“Depression is really a chemical imbalance of the brain” – just one more branch on the eugenics tree 12/03/2012Posted by ALT in Activism, Depression, Mental Health News.
Tags: chemical imbalance, depression, eugenics, mental health, Prozac, serotonin, stigma, suicide
Two Northwestern professors (Cristina Traina and Laurie Zoloth) wrote an article in response to a college student’s suicide, entitled “Culture stigmatizing mental illness must change.” It reads, in part:
Learning to accept your limits is learning what it means to be human. Realize that although difficult events can trigger depression and suicide, depression is really a chemical imbalance in the brain. You can no more adjust this balance than a diabetic can will their body to make more insulin or a person with low thyroid production can think themselves out of fatigue. At the physical level, the brain, like any organ, can become unable to function properly — in this case, to imagine that there are other futures beyond the intensity, or the injustice, or the pain of this moment.
What can you do for yourself and your friends? First, get rid of the stigma around depression, suicidal thoughts and treatment for mental illness. We need to learn to talk about mental illness like we talk about cancer, a serious emotional and physical crisis that can be treated, whose sufferers need support and decency and understanding as they face a life-threatening illness. Depression and anxiety are more common than asthma. You wouldn’t stigmatize a friend for using her inhaler; she shouldn’t feel shame if she uses Prozac to function, too.
I had to respond.
TO: Cristina Traina and Laurie Zoloth
CC: Editors, Northwestern Daily and Huffington Post College
SUBJECT: Response to your article: “Culture stigmatizing mental illness must change”
In your recent Huffington Post article (Culture stigmatizing mental illness must change), you wrote that “depression is really a chemical imbalance in the brain.” I understand this was not an academic publication – but could you provide a citation to back this up?
You’ll find it impossible to do so; because this mantra, this advertising slogan is about as scientific as the statement that “the best part of waking up is Folgers in your cup!” The best? Really?
Meanwhile, let me provide with you with a few citations of my own:
[Antidepressant] advertising campaigns have revolved around the claim that SSRIs correct a chemical imbalance caused by a lack of serotonin… Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency… In fact, there is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance.
- from Lacasse, J.R. & J. Leo (2005) Serotonin and Depression: A disconnect between the Advertisements and the Scientific Literature.
A serotonin deficiency for depression has not been found.
- Psychiatrist Joseph Glenmullen, clinical instructor of psychiatry at Harvard Medical School, in Prozac Backlash (2000)
Although it is often stated with great confidence that depressed people have a serotonin or norepinephrine deficiency, the evidence actually contradicts these claims.
- Professor Emeritus of Neuroscience Elliot Valenstein, in Blaming the Brain (1998), which reviews the evidence for the serotonin hypothesis.
But I am not writing merely to correct a factual error in your post – there’s more.
When an advertising gimmick is touted as scientific fact and even entered into the canon of “common sense,” there are bound to be some serious consequences. Consider:
- Rather than helping us “learn what it means to be human,” as you say, the chemical imbalance theory actually tells us that some people are born with brains that don’t function properly. That are, in some fundamental way, pathological. Put another way, there are the mentally fit and the mentally unfit. Sound familiar? To any student of late 19th/early 20th century eugenic thought in the West, it would sound mighty familiar.
- The theory also supports another common biopsychiatric fallacy: that an individual with a mental health diagnosis will need to take psychiatric medications for the rest of his/her life, to “correct the imbalance,” as the story goes. Long-term use of most classes of psychotropic drugs (including antidepressants, antipsychotics, and mood stabilizers) not only comes with serious, LIFE-THREATENING adverse effects, but can actually serve to make what could be rare occurrences of severe mental emotional/distress chronic and repeating. In some cases, this remains true even after withdrawal from the offending chemical agent. (see Robert Whitaker’s Anatomy of an Epidemic for chapters of information devoted to this astonishing truth).
