Mental Health Is There Biochemical 'Evidence' of Mental Illness?

[Eva 33]

I have a degree in Psychology, so I know a lot about the subject matter, but of course I don't know everything.

From everything I've studied, there is NO biochemical 'evidence' that mental illness is caused by a 'chemical imbalance' in the brain. This is a theory. This is not scientific fact.

Look at any Prozac (or other SSRI) commercial: "Depression is believed to be caused by a 'chemical imbalance' in the brain."

I was on another message board, actually trying to help someone. She became very nasty, insisting that there IS a biochemical basis for depression, schizophrenia, etc. She said that neurotransmitters are excreted in the urine, and that these excreted neurotransmitters can then be analyzed for 'imbalances'. I've never heard that one before! She went on to claim that a spinal tap can be done to further measure 'evidence' of 'chemical imbalances' within the brain's neurotransmitters. Is this true? I've never heard that one before, either.

I have some experience with people being falsely labeled by psychiatrists as "depressives", "psychotics", "bi-polar", and "schizophrenic". The drugs that these people were prescribed caused a host of nasty side effects, including tardive dyskinesia. Once these people stopped taking the drugs, their mental health actually improved and the side effects abated. (Note: Many of these people were wrongly diagnosed as children or teenagers. I think that misdiagnosis in the psychiatric community is quite prevalent, from what I've observed). Over-prescription of SSRI, tricyclic anti-depressants, and even anti-psychotics is also prevalent amongst teenage 'patients'.

Is there truly was a 'test' to 'measure' mental illness or 'chemical imbalances' within the brain, these people would have been spared years of torment by the (sometimes) unscrupulous psychiatric community. Unnecessary medications, unneeded and traumatizing 'hospitalizations', social stigma, etc. That's why I'm doubting the existence of any such diagnostic 'test'.

Even a sleep-deprived EEG cannot prove 'chemical imbalances' one way or the other. That's the only 'test' I've ever heard of being administered to someone accused of 'mental illness'. In my career, I've repeatedly seen 'normal' teenagers forced into psychiatric treatment and even psychiatric hospitalization by cruel parents, as a means of 'punishment'.

Can anyone please clear this up? Are neurotransmitters excreted in the urine, and if so, can they be measured to diagnose 'chemical imbalances' within the brain, thus diagnosing mental illness? Can a lumbar puncture and analysis of the CSF be used as a diagnostic tool to measure alleged 'chemical imbalances' in the brain, thus diagnosing mental illness? (There are so many different types of mental illness I have no idea how one would differentiate which 'imbalance' is purported to correspond with which 'illness').

Thanks to anyone who can provide a definitive answer! I'm really curious about this now.

 

[Shrooms00087]

So lets say they can't? It doesn't help anything. A person in need of help (who has money) will give anyone with authority to cure them. So lets say that they can definitely prove they are chemical imbalances. How can you manually change how you perceive thoughts, memories, and emotions? Well you can't, unless you are the person doing it. The doctor can however give them SSRI's and they may artificially be cured.

 

[a dream]

I have no definitive answers but this is what I've observed after reading hundreds of anecdotal posts online, talked to tens of other people with mental illness, read various studies and drug PI sheets, and been on quite a few drugs myself (13 different psych meds within 1 year)...

Things are way more complex than simple 'chemical imbalances' and there are probably not many good scientific diagnostic tests. Diagnostic tests can be used to rule out physical causes of certain symptoms of depression. There are tests used to see if certain drugs are working safely. There might be tests to find out if certain drugs will be effective, but I'm not sure about that. Some genetic markers have been linked to efficacy of certain antidepressants and other drugs, and to the incidence of certain disorders... but these are not at all definitive, and just say things like "people with this specific genetic state are 4 times more likely to be schizophrenic, as seen in a certain population".

I'm not sure if it's meaningful to measure neurotransmitters in a single person without having another sample from that same person at another time. The normal ranges for other medical blood tests are quite wide, IIRC, and having results outside of a normal range in of itself is not always and indicator of a problem. A measured level of a neurotransmitter probably isn't sufficient evidence to prove that symptoms are caused by that. This is total conjecture, but based on my responses to certain drugs, I think my own personal 'normal' that would be measured on such a test would be far from the median of a large population.

