Psychological researchers say depression is *not* caused by chemical imbalance

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Yeah I first heard runours of this back in 2015, that they were going to be challenging the theories regarding this. It sounds like a lack of transparency in the pharmaceutical industries too.

For my friend who passes away and had medical resistant depression and anxiety it is a justification of their inadequacies too late.

I always found my meds seemed to work better on the anxiety symptoms rather than depression.

This is about Joanna Moncrieff Nature paper I presume? Yeah, it’s really blowing up. The ‘chemical imbalance’ theory has been outmoded for several years now, but I guess the general public didn’t get the memo, partly because pharma companies and doctors couldn’t find a better buzz word to explain how these drugs potentially work ( its basically a byzantine spaghetti monster of theories and pathways)

While I generally support her stance which is critical of psychopharmacology and the hegemony of biological psychiatry in general – if you take a closer look at the paper you’ll notice that things are not quite as cut and dry as she claims.

https://www.sciencemediacentre.org/expert-reaction-to-a-review-paper-on-the-serotonin-theory-of-depression/

@son_of_bob your experience is borne out by at least one recent study.

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The human body and especially the brain is so complex. From the biological perspective, the ability to control certain variables in the scientific process is so tricky. Hence, the areas of science in physics and chemistry that have advanced faster because it is easier to control the conditions of an experiment. So, as regards psychology I am sure there is still so much to understand and untangle especially regarding how certain treatments work.

However, oversimplifications or pushing too hard a model which is not the facts contributes to the growing anti-science beliefs that seem prevalent in English speaking countries at the moment and spread by misinformation on the internet/social media.

Repeatibility of results is the foundation of any valid theory. So, who challenges these industries and their results? I have heard similar claims where scientists have been shut up in their attempts to challenge claims in the shampoo, cosmetics and make up industries too. When companies are so powerful they can use legal processes to disrupt the scientific process, then we have a societal problem. Or a company just lies outright about their achievements with no scientific evidence (see Theranos).

I guess what suprises me (only speaking for UK here) is how many doctors or medical professionals will espouse the same theories with the certainty of fact to others. So, many of them help spread the viewpoint. Many people will never challenge a doctor or medical professionals opinion, because they are the expert, the idea that they might be wrong or misinformed is something unsettling.

I guess science often tries to find a useful analogy to explain complex ideas. Sometimes though that can lead people to think a model or concept is something in its entirety rather than understand that it is an approximation to the complexity of what is actually the case.

What was interesting for me, from my friends perspective was for him to be treated like a nuisance. As each medication didn’t work. I remember him often being accused of not taking his meds but he always did. The UK mental healthcare treatment leaves a lot to be desired still I think.

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My anecdotal experience: In my sadder days I tried taking 5-HTP, which is a precursor to serotonin, with the idea that more serotonin would result in more happy .

I would notice that for a week or so I would seem to feel better, generally lighter, more relaxed. I would think that it’s working!

Then I’d stop noticing any difference in mood. The only change would be my dreams remained more vivid.

Eventually I’d stop taking it and not notice any difference after stopping to take it either.

I did this 2 or 3 times with similar results.

So possibly I can see why it relates more to release of serotonin instead of serotonin itself. While my brain was adjusting to higher levels of serotonin, more was being released (as it was being produced more). And subjective mood was better. But once new homeostasis was reached – presumably at overall higher serotonin levels than before – then there was no difference. And interestingly no difference as the excess would get washed away after stopping to take it.

All highly subjective and anecdotal of course.

But what I would say now is more obviously that mood is a result of how ‘I’ am experiencing this moment of being alive, and doesn’t have anything to do with the chemicals per se – or rather it’s not the main thing. The main thing is how ‘I’ feel about it. And that can change in an instant (far faster than any chemical change could happen)…

@claudiu I guess this is a matter of levels of analysis. I am enough of a materialist to believe that whatever happens with mood change – with or without the actualism method will necessarily involve the chemicals and neurons in the brain. Otherwise how else could it happen? These changes can actually happen extremely fast - at least at the speed of thought. So in that sense there is no distinction between ‘me’ and the neurochemical processes that are involved in ‘my’ maintenance.

@son_of_bob yes broadly agree with your general scepticism of the field. But I would say that when it comes to psychiatry and the mental health industry the truth is somewhere between rapacious, pseudoscientific villains and benign boffins who only want the best for humanity!

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Ah I was getting at the distinction between

1- ‘my’ mood changes, and chemical/neuronal changes happen as a result

Or

2- chemical/neuronal changes happen and this results in ‘my’ mood changing

It seems clear that #1 is the case. Or at least that ‘I’ am the initial cause / instigator …

Put differently, if it were #2 then an actually free person could be induced to experience feelings or emotions via chemical intake or brain stimulation etc. But it doesn’t seem like that is what would happen…

I would say that the distinction is illusory as neurochemical processes and ‘me’ (or whatever is happening or not happening in experience) are two sides of the same coin - merely examined from different POV’s.

There are limitations to what chemical intake or brain stimulation can do. The possibilities are very constrained e.g. inducing neurochemical change directly or via psychedelics/brain stimulation won’t make you a concert pianist any more than it will make you actually free (or cause an actually free person to feel emotion) We don’t know what the neurochemical basis of a sense of self is - nor its absence.