- Finally, the chemical imbalance theory takes nearly all agency away from the individuals who are suffering from mental/emotional distress – they become the victims of whatever their faulty, off-balance brains inflict on them. You write that a person “can no more adjust this [depression-inducing chemical im]balance than a diabetic can will their body to make more insulin or a person with low thyroid production can think themselves out of fatigue.” How horrible if this were so! The kinder truth is there are many strategies a distressed individual can employ that are not purely chemical or pharmaceutical, but rather make use of the mind, will, spirit, and being. That empower, enliven, and entail a joyful discovery of strength, stamina, and RESILIENCY within the human being, who is indeed FIT TO LIVE in whatever way he/she chooses!
You express a desire to reduce stigma in mental health – I think this is admirable. Unfortunately, several scientific studies have demonstrated without a doubt that the “chemical imabalance” theory of mental health issues has the opposite effect: it increases stigma.
For example, in 1997 Sheila Mehta of Auburn University conducted a simple experiment on stigma in mental health, comparing the “chemical imbalance” model to the psychosocial model (which acknowledges a broad variety of factors – including family, past trauma, diet, environment, etc. – as potential contributors to emotional distress).
55 male college students were enrolled, and each one was told that he and a partner would have to do a simple learning task. The partner was actually a confederate, who would disclose a mental illness to the subject and then explain either that he had this illness because of “the kind of things that happened to me when I was a kid” [psychosocial] or that he had “a disease just like any other, which affected my biochemistry” [biochemical].
It turned out the group presented with the biochemical explanation were far more likely to treat their partners harshly than the group presented with the psychosocial one. Says Mehta, “The results of the current study suggest that we may actually treat people more harshly when their problem is described in disease terms. We say we are being kind, but our actions suggest otherwise… Viewing those with mental disorders as diseased sets them apart and may lead to our perceiving them as physically distinct. Biochemical aberrations make them almost a different species.” [See: Mehta, S. (1997). Is being “sick” really better? Effects of disease view of mental disorder on stigma]
Rather than learning “to talk about mental illness like we talk about cancer” by doing as you suggest and falsely promoting it as a merely physical problem of chemicals out of balance, I say we need to talk about mental and emotional distress in psychosocial context. AND in context of community, society. What is it about our culture, our rather toxic life on this planet, that makes people sick? And even more importantly, what can we as a society learn from these individual experiences of distress?
I take it you are sincere in your desire to help young people support each other in dealing with the distress that seems to hit so hard at the dawn of true adulthood. Surely, as scholars and seekers of knowledge, you recognize that truth, however complicated and elusive it may be, is vastly preferable to an oversimplified falsehood? Especially when that truth embraces the human potential to survive and thrive, while the falsehood embraces a technocratic romance with chemicals and a eugenical division of what were once human beings into groups of “fit” and “unfit” participants in this consumerist, sick culture.
If you want to help, tell the truth. If you’re not sure what the truth is, take the time to find out. Go slow, think critically, ask questions. Look for the roots of ideas, the beginnings of things, and then follow them from earth to sky – and all the branchings inbetween.
This will not be easy – psychiatry is a strange plant, indeed. But our community needs you to be more than just professors; we need you to be professors of TRUTH.
Can you? Will you?
Mental health writer and activist
I have received a response from one of the professors. She actually seems pretty open to considering what I said and has asked for time to research the information I shared. I’m not going to post her response yet because I’d like to win her trust — I think she really wants to dialogue! — but I hope to document our conversation here once it’s developed a bit more. I’m looking forward to a valuable exchange with her.
Tags: antidepressants, bipolar, bipolar conversion, Bipolar UK, mania, National Bipolar Awareness Day
Two studies with nearly identical data yield very different conclusions. Beautiful lady or old hag? Both collected data showing that individuals initially receiving a diagnosis of “depression” and treatment with antidepressants convert to “bipolar” diagnoses at an impressively high rate.
