"Chemical imbalance causes mental illness" = myth

[VabaX]

your brain is nothing more than a bunch of (highly organised) chemicals in the first place, so when you phuck with the chemical balances, its obviously going to effect the other chemical reactions within your brain.
when the brain changes, of course your mental state changes; your brain is you.

[BloodFireDeath]

1) Chemical imbalance hypothesis of mental illness has never been validated and has arguably been invalidated.
2) Said hypothesis is not only scientifically invalid but also perpetuates and magnifies social stigma.
3) Everyone rants at me but no one produces evidence to the contrary.
4) Everyone believes psychiatric medication > psychological intervention.
5) They're all wrong.

That's generalizing it more than is warranted. Because firstly, you aren't talking about just about any mental illness. Mental illness would include organic and secondary causes of mental afflictions, and several other forms like retardation, extrinsic /drug related mental illnesses.

Next, psychological intervention requires the patient to have a certain level of insight and understanding of his condition, and also a willingness to accept the rationale of the treatment, one of which most patients with severe forms of these mental illnesses lack. Not to mention the various drawbacks like compliance problems, limited availability, language barriers, more dropouts etc. Thus limiting it's practicality in real world situations in present day.

[G T]

1) Chemical imbalance hypothesis of mental illness has never been validated and has arguably been invalidated.
2) Said hypothesis is not only scientifically invalid but also perpetuates and magnifies social stigma.
3) Everyone rants at me but no one produces evidence to the contrary.
4) Everyone believes psychiatric medication > psychological intervention.
5) They're all wrong.

6) You're delusional.

[mynameisuntz]

Okay, let's say , Major Depression. Could you point me to studies where pharmaco and psychotherapy are compared and psychotherapy was proven superior? Patient satisfaction and quality of life seem like a decent measure of outcome, would be interested to see what else they measure outcome with.

Actually, these measures can be problematic depending on the specific items. Some of these measures, despite what they appear to be, are just asking about symptom-reduction in one way or another.

Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006). The empirical status of cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31.

^^CBT equivalent to behavioral activation, both superior to antidepressants.

Sturmey, P. (2009). Behavioral activation is an evidence-based treatment for depression. Behavior Modification, 33, 818-829.

^^Behavioral activation slightly better than antidepressant medication without side effects, and actually addresses underlying depression (as per model of avoidance/maladaptive coping).

Dimidjian et al. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658-670.

^^Behavioral activation comparable to antidepressants while actively engaging the individual in lifestyle change and addressing underlying depression rather than symptom-masking, coupled with no negative effects unlike pharmacotherapy and lower rates of relapse.

Chartier, I. S. & Provencher, M. D. (2013). Behavioural activation for depression: Efficacy, effectiveness, and dissemination. Journal of Affective Disorders, 145, 292-299.

^^Same results as above + no negative effects (unlike drug condition) and lower rates of relapse long-term.

Consistently psychotherapy is AT LEAST as good as medication in terms of symptom reduction and yet: no negative effects, significantly lower rates of relapse (unlike for drugs where relapse can range from 60%-90%), and the individual is engaged in ACTUAL LIFESTYLE CHANGE and not just shortcuts to "feeling good." And this is just for depression. If we compared pharmacotherapy to exposure therapy for the anxiety spectrum it would be a slaughter. I would be really intrigued if there were some sort of "resiliency factor" assessment that could be made to look at long-term changes, as well.

That's generalizing it more than is warranted. Because firstly, you aren't talking about just about any mental illness. Mental illness would include organic and secondary causes of mental afflictions, and several other forms like retardation, extrinsic /drug related mental illnesses.

Next, psychological intervention requires the patient to have a certain level of insight and understanding of his condition, and also a willingness to accept the rationale of the treatment, one of which most patients with severe forms of these mental illnesses lack. Not to mention the various drawbacks like compliance problems, limited availability, language barriers, more dropouts etc. Thus limiting it's practicality in real world situations in present day.

1) No substantial evidence behind your first claim and it's not entirely difficult to raise self-insight, it simply requires more time.
2) Psychoeducation is pretty easy when you use scientific evidence as the rationale for an intervention. Also, define "severe" mental illness.
3) Compliance is not difficult to measure, dropout rates are LOWER in psychotherapy conditions than drug conditions.
4) So, what is impractical again?

