Part 7: Anxiety Medications Series

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The “Chemical Imbalance” Theory

Over the past two decades there has been a dramatic shift in the way our culture thinks about mood problems (depression, anxiety, fear, etc.). The trend is to regard these problems as treatable medical conditions caused by chemical imbalances in the brain that are easily corrected with medication. Drug companies have increased sales exponentially by marketing antidepressants directly to consumers, claiming that mood problems are caused by an imbalance of chemicals in the brain that can be “evened out” with medication.

The chemical imbalance theory, however, is far from enjoying any scientific consensus. Elliot Valenstein Ph.D., Professor Emeritus of psychology and neuroscience at Michigan University, states emphatically, “Contrary to what is often claimed, no biochemical, anatomical or functional signs have been found that reliably distinguish the brains of mental patients.”[1] It is not currently possible to measure serotonin levels or absorption rates inside the brain.[2] It can be measured in various bodily fluids, but the levels in those fluids may not reflect levels in the brain. In a psychopathology textbook used for second-year medical students, the authors state, “Psychiatry is the only medical specialty that … treats disorders without clearly known causes.”[3]

The only things we know for sure about these drugs are (1) they do something to the brain and (2) they affect the way a person feels.

Do Antidepressants Work?

In 2005 Joanna Moncrieff and Irving Kirsc published a review of the data from studies done by the National Institute for Clinical Excellence (NICE) in the British Medical Journal. They point out that the NICE data reveals the following:

SSRI’s have no clinically meaningful advantage over placebo.

Claims that antidepressants are more effective in more severe conditions have little evidence to support them.

Antidepressants have not been convincingly shown to affect the long term outcome of depression or suicide rates.[4]

NICE continues to recommend that antidepressants should be first line treatment for moderate or severe depression, despite the evidence from its own research data.

The Placebo Effect

These findings are remarkable, particularly in light of the fact that it is impossible to know how much influence the “placebo effect” has in the studies.[5] The placebo effect refers to the fact that there are very powerful influences at work in the body in response to the belief that a medicine will work.

It is not unusual for doctors to prescribe placebos when no medical problem can be discovered, and research as demonstrated that this practice can be remarkably effective. The pharmacist fills a bottle with sugar pills, affixes a fictional label such as, “Reniphin, for severe pain,” and very often the patient experiences relief.

This does not mean the ailment was imaginary. The body has remarkable ability to heal itself when there is a high level of confidence in a remedy. Double blind crossover studies have shown that placebos have worked well for a variety of ailments, including:

severe pain (35 percent of those studied said a placebo had the same effect as an injection of morphine)

stomach ulcers (the placebo was found to be 50 percent to 75 percent effective in stopping the bleeding, even though there was no active ingredient)

incontinence (74 percent of the people with this problem improved with a placebo)

arthritis

high blood pressure (85 percent of those affected experienced a significant drop in blood pressure with a placebo).[6]

If placebos are that effective for physical problems, it would be no surprise to discover they can be even more effective for mood problems. And the placebo effect in mood medications is decidedly greater due to the fact that they take so long to take effect. A patient feels depressed, is given an antidepressant, and is told to watch for a change in the next couple weeks. It is normal to have emotional ups and downs over a period of weeks, and if a person has begun taking a medication the natural “ups” will be attributed to the drug rather than to the countless other factors that may have caused them.

It Isn’t Working

The use of SSRI’s has increase 1300% since 1990,[7] but the percentage of the population suffering from depression has not seen a corresponding decrease. In fact, studies have shown no decrease at all in the occurrence of depression over the past ten years.[8] There are some who report feeling better after taking certain antidepressants, but the reason remains unknown. There is a possibility that the drugs actually have a positive effect on the mood of certain people. However there are several possible explanations:

The Placebo Effect

The general deadening effect antidepressants often have on the emotions. Taking an antidepressant does not cause a person to feel refreshed, energetic, happy, and full of motivation. Even those who are helped the most by antidepressants usually report not joy or happiness, but rather feeling slightly less depressed.