But the survey released today (in honor of the UK’s “National Bipolar Awareness Day”) by Bipolar UK portrays the data on conversion as evidence of misdiagnosis and the need for better awareness of bipolar disorder by mental health professionals, while this study from 2004 attributes conversion, not to misdiagnosis, but largely to antidepressants’ tendency to cause mania (it is a PDR-listed side effect, after all).
Is the rise of bipolar diagnoses in the US (a 56% increase in adults between 1996 and 2004) and Western Europe a largely iatrogenic phenomenon?
I decided to write Bipolar UK to ask them their thoughts on the matter.
To: the folks at Bipolar UK
Subject: Enquiry Related to “Challenges to Diagnosis” Survey
First, let me wish you a happy National Bipolar Awareness Day!
I read the executive summary of your recent survey of individuals diagnosed as “bipolar” with great interest. I was particularly struck by two statistics you presented:
- 85% of respondents were diagnosed with and treated for depression before being diagnosed as bipolar
- 71% of those receiving delayed diagnosis felt that their symptoms had been made worse by antidepressants or sleeping pills
Your data reminds me of a widely cited 2004 study in which 87,920 individuals initially diagnosed with depression were followed for 5 years. 4182 eventually received a diagnosis of bipolar (“converted”) during the course of the study, and 81% of them were being treated with antidepressants. The authors state in their analysis that “the conversion rate amongst antidepressant-treated patients (7.7% per year) was 3-fold that amongst unexposed patients (2.5% per year).” These findings are quite consistent with yours.
Your interpretation of this data seems to be that the timely diagnosis of bipolar disorder is an area that needs improvement amongst mental health professionals, who currently are misdiagnosing many bipolar individuals with depression.
However, I would like to suggest to you another interpretation, one that the previously cited study puts forward. Its authors state that “It has long been known that antidepressant medications can precipitate mania in vulnerable individuals” and that “treatment with antidepressants is associated with … conversion hazards.” “Mania/hypomania” are also listed in the Physician’s Desk Reference as effects of both SSRIs and tricyclic antidepressants. The PDR entry on imipramine (the very first tricyclic antidepressant) explicitly states “Manic or hypomanic episodes may occur; consider decrease until episode is relieved.”
Is it possible that many of the respondents to your survey, and many of the individuals you serve – in short, people with “bipolar” diagnoses – are dealing with an entirely iatrogenic phenomenon?
On this inaugural “Bipolar Awareness Day,” I think it is vital that we pursue awareness, not only of the diagnostic criteria, but also of the very real possibility of diagnostic inflation that is iatrogenic in nature.
I look forward to hearing your thoughts on this.
Writer, mental health activist
Tags: Afghanistan, Iraq, Native American culture, PTSD, suicide, veteran, Veteran's Affairs, war
So says a report released a couple weeks ago.
It bears repeating:
In 2010, and again in 2011: More US soldiers died from committing suicide than died in combat.
And that’s according to official reports, numbers that the Army itself tracks and then [if prodded] releases to the public. Are they renowned for their excellent body-counting abilities, their unflinching and honest reporting of the true costs of war? No, not even a little bit. *
[Oh, and on that note – check out this clever vocabulary replacement policy the Army has employed to mask the number of people wounded in combat.]
Yes, as it turns out the Department of Veteran’s Affairs went to trial in 2010 for (among other things**) deliberately hiding rates of suicide amongst soldiers and veterans. Internal emails from Dr. Ira Katz, Deputy Chief of Patient Care Services for the VA’s Mental Health Division, contain some juicy tidbits not meant for public eyes:
From: Katz, Ira R.
To: Chasen, Ev [top media advisor for the VA]
Subject: FW: Not for the CBS News Interview Request
Our suicide prevention coordinators are identifying about 1000 suicide attempts per month among the veterans we see in our medical facilities. Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?