It's been two years since I've looked into it, but I seem to recall a before/after fMRI study dealing with serotonin... maybe it was immediately after excess MDMA (ecstasy) use, and again a few months later after the problems of excess use subsided... It was interesting, and seemed to show a clear correlation between symptoms and scientific measurements, with the cause presumably being temporary changes within the brain due to overuse of the drug. I was researching it in the context of having such suspected temporary changes caused by my own drug use.

There are probably identifiable neurological markers and neurochemical states that can be detected and linked to specific disorders. This in itself might not be enough to actually identify the cause of a disease, but only something correlated - which could be a downstream effect of the disease. But I'm not sure whether current studies and measurements are sophisticated enough.

I believe depression as a label is too high level and that prescribing any treatment based ONLY on a broad general diagnosis like that is harmful. There are very clearly different clusters of symptoms of depression, probably with different causes, and different drugs work differently depending on the specific sets of symptoms. This makes many studies not entirely useful, as they often show that drugs are not that much more effective than placebo - while they are often just testing people with "depression". A given drug can be harmful for some kinds of depression, ineffective for others, and highly effective for others.
As an example, Wellbutrin can be a good antidepressant for someone with low energy (as it's a stimulant) and Remeron may not be as it's basically an antihistamine and will make people sleepy.

It's likely that many other psychiatric labels are overly broad and prescribing treatment just based on a label is bad; treating the symptoms is better, and specifically only treating natural symptoms and not medication-induced ones. Because of the variety of symptoms, drug responses, etc. different people have, I think there are many potential causes of lots of these symptoms, and that the "undisordered" state for one person with a disorder is not going to be the same as it is for another with that disorder unless the cause of those symptoms is near-identical.

My personal situation - was prescribed various treatments for bipolar I without having any problem with natural mania; only antidepressant-induced hypomanic behavior, which didn't even meet the diagnostic criteria for bipolar II. (Ultimately a bipolar disorder expert agreed and said I'm barely bipolar, just enough that the bipolar NOS label fits better than a major depression diagnosis) The proper treatment all along was to simply discontinue the antidepressant that was causing the hypomanic behavior and consider other antidepressant approaches; not prescribe mood stabilizers and antipsychotics to reduce (hypo)manic episodes that did not exist naturally. The bipolar specialist psychiatrist has yet to order any blood tests or anything like that, so if there are any meaningful tests, they probably do not apply to my case.

I probably saved some of the sources I read while developing this opinion, but my notes are a mess and I don't have the energy to track them down right now .

 

[Eva 33]

Thanks for your reply. When certain anti-epileptic drugs (such as Depakote) are prescribed, blood tests are done to monitor liver function. This is because Depakote can potentially cause liver damage (in some people). So in that case doctors are just monitoring drug side effects.

There is so much that science does NOT know. I agree it's an extremely complicated subject, which is why I do not believe that a test exists to 'diagnose' people with depression or schizophrenia. From all that I know, the diagnosis is done through 'talk therapy', description of symptoms, and many other intangible factors.

People do NOT get diagnosed with mental illness by peeing in a cup. And as you stated, the levels of neurotransmitters would vary not only amongst patients, but would also vary within a specific patient, depending on what day they took the test and whether they had ingested any drugs. Even which food the person ate would probably alter the test result. (Low blood sugar can cause a lot of different problems). Sleep is also a crucial factor. Stress needs to be taken into consideration, as well. I'm sure the neurotransmitter results can vary depending on a person's mood at the time of such a test. Also, is the person going through situational problems, such as loss of a loved one, divorce, financial troubles, work-related stressors, family problems, etc.

I have looked at many MDMA studies and agree that they are very interesting. That's a topic that I know a fair amount about, having studied MDMA quite a bit. MDMA affects the serotonin levels in the brain, as do SSRI antidepressants.

It's also important to always remember that correlation does not equal causality. This is a scientific axiom that even many scientific researchers appear to sometimes forget. When a researcher gathers data to support his/her hypothesis, the data can often be manipulated to support the researcher's original hypothesis.

I am glad that you were able to recognize that a specific antidepressant was the cause of the hypomanic behavior and thus were able to discontinue it. Best of luck to you!

This is a fascinating topic!

 

[Jackeh]

I don't think they can really measure chemical imbalances, but I know some medications get tested and knowing their mechanism of action they can deduce what may be wrong in the brain.

