • Registeredforthissite: Thank you for reading my post. Was your response intended to criticize our use of a study to bring an important matter to the attention of the attending psychiatrist? Or were you being rhetorical and satirizing that advocates shouldn’t have to jump through hoops to have concerns validated?
        Outside of psychiatry, patients frequently present articles to their personal care physicians during treatment discussions. That happens in the best of situations when the doctor actually is interested and free to do what is in your best interests. However, in psychiatry, as you already know , it is too commonly a losing battle to be heard and helped by a psychiatrist.

        As parents we have witnessed the slow torture of our daughter over years, and that is also torture for us. When the psychiatrist wasted our child’s shrinking opportunity to taper meds to spare her from ruin, we did what we could to be heard.

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        • @Daisy Valley:

          I did not know about your daughter (my apologies) and I didn’t mean what I wrote as some insult to you personally. It’s this “we will discuss only peer reviewed papers” mentality in the context of psychiatry that is irritating to me. I would usually not question this request in purely medical branches that deal strictly with the problems of the body. But psychiatry is a different matter. You can’t have a peer-reviewed study for everything when it comes to people’s behaviour.

          When someone writes an article with a statement like “I was laughed at and mocked by my classmates when they found out I have a BPD diagnosis”, the reader would obviously and justifiably be hesitant to let a mental health worker label them that way (especially when he/she sees numerous such accounts from completely unrelated people). But I have seen psychiatrists and patients alike dismiss and scoff at this stuff as “random criticism on the internet”. You can’t have a peer-reviewed study for everything when it comes to people’s behaviour and their experiences with other people.

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          • That’s right. Exactl. There will never be peer-reviewed articles and there shouldn’t be the expectation that they are necessary to defend our nature as individuals.
            I’m still stymied why I’m getting messages that sound as though the reader doesn’t think that I “get it”. So, I have to give whomever the benefit of the doubt that I did not explain the situation adequately. The situation had to do with us trying to solicit some compassion from a psychiatrist to honor Best Practices of medication management, including the expertise of Dr. Guy Chouinard, and to show some concern about avoiding the development of Super-Sensitivity Psychosis and other important matters that sorely afflicted our precious daughter. I only share here to add our experience to the rest who refuse to remain silent.

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    • Among the events of inflammatory conditions preceding psychiatric set-back that have occurred in one daughter was the development of the now validated hypo-motility of the gastro-intestinal tract with serious entero-fissure that occurs with the use of clozapine. This required an antibiotic, as I recall. A medical advisory now dictates that all clozapine patients be closely monitored for this complication and be given preventive supplements to keep the G.I. system moving. During this extended period of forced clozapine use, said daughter also developed debilitating rheumatoid inflammation featuring swelling and painful joints of her hands, wrists, ankles, feet. Within this context of toxic debilitation and inflammation, said daughter developed a mania that resulted in a psychiatric hospitalization out of town. During my advocacy for her, I discovered in plain sight in my daughter’s apartment an overdue lab requisition for a screen for rheumatoid factors. That was exactly what I needed to advocate for her inflammatory conditions to be addressed so that she could begin to resolve her mania in hospital. I delivered the lab requisition with a message to the ward. A week later, I met with the attending physician and presented a list of studies that validated the role of inflammation in the development of psychiatric systems. I endured a haughty, mocking, and dismissive attitude from the attending physician, who had still not seen the lab req and message that I had delivered to the nurses’ desk a week earlier. I stood my ground. I suspect that it was his fun to torment me and that he already knew what I was talking about. Perhaps he attacked my certainty because of his loyalty to the profession to neutralize threats of liability. Fortunately, there was another doctor present to witness our exchange; he remained silent. Mysteriously, our daughter began to improve after that. Was it simply a matter of time after the removal of the toxic and inflammatory clozapine or some additional anti-inflammatory supplement that potentiated the resolution of her mania?

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    • Among the events involving inflammatory conditions that have preceded a loved-one’s psychiatric set-back was the development of hypo-motility of the gastro-intestinal tract with serious entero-fissure that has become common with the use of clozapine. This required an antibiotic, as I recall. A medical advisory now dictates that all clozapine patients be closely monitored for this complication and be given preventive supplements to keep the G.I. system moving. During this extended period of forced clozapine use, the patient developed debilitating rheumatoid inflammation featuring swelling and painful joints of her hands, wrists, ankles, feet. Within this context of toxic debilitation and inflammation, said patient developed a mania that led to a psychiatric hospitalization out of town. During my advocacy for her, I discovered in plain sight in her apartment an overdue lab requisition for a screen for rheumatoid factors. That was exactly what I needed to advocate for her inflammatory conditions to be addressed so that she could begin to resolve her mania in hospital. I delivered the lab requisition with a message to the ward. A week later, I met with the attending physician and presented a list of studies that validated the role of inflammation in the development of psychiatric systems. I endured a haughty, mocking, and dismissive attitude from the attending physician, who had still not seen the rheumatology lab requisition and my message that I had delivered the week before. I stood my ground. He seemed eager to badger my concerns. Perhaps he attacked my certainty because of his loyalty to the profession to neutralize threats of liability. Fortunately, there was another doctor present to witness our exchange; he remained silent. Mysteriously, our daughter began to improve after that. Was it simply a matter of time after the removal of the toxic and inflammatory clozapine for the mania to resolve? Or, did the effect of an anti-inflammatory supplement potentiate the resolution of her mania?