6) You're delusional.

Are you still thinking anyone takes you seriously? Please, this is a scientific discussion based on facts, which you have clearly illustrated you do not care for.

[BloodFireDeath]

Not clear enough. From a quick glance at a couple of studies you posted, and other ones (will link) CBT has better relapse and recurrence rates, but pharmacotherapy has better remission rates. Also, from other studies, a combination of the 2 was superior than each alone. Couldn't find much that compared continuation treatments between the two.


Relapse rates with newer SSRIs are lower today, specially when the doses are tapered and other co-morbidities are considered beforehand.

Insight wouldn't be lost in depression but more so in psychosis

Therapist's training and experience are directly associated with patient outcome, are they not?

A study that found drugs more effective than placebo or cBt: Also read about some supposedly large scale TDCPR study too, couldn't find link.

Elkin I, et al. Initial severity and differential treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol.

"in a major placebo-controlled trial of ADM versus CT, Elkin et al. reported that, for patients who began the trial with severe symptoms, ADM was more efficacious than CT, and CT was not demonstrably more efficacious than placebo.31"

[mynameisuntz]

Not clear enough. From a quick glance at a couple of studies you posted, and other ones (will link) CBT has better relapse and recurrence rates, but pharmacotherapy has better remission rates. Also, from other studies, a combination of the 2 was superior than each alone. Couldn't find much that compared continuation treatments between the two.


Relapse rates with newer SSRIs are lower today, specially when the doses are tapered and other co-morbidities are considered beforehand.

Insight wouldn't be lost in depression but more so in psychosis

Therapist's training and experience are directly associated with patient outcome, are they not?

A study that found drugs more effective than placebo or cBt: Also read about some supposedly large scale TDCPR study too, couldn't find link.

Elkin I, et al. Initial severity and differential treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol.

"in a major placebo-controlled trial of ADM versus CT, Elkin et al. reported that, for patients who began the trial with severe symptoms, ADM was more efficacious than CT, and CT was not demonstrably more efficacious than placebo.31"

^^I don't deny that, because cognitive therapy by itself is garbage. Notice that my studies were NOT looking at cognitive therapy. You need to get out of the mindset of any ol' therapy vs. drugs. When you find trials comparing hardcore behavioral interventions to pharmaceuticals, you let me know. Then we'll have something to talk about and assess.

You let me know when you actually look at the research rather than a "quick glance" and tell me your contention then. I'm not going to invest time if you aren't. I provided the evidence, you give me a thorough assessment of what you disagree with.

[BloodFireDeath]

^^I don't deny that, because cognitive therapy by itself is garbage. Notice that my studies were NOT looking at cognitive therapy. You need to get out of the mindset of any ol' therapy vs. drugs. When you find trials comparing hardcore behavioral interventions to pharmaceuticals, you let me know.

You let me know when you actually look at the research rather than a "quick glance" and tell me your contention then. I'm not going to invest time if you aren't. I provided the evidence, you give me a thorough assessment of what you disagree with.

That will need more time than I can invest, nor do I have access to the full text of the ones you posted.

[mynameisuntz]

That will need more time than I can invest, nor do I have access to the full text of the ones you posted.

Then why even bother asking for evidence if you didn't have time to look at it in the first place?

[MrJohnLocke]

How long have you suffered from depression OP?

[BloodFireDeath]

Then why even bother asking for evidence if you didn't have time to look at it in the first place?

Thought it'd be more direct. Too many variables in these.

[mynameisuntz]

How long have you suffered from depression OP?

How is that relevant to the scientific inquiry of the mechanisms of depression and the observable treatments which lead to systemic change in those with depression? Do I need to have cancer to know its etiology and the efficacy of chemotherapy?

Thought it'd be more direct. Too many variables in these.

Nope, these are pretty standard studies with generalizable results.

[MrJohnLocke]

How is that relevant to the scientific inquiry of the mechanisms of depression and the observable treatments which lead to systemic change in those with depression? Do I need to have cancer to know its etiology and the efficacy of chemotherapy?



