nandm

An interesting article that addresses the question that mood disorders may not be caused simply by a "chemical" imbalance. Doctor, Is My Mood Disorder Due to a Chemical Imbalance? | World of Psychology

What are your thoughts on it.

It makes a lot of sense to me as my experience has been that medication treatment alone has only caused my mental health diseases to progress from bad to worse. I am now using both therapy and medications and feel it is more likely to help in the long run although initially, right now, it has been making things worse.

onlythetruth

I recently took a number of graduate level courses on, among other things, mood disorders, and my understanding is that they have a complex etiology. They are thought to be caused by a combination of three factors: neurotransmitter imbalances, psychological vulnerabilities, and environment. For any given person, the specific factors and their relative contribution may vary, but it's rare that only ONE factor alone is sufficient to create the disorder.

I know that for myself, my GAD responds well to medication--BUT I also needed some intense therapy (a combination of psychodynamic and CBT) to really bring the thing under control. My experience has been that the medication is necessary but not sufficient for full remission of the symptoms.

Of course, your experience will vary. Do not take ANYTHING I say as medical advice, just my own personal experience and opinion.

shadeofplato

As for me, the most important are practical issues, not theoretical ones. I mean, if the way how you deal with your problems helps you (in the long run and with no harmful consequences, not as alcohol helps to relieve stress for a while), then don't care too much about theory, which besides changes very rapidly. And each of us is unique, after all.

JimE

That is an interesting article. I just got around to reading it. Since joining SR recently I have spent most of my online time here reading the alcoholism forums. In my case, I was involved in therapy several years before seeing a psychiatrist and starting medication. My mood swings were worse before medication, especially major depressions that seemingly came out of nowhere. There is a history of mental illness on my fathers side of the family and my mother had depression later in life.

I was molested as a child by a neighbor and never told a soul till I was well into sobriety. I felt terrible shame growing up. I carried a big secret around. In AA I heard the phrase, 'you're as sick as your secrets' and I thought, you betcha.

My Dad heard voices and suffered from paranoia. He was also an alcoholic. His father died in a mental institution but I didn't know him at all. I've always attributed my Dad's illness to the fact his mother died when he was born and his Dad didn't want him so he was raised by other relatives, kind of passed around from one to another his whole childhood. That kind of upbringing had to have done a number on him mentally and emotionally. That combined with whatever he may have inherited from his Dad now makes me appreciate how well my Dad functioned up to a point when the delusions took over the last 15 yrs of his life. His death certificate listed severe dementia as a cause of death along with heart failure.

I told my Mom in my 20's that I didn't want to pass along mental illness to a child. That was 20 yrs before I was diagnosed but I knew something was wrong with me due to the depressions I had.

So, I've certainly gotten off the subject here! The question of whether mood disorders or mental illness is just a chemical imbalance..... I'd say that's only part of it. Family history, events in childhood, environment and so on may have something to do with it all. To keep it simple (which is a real chore for me sometimes), I have mental health issues that are helped by taking medications but I also need human interaction with someone who understands to help me deal.

Mattcake

I fully agree with Onlythetruth. The chemical imbalance theory is extremely oversimplified.

I once asked a lady why she was taking Lexapro, and her matter-of-fact answer was literally "because I have a chemical imbalance so my brain needs more serotonin". She didn't even mention depression/sadness/anxiety etc.

Medication alone is not the answer, in my experience. However whenever I plunge into depression, I have a reliable weapon of sorts that brings me relief within a few days (Remeron - mirtazapine). Then I grudgingly go back to therapy, CBT + psychodynamics.

Right now I'm learning to identify the factors that trigger my moods. I wish the answer were more simple, but it's not. Popping a pill is only a part of it - and there's really no way to know if a med will be benefitial, as nobody really knows how they work. Docs basically guess what needs to be "tweaked", and those of us who have tried many meds know that sometimes the results are disastrous.

Complicated topic. Thanks, Nandm.

Mattcake

Great post, Wendy.

My last shrink was *huge* on the plastic brain theory. Alcohol is a powerfiul toxin that basically destroys the brain, and creates pathways that enable/encourage further consumption. With continuous sobriety, these pathways gradually disappear.

There are many articles in PubMed which show that therapy -talking- does eventually create new pathways. This has tremendous consequences. Words are incredible.

I'm glad that you mentioned Big Pharma. Without launching into an endless rant, I'll just say that these companies are *not* necessarily interested in finding effective meds. Nope- their real interest is money.

This is especially true in places like the US, where psychotropics are freely advertised as though they were candy, making their drugs appealing and even sexy (!!!). For instance, take the Zoloft shilling, or the BusPar ads (youtube).

There are a few independent companies which are alienated or ignored. My favourite is Servier, a French co. that has created a med that enhances serotonin reuptake (tianeptine). Tianeptine rips the "serotonin imbalance" theory to shreds. It's just as effective as traditional SSRIs, if not more so, and does the exact opposite, thus destroying the common imbalance theory.

Anyway, the main point is that words are extremely powerful. Apparently they are just as effective as meds... and AA, therapy or, say, SMART can change our circuitry. The words we use create our reality.

nandm

As I said in response to your other post: My experiences do not parallel yours. I do not believe that there is some big conspiracy going on with all the medical professionals and drug companies. I worked in the medical field for 20 years and never once saw any sign of this. But I have seen way too many people who did not take mental health diseases seriously by doing so caused harm to those that did need medications, therapy, etc... To state that everyone should stop taking their meds, stop working with their doctors, and just think positive is a non productive and dangerous stand. I will leave my mental and physical health in the hands of a qualified medical professional.

onlythetruth

Here, here!

Nightsd

Depression isn't simply a medical disease. I believe in some people it is simply an issue of a chemical serotonin imbalance in the brain. Some people's depression will be completely cured with an SSRI. However, depression in most people results from flawed/ineffective thinking processes, which are best treated with counseling and cognitive behavioral therapy.

I can tell you from experience that strong SSRI's, such as tramadol, have eased my depression for a while but without the drugs it comes back worse than ever. So there definitely IS a chemical component. But I believe our brains have the power to restore a normal amount of serotonin, which can be changed when you change how you think.

FenrirUlf

I read the article. It's interesting. Really, however, all I can do is speak from my own experience rather than theory. There is a VERY strong genetic component, especially on my father's side of the family, toward anxiety/depression (as well as chemical dependency). In addition, the family environment in which I grew up was not conducive to "mental/emotional" well-being. Those two things together seemed to flip the switch in me regarding my diagnosed anxiety disorder and depression. I've been through several types of therapy and am also on medications. As many have stated, medication by itself rarely works. There are so many things to be talked out in therapy.

And I also give a lot of credit to those who have mentioned the laying-down of new neural pathways. The therapist to whom I wish to return works in that area and has a lot of information about that. We can transform our seemingly-set neural pathways to being healthier, over time. (I'm currently in Dialectical Behavioral Therapy right now. While it's great at teaching skills regarding how to keep "emotional dysregulation" in check, I am feeling the need for something different. Not to mention, my individual therapist seems to want to run my life... but that's another story!)

So, "chemical imbalance," in my case is part of the situation, but not all of it. It varies from person to person, the ratio of "nature vs. nurture" and that sort of thing. Thanks for posting the article!