Challenging the Empty Metaphors of the “Chemical Imbalance” Myth

A new article published in the Revista Antropología Social evaluates the conceptions of mental illness and psychopharmaceuticals through a discussion of the cultural trope of the “chemical imbalance.”  

The author, Janis H. Jenkins, is a psychological and medical anthropologist and Director at the Center for Global Mental Health at the University of California San Diego. Jenkins highlights what the global mental health movement is missing in its addressing of the “treatment gap,” which is the absence of local, sociocultural knowledge of the conceptions of diagnoses and treatments.  

She set out to address this problem by conducting an ethnographic study of the subjective and cultural experiences of individuals taking antipsychotic and other psychotropic medications for the treatment of schizophrenia-related conditions. Drawing from the interview responses looking at their lived experiences, Jenkins concluded that the metaphor “chemical imbalance:” 

“Explains everything and nothing. More important, it does not take us to the actual experience of participants on medication, or to any bodily feeling of chemical imbalance.”  

Rather than focusing on the subjective lived experience of illness and the effects of treatments, global mental health has made its primary concern the availability of drugs in middle and low-income regions, identified as the “treatment gap,” and sociocultural knowledge of their use is seen as distinct from it and inconsequential. This article aimed to find a more informed understanding of treatments in relation to subjective experiences and cultural meanings, particularly concerning the popular discourse of “chemical imbalances.”