      As for therapeutic elements, the patient had become distraught when a male patient stalked her and actually entered her room while she was in the shower. This was very frightening for her, especially because she had been given thorazine that made her joints so stiff that she couldn’t raise her arms to change clothes , much less to defend herself. The stalker was removed.

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    • My saliva is formed of chemicals, my plasma is formed of chemicals, my breath is formed of chemicals, my hair is formed of chemicals, my fingernails are formed of chemicals. Bioluminescent algae is formed from chemicals. Pinwheel galaxies are formed from chemicals. Combustion after the Big Bang is formed from chemicals. A lovers kiss is formed from chemicals. A zygote is formed from chemicals. On and on it goes. A rose. A lemon.

      I am not going to imagine my brain is devoid of similar chemicals. I feel that the key word is rather the word “imbalance”. There is a problem with “how” humans regard “imbalance” as being akin to imperfection or just plain bad. But to me the word “balance” is holy.
      And to me the word “imbalance” is also holy.
      This is because to achieve “balance” there has to be a constant flexible fluctuation, a quivering like a trapese artist on a high wire. That quivering involves balance one moment then imbalance the next moment then balance then imbalance on and on….forever. The myth of the perpetually fixed person is like a myth of a perfectly balanced brain. The brain, like everything else in nature, is continuously going through this quivering between balance and imbalance and back again. Imbalance is not a dirty word. You do not know if you feel balanced unless there is a perception of potential imbalance surrounding it. Balance and imbalance are “near” to each other and speak to each other. They both inform optimal wellbeing. In my brain there will be balance and imbalance constantly correcting each other like dancers in a waltz.

      What has been a problem for humans is the wish to “get rid of” imbalance and “only” have balance. But without imbalance how can balance know it is balanced?

      The wish to “eradicate” imbalance by giving lots of pharmaceuticals to the brain causes worse imbalance in many. Rather than going with the flow of holy imbalance and the way it naturally tries to adjust into holy balance, busy scientists have wanted to hurry that arrival at holy balance to help people find mental peace. But holy imbalance is the best and safest way to find mental peace. A breakdown is the soonest way to recover from a breakdown. But this requires “acceptance” of brokenness or yeilding to tiltedness “off balance”. Accepting imbalance heals a person back to balance. Accepting howling heals a person back to smiling. There is no need for lots of drugs to find mental peace if we live in a world that understands holy imbalance. The breakdown is renewal in progress. But the myth of the perfectly fixed person gives no time for a lavish breakdown. Breakdowns occur all over nature. On a forest floor matter is continuously breaking down into finer fertile silt. Decay and rebirth aid each other. Perhaps there is nothing wrong with the word chemical, it is life and it is beautiful. Perhaps there is nothing wrong with the word imbalance, it is life and it is beautiful. There is everything wrong with feeding both of these “known poisons”.

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  2. Could it be trauma that makes this next recollection to be somewhat uncertain? The hospitalization described above occurred while my second and now deceased daughter was still in her notorious hospitalization of 2017, or it was very close in time to it.

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  3. As for the neediest: Their greatest need may be the freedom not to be forced into social constructs that don’t fit them, free not to take into their bodies toxic substances, free to learn their own way, free to holistically explore the world and make their own path in it.

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  4. I did not know that NSAIDs are “some of the deadliest drugs we have.6:155” No wonder why my attempted murdering doctor refused – for years – to let me stop taking them.

    Thank you for all you do, Peter. And please include in your book that both the antidepressants and antipsychotics can create “psychosis,” via anticholinergic toxidrome. And the antipsychotics can create the negative symptoms of ‘schizophrenia,’ via neuroleptic induced deficit syndrome.

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    • I think you’re picking up on my basic criticism of this series as expressed in the previous chapter, that labeling atypical thought, behavior and emotion in terms of “psychiatric disorder” — in and of itself — medicalizes and invalidates human experience. Even when there may be genuine insights lurking amid the semantic obfuscation.

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  5. “Religious leaders couldn’t have invented a better bluff, if people had required proof that God exists: “We priests and cardinals will not be distracted by those who would deny that God exists and knows about people’s problems and can treat them effectively.””

    This is not the attitude of priests nor cardinals. In fact, many of them have already produced countless proofs and evidence for the existence of God. Just do a basic study of philosophy of religion and you will see numerous, given how vast and antique this study is. The comparison is, therefore, extremely weak.

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  6. There is not a single valid proof in the universe of the existence of one or more gods. All attempts at proving this has failed and it is extremely unlikely that any gods exist. I can recommend Richard Dawkin’s book, The God Delusion, and Bertrand Russel’s book, Western Philosophy. I will not engage in a discussion about this.

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