Chemical imbalance

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Chemical imbalance is a term used as a lay explanation of mental illness or mental disorders.

The basic concept is that a chemical imbalance within the brain is main the cause of a psychiatric conditions and that these conditions can be improved with medication which corrects this imbalance. The phrase originated from the scientific study of brain chemistry. In the 1950's the monoamine oxidase inhibitors (MAOIs) and tricyclic antidepressants were accidentally discovered to be effective in the treatment of depression^[1]. These findings and other supporting evidence led Joseph Schildkraut to publish his paper called "The Catecholamine Hypothesis of Affective Disorders" in 1965.^[2] Schildkraut associated low levels of neurotransmitters with depression.

Research into other mental illnesses such as Schizophrenia also found that too little activity of certain neurotransmitters were connected to these disorders. In the scientific community this hypothesis has been referred to as the Monoamine Hypothesis. This hypothesis has been a major focus of research in the fields Pathophysiology and Pharmacotherapy for over 25 years ^[3] and led to the development of new classes of drugs such as SSRIs (selective-serotonin reuptake inhibitors)^[4]. This conceptual framework has been challenged within the scientific community, though no other demonstrably superior hypothesis has emerged. While the hypothesis has been shown to be simplistic and lacking, there is sufficient evidence to consider it as a useful heuristic in the aiding of our understanding of brain chemistry and explaining pharmacotherapy.^[5] ^[6]. Wayne Goodman, Chair of the FDA Psychopharmacological Advisory Committee, described the serotonergic theory of depression as a "useful metaphor" for understanding depression, though not one that he uses with his own psychiatric patients.^[7]

According to social critics the chemical imbalance hypothesis has routinely been promoted, and continues to be promoted as fact by pharmaceutical companies. They believe that the general population has widely accepted this flawed hypothesis into their understanding of what causes mental illness. Certain pharmaceutical companies such as Pfizer continue to prompt its antidepressant drug, Zoloft, with advertisements asserting that mental illness may be due to a chemical imbalance in the brain, and that "Zoloft works to correct this imbalance."^[8]. Most experts agree that these advertisements are oversimplified and don't directly explain what is happening. ^[9]

Beyond the advertisements, a recent piece published in Society shows that journalists often report the chemical imbalance as if it were a fact.^[10]