I don’t read the JC’s work as disallowing a neurochemical basis for mood. She’s simply saying that the simplistic idea of ‘low serotonin’ or ‘imbalance we can balance by this nice antidepressant’ cannot be substantiated by the evidence. She would probably say that yes every human experience has a neurochemical basis but we’re very very far from figuring it out in depression and our ignorance and ham fisted attempts at pharmacological solutions have mostly been very harmful and we should focus on more social, psychological means. ( that’s me doing her haha, not my opinion exactly but I share some of her ideas)

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Also what ‘I’ am doing depends a lot on what’s happening in the neuro-pathways themselves, eg what ‘programs’ are being run and that’s a level of complexity that science is really only brushing the surface level of at this stage.

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Yes, I agree with what you say. Many of the professionals I have encountered or those in the care of family and friends have been well meaning, I have never had the situation where they aren’t trying to help. Maybe, sometimes it seems like you are not listened to, another criticism might be a lack of adaptability when situations don’t follow the expected textbook outcome.

My cousin is a psychiatrist in New Zealand now, I know it is not an easy job there are times when she has been physically hurt. I am glad there are people willing to work in this field. However, there is always room for improvement in any discipline.

Funnily enough, I almost wrote a similar draft wondering about the outcome of these myself, in relation to the long facts and feelings post (Drawing the line between feeling and fact). I was wondering about the mechanisms behind emotion/reaction.

Yes, I agree that there must be some neurochemical basis. This ties in to what I was saying was for the need for people to give an oversimplification of the process just to try and appease the public. That is why I am curious as to what additional data something link Elon Musk’s Neuralink might gather. I don’t think it will be some utopian cure for mental health issues but I am curious as to what type of data it might gather in helping to try and understand these disorders better.

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Perhaps for mood it’s trickier. But for an emotion, experientially I can see that first the emotion is triggered, and afterwards comes the chemicals and increased heart rate etc. It’s a split second perhaps but the order is clear…

Maybe the answer is very weird. Of course the physical is primary. No body or brain, no feelings. I know I talked to Richard about this and I was saying how thoughts and feelings are basically the neurons firing in action. And he said thoughts are neurons firing in action, but feelings are not. That rather feelings cause neurons to fire but are not the neurons firing themselves.

Now he can certainly be wrong. And I didn’t get into detail with him at that point of why he thought that. I don’t believe it but I don’t disbelieve it either, I am reserving judgement for a later date and keeping the idea in mind.

It certainly raises the question of what then is a feeling? :smile:

Also if feelings are neurons firing then what does that make psychic currents? … it gets weird fast.

Fair enough !

I agree that I don’t think her work says there’s no neurochemical basis for mood.

It’s certainly complex.

Where I’m coming from is that I see that the more sincere I am, the more I see it is my choice what emotions or moods I feel. Do I decide to fuel the anxiety or back out of it? Etc. so I would hesitate to say that anxiety itself has a basis, as in a fundamental founding, in neurochemistry. I would say that an anxious state is certainly characterized by a certain neurochemistry , but the way it is arrived at can’t be just certain neurons or chemicals arising. There is the ‘me’ aspect.

You say that it’s the same thing but … maybe too reductionist? What we get at is to what is the mechanism for conscious choice? How does that work? And that means we have to answer what consciousness is, in the sense of what the physical basis for it is and how it works. And humanity knows very little about that! Maybe it’s in the quantum entanglement of microtubules in the neuronal cells. Or maybe something else. Maybe neuronal activity gives rise to a physical field of some sort that then has its own rules governing it’s activity that doesn’t one-to-one correspond to the neurons themselves anymore? That seems possible given how resilient the ‘self’ is to any outside attempts to remove it. It has to decide on its own to allow to go away …

Maybe we just come at it from 2 different angles, which I suppose is what you were getting at.

The actualist/experiential angle: is mood or emotions caused by neurochemical processes? Well the question doesn’t apply , or it’s just “no”, it is caused by ‘me’ deciding , and I can decide not to.

The physical angle: is mood or emotions caused by neurochemical processes? well ultimately it’s something physical but we don’t know exactly what, so … maybe!

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I have creeping depression which seems caused by pain and pain meds. I don’t feel suicidal. It’s more like wishing I could go to sleep and not wake up.

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Sounds like oblivion to me!

@claudiu I can’t think of how an emotion exists in the absence of neurochemical change. Mood is simply emotion over a long period of time. But I’m not a atomic or molecular reductionist. I don’t believe that just because some neurons are firing or neurotransmitters are being released that emotions are less phantasmic than if they weren’t firing. And I can’ t see how Richard’s reasoning could be correct here. But in my mind, it doesn’t really matter if he is wrong. It doesn’t make emotions more ‘actual’.

Besides the above I actually agree with you. Even though I am saying that all (or most?) human experience including emotion has a neurochemical or neurophysiological correlate, I wouldn’t say that this is the most fundamental or ultimate level of analysis. This has become the default way of looking at things in our world but it doesn’t make sense to e.g. appreciate a Sonata by doing a mass spectrograph of the score or to say that ultimately a delicate pink rose is nothing but it’s atoms. A lot is lost in doing so. So I think the ultimate level of analysis for an actualist is by examining his or her experience as you are saying.

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Is that Richard’s reasoning?
I understood him to mean that emotions/feelings are not actual, not that they are not physical. AF is a physical event which changes/destroys the ability to perceive emotions. It’s a transformation of consciousness. From this position or while in a PCE it can be seen that feelings are indeed illusions. Happening, but without ultimate/rational/sensible basis.

@Elgin I was speaking specifically about the incorrectness of this reasoning or viewpoint