The Harmful Myth About the Chemical Imbalance Causing Psychiatric Disorders

By Prof. Peter C. Gøtzsche, June 28, 2019.

Mainstream psychiatry is built on myths that are harmful for patients. I described 10 of them in an article for a Danish newspaper on Jan. 6, 2014, which I published in English two weeks later on psychiatrist David Healy’s website as “Psychiatry Gone Astray” (1).

On Jan. 17, three Danish professors in psychiatry responded to my article, claiming they represented all professors in psychiatry (which trick moral philosopher Arthur Schopenhauer calls an “appeal to authority rather than reason”), in the same newspaper. I responded to the eminences in a new article four days later called “Leading Psychiatrists Have Still Gone Astray.”

As they could not win with scientific arguments, the Danish Psychiatric Association (DPA) attempted character assassination two months later and almost succeeded (2). They wrote to the leadership of the Cochrane Collaboration, which I co-founded in 1993, and found a willing instrument in Cochrane’s CEO, journalist Mark Wilson, who has never liked my reform work for patients (3), although Cochrane is about helping patients make evidence-based decisions. With his help, the DPA caused an uproar in the Danish establishment, and the Minister of Health threatened that I could get fired (2). Thou shalt not question the new clothes of psychiatry without eliciting the emperor’s rage!

One year later, I documented in great detail in my book about psychiatry why the 10 myths are myths (2).

The first myth I mentioned is also the worst: the one about chemical imbalance. Psychiatrists routinely tell their patients that they are ill because they have a chemical imbalance in the brain and they will receive a drug that fixes this. When I confronted a Danish professor of psychiatry about this nonsense back then, he declared in a newspaper that the psychiatrists had abandoned this hypothesis decades ago. However, a few weeks later the same professor spoke about chemical imbalance at a meeting where I also lectured. Clearly, the myth about chemical imbalance is only a thing of the past when challenged.

Last summer, one of my researchers and I collected information about depression from 39 popular websites in 10 countries, and we found that 29 (74%) websites attributed depression to a chemical imbalance or claimed that antidepressants could fix or correct that imbalance (submitted for publication).

It has never been possible to show that common mental disorders start with a chemical imbalance in the brain. The studies that have claimed this are all unreliable (2). A difference in dopamine levels, for example, between patients with schizophrenia and healthy people cannot tell us anything about what started the psychosis. If a house burns down and we find ashes, it doesn’t mean that it was the ashes that set the house on fire. Similarly, if a lion attacks us, we get terribly frightened and produce stress hormones, but this does not prove that it was the stress hormones that made us scared. People with psychoses have often suffered traumatic experiences in the past, so we should see these traumas as contributing causal factors and not reduce suffering to some biochemical imbalance that, if it exists at all, is more likely to be the result of the psychosis rather than its cause (4).

The myth about chemical imbalance is very harmful. It makes people believe there is something seriously wrong with them, and sometimes they are even told that it is hereditary. The result of this is that patients continue to take harmful drugs, year after year, perhaps even for the entirety of their lives. They fear what would happen if they stopped, particularly when the psychiatrists have told them that their situation is like patients with diabetes needing insulin. The Danish professor I alluded to before is considered one of the best in my country when it comes to depression, but he has also used the misleading comparison with diabetes by saying: “Who would stop taking insulin?”

Issues with mental health, ranging from mild anxiety to severe psychosis, are not caused by a chemical imbalance. In some cases, we don’t know what the cause is, but very often, it is a response to unhealthy living conditions. Most psychiatric disorders are related to anxiety and often start that way (5). When the anxiety becomes worse and hinders normal life, it can progress to depression or psychosis with delusional thoughts about people watching your every step. When people cannot live normal lives because of their anxiety, it is no wonder that a test for depression turns out positive. By not taking a complete history, going carefully and patiently many years back in time, psychiatrists and other doctors often miss the real problem completely and fail to see that they should address their patients’ anxiety with psychotherapy, not their “depression” with drugs, which do not solve any problems.

A psychiatrist I respect highly, who only uses psychiatric drugs in rare cases as an aid when he withdraws drugs his colleagues have instituted (6), has said that most people are depressed because they live depressing lives. No drug can help them live better lives. It has never been shown in placebo-controlled trials that a psychiatric drug can improve people’s lives — e.g., help them return to work, improve their social relationships or performance at school, or prevent crime and delinquency. The drugs worsen people’s lives, at least in the long run (2).

If doctors take their time at the first consultation, they will find that even severe psychoses are often related to previous trauma (7). Obviously, pills cannot heal severe trauma, although they can be useful in the hyperacute phase as an aid for falling asleep and calming down. But antipsychotics are not needed for this; benzodiazepines perform better (8).

Antipsychotics have no specific effects at all on psychosis (2). They should therefore be called their original name: major tranquilizers. This is what they do. They knock people down and render them passive. They surely create a “chemical imbalance.”


Professor Peter C. Gøtzsche, MD, co-founded the Cochrane Collaboration. He has published more than 70 papers in the top five general medical journals and six books, most recently, Death of a Whistleblower and Cochrane’s Moral Collapse. He recently launched the new Institute for Scientific Freedom with the goal of preserving honesty and integrity in science.


References

  1. Gøtzsche PC. Psychiatry gone astray.  21 Jan. 2014. DavidHealy.org. Available here.
  2. Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press, 2015.
  3. Gøtzsche PC. Death of a whistleblower and Cochrane’s moral collapse. Copenhagen: People’s Press, 2019.
  4. Gøtzsche PC. Psychopharmacology is not evidence-based medicine. In: James D (ed.). The sedated society. The causes and harms of our psychiatric drug epidemic. London: Palgrave Macmillan, 2017.
  5. McLaren N. Anxiety, the inside story. How biological psychiatry got it wrong. Ann Arbor: Future Psychiatry Press, 2018.
  6. Breggin P. Psychiatric drug withdrawal: a guide for prescribers, therapists, patients, and their families. New York: Springer Publishing Company, 2013.
  7. Varese F, Smeets F, Drukker M, et al. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull. 38(2012): 661-71.
  8. Dold M, Li C, Tardy M, et al. Benzodiazepines for schizophrenia. Cochrane Database Syst Rev. 11(2012): CD006391.

This article was written for CrossFit and is published on their website.