Nope, these are pretty standard studies with generalizable results.

okay brah judging by your crusade to spread the message, and the barriers you put up against a simple question (almost as if you're defensive about being depressed, in this day and age) I would have said that it must have affected you personally. Maybe your family members have suffered from it? Is it because you feel their treatment was subpar that you want to spread the message about better treatments? Its cool brah, just I would rather know why you are so passionate about it.

[Delgadido]

^^I don't deny that, because cognitive therapby itself is garbage. Notice that my studies were NOT looking at cognitive therapy. You need to get out of the mindset of any ol' therapy vs. drugs. When you find trials comparing hardcore behavioral interventions to pharmaceuticals, you let me know. Then we'll have something to talk about and assess.

You let me know when you actually look at the research rather than a "quick glance" and tell me your contention then. I'm not going to invest time if you aren't. I provided the evidence, you give me a thorough assessment of what you disagree with.

You make it seem like pharmacotherapy is complete trash and i wasnt the only one who interpreted this was cbt vs drugs.

All of our learning in class and in the workplace always talks about both. The nurse isnt there to provide full blown cbt but we help "stabilize" them for treatment.

As i said before its similair steps for physical therapy

The main difference between our sides is mine is much more extreme than what you would see more of. Mine already went over the edge so we would have to drug them, calm them, and give them to you for advanced treatment.

I am not saying the pharmaceutical industry is a wonderful place because simply suggesting meds to mask or temporary fix the problem i am heavily against.

Its like saying giving vicodin a trauma victim with no physical therapy will get him better.
But other way around is physical therapy with nothing to reduce inflammation or pain will not be beneficial.

I cant speak for pharmacists or doctors but true nursing is supposed to be the midpoint between therapy and drugs. Not saying that all nurses care and are wonderful people. I am sure you know many pos therapists

Btw i am trying to type on a tablet that is hard to. I am waiting for the new models this summer

[mynameisuntz]

okay brah judging by your crusade to spread the message, and the barriers you put up against a simple question (almost as if you're defensive about being depressed, in this day and age) I would have said that it must have affected you personally. Maybe your family members have suffered from it? Is it because you feel their treatment was subpar that you want to spread the message about better treatments? Its cool brah, just I would rather know why you are so passionate about it.

No, because I'm in graduate school for clinical psychology and the state of the mental health field is disgusting right now because it just perpetuates misinformation. Further, psychiatry promotes medication in the same "magic bullet" fashion as does the fitness industry with "fat-burners." It's disgusting and malpractice-worthy.

You make it seem like pharmacotherapy is complete trash and i wasnt the only one who interpreted this was cbt vs drugs.

All of our learning in class and in the workplace always talks about both. The nurse isnt there to provide full blown cbt but we help "stabilize" them for treatment.

As i said before its similair steps for physical therapy

The main difference between our sides is mine is much more extreme than what you would see more of. Mine already went over the edge so we would have to drug them, calm them, and give them to you for advanced treatment.

I am not saying the pharmaceutical industry is a wonderful place because simply suggesting meds to mask or temporary fix the problem i am heavily against.

Its like saying giving vicodin a trauma victim with no physical therapy will get him better.
But other way around is physical therapy with nothing to reduce inflammation or pain will not be beneficial.

I cant speak for pharmacists or doctors but true nursing is supposed to be the midpoint between therapy and drugs. Not saying that all nurses care and are wonderful people. I am sure you know many pos therapists

I already acknowledged that, in serious cases, I understand medication.

To give a bit of anecdotal experience: I recently assessed an individual with a full personality assessment inventory. Basically, major depression since he was an adolescent. That's it. Very severe, a few episodes of suicidality, but no additional diagnoses aside from that. He saw a psychiatric nurse and was given a diagnosis of bipolar I disorder (despite NO MANIA ever) and prescribed: Risperdal, Lamictal, and Pramipexole, along with ****** for sleep problems. The negative effects were atrocious, and it didn't do anything except "zombify" him (in his words).

I wish this were an outlier case, but I hear garbage like this with almost EVERY client I have in an outpatient setting, for the most BASIC disorders. People being prescribed benzos for panic disorder? It's absolutely horrific.

[MrJohnLocke]

No, because I'm in graduate school for clinical psychology and the state of the mental health field is disgusting right now because it just perpetuates misinformation. Further, psychiatry promotes medication in the same "magic bullet" fashion as does the fitness industry with "fat-burners." It's disgusting and malpractice-worthy.