(from a set of emails made public here)
Oooh. That doesn’t sound good, Dr. Katz. Especially since you told CBS reporters in November of 2009 that “there is no epidemic of suicide in VA,” and that their statistics, remarkably similar to the ones quoted in the email above, were “not, in fact, an accurate reflection of the [suicide] rate.”
The courts ruled in the veterans’ favor.
Suicide rates aren’t the only thing going up
Mental health diagnoses in the military population (especially that of Post-Traumatic Stress Disorder [PTSD]) and usage of psychotropic drugs are, too. The New York Times reported on the sometimes disastrous effects of overmedicating active duty and returned veterans thusly diagnosed. Part of the problem may be the current view of PTSD as a mental illness, when it is perhaps better understood as an injury to the autonomic nervous system. More information on that here.***
One article I was reading this morning suggested making acupuncture more widely available to active duty troops. They call it “battlefield acupuncture.”****
Yeah, sure, ok.
But how about NOT HAVING A WAR IN THE FIRST PLACE?
That’s apparently not an option. I guess the engine of our economy, the military-industrial complex (which now certainly includes pharma) cannot run on fumes alone; we need this war. Like an internal combustion engine needs fossil fuels to burn? Yes.
And let’s not hear any nonsense about alternatives.
More nonsense about alternatives
One commenter’s perspective on the military suicides issue really resonated with me:
Native American cultures used a ritual of honor, respect, and spiritual cleansing to help their warriors return to “normal” life. Our society could sorely use a similar process.
- commenter from news article “More US soldiers died from committing suicide than died in combat”
On the road trip I took last summer, I had the opportunity to witness at least part of this ritual — in North Dakota, on the Fort Berthold (3 Affiliated Tribes) Reservation, at their annual Pow Wow.
A young woman had returned from 2 tours of duty, one in Afghanistan and one in Iraq. On the first night of the Pow Wow (the giveaway night), a large part of the ceremony centered around her. She was asked to stand in the middle of the sacred ceremonial dance space, wearing her full military attire. She was given a strikingly beautiful, handmade bonnet of eagle feathers. It reached almost to the ground! She was honoured with specially composed songs and tributes from relatives and friends. Her body was wrapped in 8 or 10 homemade quilts of beautiful colors.
At the close of the ceremony, a box was placed in front of her, and all who watched were asked to step forward and place something of value (money, basically) in the box. To help her as she adjusted to being home. To support her and her family. They would then press her hand gently, kiss her cheek, or perhaps touch her feet. Signs of respect and love were heaped upon her.
Over and over the emcee emphasized the fact that “in our culture, we honor our warriors, we honor our veterans. We welcome them home with open arms.”*****
It was a powerful and moving ceremony. I truly felt the whole community’s support for this brave young woman; I hope that she felt it, too. Contrast this with most returning veterans’ feelings of utter isolation, and perhaps even shame and despair.
The contrast is somewhat apparent in the data on veteran suicide, too. National data for veteran suicide by ethnicity was not available, but this analysis of veteran suicide data from 2008-2010 in Nevada shows (in that state at least) suicide rates amongst returning White veterans were almost 5 times higher than those of Native American vets. Native Americans, as an ethnic group, had the second lowest suicide rate of those surveyed (the “Asian” ethnic group had the lowest).
We as a culture have so much to learn.
* Here’s an older reference on that, too, specific to US casualties… Doubtless the trend continues.
**Those “other things” included deliberate and unnecessary delays in the provision of mental health care and in the adjudication of service-connected death and disability compensation claims by the VA. The court ruled in favor of the veterans, stating that this was a violation of “veterans’ due process rights to receive the care and benefits they are guaranteed by statute for harms and injuries sustained while serving our country.” Full opinion available here; a very good read.
*** The PTSD label may be the new “hysteria” – a diagnostic catchall category in mental health that is really describing brain injury or pathology.
**** Which nobody seems to find ironic. Ho-hum.
*****More information on the Native American attitude towards veterans here.