Chemical Imbalance Theory

INTRODUCTION On June 23, 2020, Awais Aftab, MD, a clinical professor of psychiatry at Case Western, interviewed Ronald Pies, MD, also a psychiatrist, and a professor at Tufts and SUNY. During the interview, Dr. Aftab stated: "I have followed the controversy surrounding 'chemical imbalance' with some interest over the years, including the multiple articles you have written on this issue. Generally, I agree with you that the chemical imbalance was never accepted as the 'truth' by academic psychiatry or by our professional organizations. It was likely an advertisement strategy by pharmaceutical companies that took on a life of its own. However, I am not sure I am ready to exonerate our profession. At best, it seems like we were silent spectators, watching as this misleading idea spread like wildfire in the society (including among our patients and patient advocacy groups), doing little to nothing to correct these public misperceptions. At worst, it seems like at least some of us were participants. Ken Kendler writes in a 2019 JAMA Psychiatry commentary, 'I would commonly see patients who would say some version of "my psychiatrist said I have a chemical imbalance in my brain."'10 I have had a very similar experience myself. Either way, surely as a profession, we could have done a better job of educating our patients and the public?" ...

INTRODUCTION For the past several years, the eminent and scholarly Ronald Pies, MD, psychiatrist, of SUNY Upstate Medical and Tufts Universities, has labored the point that psychiatry has never endorsed the simplistic chemical imbalance theory of “mental illness”. As various anti-psychiatry bloggers, including myself, began to accumulate a great many instances of prominent psychiatrists doing just that, Dr. Pies began digging himself in on this particular topic. In Nuances, Narratives, and the “Chemical Imbalance” Debate (April 2014, Medscape), he wrote: ...

INTRODUCTION On September 9, 2020, Jonathan Stea, PhD, Tyler Black, MD, and Joseph Pierre, MD, published a piece on MedPage Today. The article is titled Why Anti-Psychiatry Now Fails and Harms. Dr. Stea is a clinical psychologist and adjunct assistant professor at the University of Calgary. Dr. Black is the psychiatric medical director of British Columbia Children’s Hospital. He is also a clinical instructor in psychiatry at the University of British Columbia. ...

On March 4, 2020, the very eminent Allen Frances, MD, published an article in Aeon, which according to its About page is “a digital magazine, publishing some of the most profound and provocative thinking on the web. We ask the big questions and find the freshest, most original answers, provided by leading thinkers on science, philosophy, society and the arts.” The article is called The lure of ‘cool’ brain research is stifling psychotherapy. The central theme is that prior to 1990, the National Institute of Mental Health (NIMH) “appreciated the need for a well-rounded approach [to mental health] and maintained a balanced research budget that covered an extraordinarily wide range of topics and techniques.” However, since 1990, the opening year of the Decade of the Brain, the NIMH has “increasingly narrowed its focus almost exclusively to brain biology – leaving out everything else that makes us human, both in sickness and in health.” ...

The spurious chemical imbalance theory of depression is arguably the most destructive thing that psychiatry has ever done. Worldwide, millions of individuals are taking antidepressants, often with a cocktail of other drugs, because they have been told the blatant falsehood that they need the pills to combat a brain illness – a “real illness just like diabetes.” Many of these individuals were told the additional lie that they needed to take the pills for life and are now addicted to the products. ...

On April 30, 2019, the very eminent and learned psychiatrist Ronald Pies, MD, published a piece in Psychiatric Times titled Debunking the Two Chemical Imbalance Myths, Again. Here’s the opening paragraph: "Like the legendary Count Dracula, who could be killed only by driving a stake through his heart, some myths seem almost immortal. For more than eight years now, I have tried to drive a stake through the heart of two myths regarding the so-called 'chemical imbalance theory'1-3—but with only limited success, as a recent piece in The New Yorker brought home to me.4" ...

On November 18, 2015, Dr. Pies sent his response to my November 17 article to MIA. MIA posted it, and forwarded a copy to me. It reads: “I have read Dr. Philip Hickey’s 8400+ word treatise, and I have only the following to say with regard to the two key points at issue: Notwithstanding my omission of quotation marks in my original Medscape article [1]—for which I take responsibility—the fact remains: I have never believed or argued that the so-called chemical imbalance theory (which was never really a theory) is merely a “little white lie.” It is that point of view—not merely typed words on the page—that has been falsely and carelessly attributed to me. I have never received a dime from any pharmaceutical company or private agency with any verbal or written understanding that I would “promote” (elevate, popularize, hype, etc.) a particular drug. If any of the papers I wrote or co-authored over a decade ago had the effect of putting a drug in a favorable light, it was because the best scientific evidence available at that time supported the drug’s benefit. Nothing in Philip Hickey’s belaboring of half-truths, innuendos and guilt by association demonstrates otherwise.   Sincerely, ...

This morning, I received, by way of a forward from MIA, the following from Dr. Pies. . . . . . . . . . . . . . . . .   I have read Dr. Philip Hickey’s 8400+ word treatise, and I have only the following to say with regard to the two key points at issue: 1. Notwithstanding my omission of quotation marks in my original Medscape article [1]—for which I take responsibility—the fact remains: I have never believed or argued that the so-called chemical imbalance theory (which was never really a theory) is merely a “little white lie.” It is that point of view—not merely typed words on the page—that has been falsely and carelessly attributed to me. 2. I have never received a dime from any pharmaceutical company or private agency with any verbal or written understanding that I would “promote” (elevate, popularize, hype, etc.) a particular drug. If any of the papers I wrote or co-authored over a decade ago had the effect of putting a drug in a favorable light, it was because the best scientific evidence available at that time supported the drug’s benefit. Nothing in Philip Hickey’s belaboring of half-truths, innuendos and guilt by association demonstrates otherwise.   Sincerely, ...

In the October 2015 issue of the Behavior Therapist (pages 206-213), Jeffrey Lacasse, PhD, and Jonathan Leo, PhD, published an article titled Antidepressants and the Chemical Imbalance Theory of Depression: A Reflection and Update on the Discourse, I thought the article had particular merit, and I drew attention to it in a post dated November 2. The post, More on the Chemical Imbalance Theory, was also published on Mad in America. In that post, I quoted a number of passages from the Behavior Therapist article, including: ...

On November 5, Kermit Cole, Front Page Editor at Mad in America, forwarded to me the following email which he had received from Ronald Pies, MD. . . . . . . . . . . . . . . . .   From: Ronald Pies MD <contact-page@madinamerica.com> Date: November 4, 2015 at 2:17:53 PM EST To: kcole@madinamerica.com Subject: Misstatements in Philip Hickey\'s blog Echo Misstatements by Lacasse & Leo ...