Glad you're trying to sort out some of the myths then. Now I know where your heads at I can go through these posts more objectively, as before I thought you might have just been arguing for the sake of it.

[mynameisuntz]

Glad you're trying to sort out some of the myths then. Now I know where your heads at I can go through these posts more objectively, as before I thought you might have just been arguing for the sake of it.

Understood. I know I came off as troll-ish, and I was undoubtedly looking to rustle jimmies (it's the misc, my bad), but what I am providing is scientifically accurate; I am not just making this up, and I have now posted several studies to defend several of my points.

[Delgadido]

I already acknowledged that, in serious cases, I understand medication.

To give a bit of anecdotal experience: I recently assessed an individual with a full personality assessment inventory. Basically, major depression since he was an adolescent. That's it. Very severe, a few episodes of suicidality, but no additional diagnoses aside from that. He saw a psychiatric nurse and was given a diagnosis of bipolar I disorder (despite NO MANIA ever) and prescribed: Risperdal, Lamictal, and Pramipexole, along with ****** for sleep problems. The negative effects were atrocious, and it didn't do anything except "zombify" him (in his words).

I wish this were an outlier case, but I hear garbage like this with almost EVERY client I have in an outpatient setting, for the most BASIC disorders. People being prescribed benzos for panic disorder? It's absolutely horrific.

i am glad we finally agree. There are pieces of **** across every branch of the medical field. There has to be something with the nurse. Nurses cannot legally do a medical diagnosis unless they are a nurse practioner

[mynameisuntz]

i am glad we finally agree. There are pieces of **** across every branch of the medical field. There has to be something with the nurse. Nurses cannot legally do a medical diagnosis unless they are a nurse practioner

I imagine our definition of "severe" may differ, but at no point am I saying we just need to rid the world of psychiatric medication. I am saying it needs to be an absolute last-ditch effort. Always.

Not sure about the nurse - the client just said it was a psychiatric nurse at an inpatient/critical outpatient hospital. That's all he knew, so maybe he misspoke or maybe the nurse was a practitioner.

[P5yduck]

I know this bich that has been diagnosed as bi-polar and manic depressive. She thinks it's her excuse to treat people like crap and get away with it. She seems to think that because of this issue, she has no liability. She knows what she is doing and uses it. I have nothing to do with her.

lol there was a kid in my high school with tourette's that would do the same ****. Would straight up grab a bitches titty and be like "Sorry it was the tourette's HEEEEEEEEP!" srs kid was a piece of ****

[TheAdlerian]

lol there was a kid in my high school with tourette's that would do the same ****. Would straight up grab a bitches titty and be like "Sorry it was the tourette's HEEEEEEEEP!" srs kid was a piece of ****

I've had tourette's patients and realized from the start it's not real.

It's some kind of passive-aggressive condition caused by family dynamics.

[Delgadido]

I imagine our definition of "severe" may differ, but at no point am I saying we just need to rid the world of psychiatric medication. I am saying it needs to be an absolute last-ditch effort. Always.

Not sure about the nurse - the client just said it was a psychiatric nurse at an inpatient/critical outpatient hospital. That's all he knew, so maybe he misspoke or maybe the nurse was a practitioner.

And i completely agree. On top of unknown long term effects. People are already non compliant with treatment regimens regarding medication and therapy.



As for me i refused to get on anti depressants after my fathers suicide. I used therapy to face the problems. Antidepressants would probably prolong the greiving process and made it worse in the long run.

Even if we did stop the suicide iknow he wouldnt be compliant with drugs or therapy

[mynameisuntz]

And i completely agree. On top of unknown long term effects. People are already non compliant with treatment regimens regarding medication and therapy.



As for me i refused to get on anti depressants after my fathers suicide. I used therapy to face the problems. Antidepressants would probably prolong the greiving process and made it worse in the long run.

Even if we did stop the suicide iknow he wouldnt be compliant with drugs or therapy

Antidepressants to "aid in grieving" is such a disgusting topic for me. And you know in the DSM-5 they are removing the bereavement exclusion criteria for MDD, so people who are grieving after the loss of a family member can be diagnosed with MDD and prescribed antidepressants. And, by psychiatric standards, that would be "acceptable practice." Disturbing.

