Today I am talking about fixing depression quickly through medication, the years old fairy tale of the “Chemical imbalance” in the brain that causes depression and a whole array of other mental illnesses. Whereas in past decades people have blamed mothers for peoples’ mental health problems, nowadays theories favour the defective brain as the cause for issues people struggle with.
It is amazing that theories of biological causes manage to remain in the forefront of the discussion between doctor/health professional and patient – given that there is no evidence to prove these theories right. A large number of researchers have already in the late 90s pointed out that the biological-chemical-imbalance-theory is a creative construction kept alive by the pharmaceutical industry.
Elliot S. Valenstein has shown in 1998 (Blaming the Brain: The Truth about Drugs and Mental Health, The Free Press, New York) that biological theories are based on accidental discoveries, for example that depressed people often have a low level serotonin. Drug companies through their funding of research, professional organisation, professional journals, and conferences exercise a huge influence on researchers and clinicians. In 96% of studies that received financial support for their research, researchers found in favour of the drug tested while only 37% of researchers who did not receive support found in favour of the drug (Tanouye, 1998, Does corporate funding influence research. Wall Street Journal, B1, B6).
Aggressive promotion (pharmaceutical companies spend between US$ 10.000 and 15.000 per year per physician on marketing, between 20 and 30% of the annual budged for the American Psychiatric Association comes from pharmaceutical companies (Duncan, Miller, and Sparks, 2000. The myth of the magic pill. Family Therapy Net worker).
However, it seems to be more comfortable for people to accept a floored theory of biological origins of mental illness rather than dealing with the discomfort of not really knowing how come people become so disturbed. Indeed, so much so that in 1997 overall 74% of patients were treated with drugs for depression while a decade earlier only 37% turned to drugs. Clients attending psychotherapy declined proportional to the rise of drug use.
Valenstein argues that we barely understand the origins of mental illness. He found in the studies he analysed that a combined approach of medication and therapy seems to give the highest likelihood of success at treating common disorders. And when it comes to therapy, we enter into a similar controversy, namely which of the different theoretical models is most effective. But that is another post. A brief preview: none of the therapeutic approaches has demonstrated to be more effective than others. It’s not the approach that delivers the active ingredient, it’s the relationship that is developed between therapist and client.