[P5yduck]

I've had tourette's patients and realized from the start it's not real.

It's some kind of passive-aggressive condition caused by family dynamics.

There was also a girl in my class who claimed to have tourette's; she moved away senior year and before she left she admitted to her friends that it wasn't real and she only did it for attention. one of the friends she told told me and didn't understand why I thought the chick was a dumb lying kunt

[Delgadido]

Antidepressants to "aid in grieving" is such a disgusting topic for me. And you know in the DSM-5 they are removing the bereavement exclusion criteria for MDD, so people who are grieving after the loss of a family member can be diagnosed with MDD and prescribed antidepressants. And, by psychiatric standards, that would be "acceptable practice." Disturbing.

Yea... that doesnt make any sense. You have to face the pain to treat it. The best treatment for that is counseling, facing the pain, and some people need breaks. But antidepressants are not something someone should use for basic grief.

[mynameisuntz]

Yea... that doesnt make any sense. You have to face the pain to treat it. The best treatment for that is counseling, facing the pain, and some people need breaks. But antidepressants are not something someone should use for basic grief.

This is how I perceive essentially ALL mental illness, and based on current literature, it may be the best answer. New learning = everything. People who use medication as a crutch are depriving themselves of using their struggles as a moment of learning. And THAT is what is prognostic of recovery. Feeling better is a perk, but the goal is to face the struggle and develop adaptive patterns of responding which are beneficial to...well, your values, and what you find to be meaningful.

Otherwise we're just numbing ourselves. Life becomes a problem to be solved rather than something to be experienced. It's a shame, but we live in this "feel good" culture where a mood state is supposedly the end-all ("happiness is the point of life!") It leads to poor decisions.

[Delgadido]

This is how I perceive essentially ALL mental illness, and based on current literature, it may be the best answer. New learning = everything. People who use medication as a crutch are depriving themselves of using their struggles as a moment of learning. And THAT is what is prognostic of recovery. Feeling better is a perk, but the goal is to face the struggle and develop adaptive patterns of responding which are beneficial to...well, your values, and what you find to be meaningful.

Otherwise we're just numbing ourselves. Life becomes a problem to be solved rather than something to be experienced. It's a shame, but we live in this "feel good" culture where a mood state is supposedly the end-all ("happiness is the point of life!") It leads to poor decisions.

I feel that it is a coping problem. Which goes back to how we are raised. People are weaker and weaker by the day mentally and physically(immune wise).
Have you had experience with these "troubled "kids with parental manufactured behavior "disorders"

Some of them get their kids classified as add for some type of money

[Delgadido]

There was also a girl in my class who claimed to have tourette's; she moved away senior year and before she left she admitted to her friends that it wasn't real and she only did it for attention. one of the friends she told told me and didn't understand why I thought the chick was a dumb lying kunt

Many people that claim disorders are full of ****. Most people are too scared of what the world will think of them.

[KosanFalcon]

An illness IS a collection of symptoms. If the thing didn't cause any symptoms it wouldn't be an illness would it. For example humans carry lots of bacteria, but since they don't cause us harm, they don't cause any illness.

THIS type of thinking is exactly what's wrong with modern "healthcare."

[MakeABanana]

Antidepressants to "aid in grieving" is such a disgusting topic for me. And you know in the DSM-5 they are removing the bereavement exclusion criteria for MDD, so people who are grieving after the loss of a family member can be diagnosed with MDD and prescribed antidepressants. And, by psychiatric standards, that would be "acceptable practice." Disturbing.

That is absolutely appalling.

[mynameisuntz]

That is absolutely appalling.

Pretty sure adult-onset ADHD is going to be a thing, too. Currently, RESPONSIBLE psychologists/psychiatrists will not give an ADHD diagnosis unless the individual has been experiencing problems his/her entire life, dating back to 7-8 years of age and earlier. But, that may soon disappear!

So you thought ******** prescriptions were high as is? They are going to skyrocket.

The DSM is a scientific joke. Psychology has utilized all these modern day statistical analyses which could make the DSM crazy awesome and empirically standardized, and has been publishing this stuff for years. But, psychiatry is just kind of clinging to its old ways and, now, seemingly going full speed ahead on the awful bus that is the DSM.