For example, SSRIs and depression. They believe it works for some people and due to it inhibiting serotonin reuptake, they believe depression is a serotonin issue. There may be mistakes made though, they aren't right for everything. I think one example I seem to remember reading was serotonin possibly wasn't the cause of depression. The SSRIs may have worked by indirectly causing either upregulation or downregulation (can't remember which) of dopamine receptors, so it may be a dopamine problem that needs treated.

Can't remember if the last example is true though, I read it somewhere on this forum but don't remember when.

 

[dwamn]

i'd have to say that in a lot of cases there is no chemical imbalance causing mental illness i've known too many mentally ill people who all the different psych meds have not helped

 

[herbavore]

The idea of a chemical imbalance does two things very well: it allows people to put a name to something(from troubling to debilitating) that is obviously more than situational and 2) it sets the person up to think that there will be a purely chemical solution. For the field of psychology--from psychiatrists to medical researchers--to truly be working in towards an understanding of mental health I think it needs to be wary of unscientific terms like "chemical imbalance"..

 

[nuttynutskin]

Yeah, there's definitely changes in the brains of people with real mental disorders. I'm surprised some people think there aren't. I think the problem is that there's still a lot that isn't known and a lot more research that needs to be done (and is being done).

i'd have to say that in a lot of cases there is no chemical imbalance causing mental illness i've known too many mentally ill people who all the different psych meds have not helped

Medication affects people differently tho. I don't think it's accurate to make the assumption that there's no chemical imbalance just because psych meds didn't help someone you knew.

 

[dcrmt]

I don't think they can really measure chemical imbalances, but I know some medications get tested and knowing their mechanism of action they can deduce what may be wrong in the brain.

For example, SSRIs and depression. They believe it works for some people and due to it inhibiting serotonin reuptake, they believe depression is a serotonin issue. There may be mistakes made though, they aren't right for everything. I think one example I seem to remember reading was serotonin possibly wasn't the cause of depression. The SSRIs may have worked by indirectly causing either upregulation or downregulation (can't remember which) of dopamine receptors, so it may be a dopamine problem that needs treated.

Can't remember if the last example is true though, I read it somewhere on this forum but don't remember when.

The 'chemical imbalance' theory has completely fallen apart over the past few years. It's probably still being used to market the drugs, but it's dead in the water and un-defend-able academically.

 

[nuttynutskin]

 

[Eva 33]

The 'chemical imbalance' theory has completely fallen apart over the past few years. It's probably still being used to market the drugs, but it's dead in the water and un-defend-able academically.

Thanks, that's exactly what I thought. I've had serious doubts about the 'chemical imbalance' theory of mental illness for years. Then when I got my Psychology degree, I learned that medical science really does not know the cause of many disorders.

For example, I suffer from debilitating migraines. For years, 'medical science' told us that migraines were believed to be caused by the constriction (followed by the dilation) of blood vessels in the brain. Now, the 'theory' is a sometimes a different one: "Migraine is believed to be caused by a disorder in the 'electrical activity' in the brain". The second 'theory' is as vague and non-definitive as the first 'theory'. Yet many medical doctors still espouse the 'constriction and dilation of blood vessels' theory of migraine.

It is very frustrating when modern medical science does not even know the cause or the cure of prevalent illnesses. I'm not sure if the drugs not working for some people with mental illness really tells us anything (one way or the other) about the root cause of mental illness. Maybe, maybe not. I've taken ALL of the 'migraine drugs' (from the triptans to the ergots) and NONE of them have ever helped me. Yet there is no doubt that it is severe migraine that I suffer from. (Even the drug companies that manufacture the triptans admit that only about 75% of the patients in their own studies responded favorably to the drugs). So 25% of the subjects are still left in excruciating migraine pain. That's not all that great a success rate, particularly if you happen to be part of that unlucky 25%.

The person whom I was speaking with who was so adamant about the 'biochemical basis' for mental illness insisted that *I* produce peer-reviewed articles from scientific journals that disprove the 'chemical imbalance' hypothesis. She posted some links to scientific journal articles that she claimed supported the 'chemical imbalance' hypothesis. (I suspect those articles were funded by the drug companies). We must remember that correlation does not equal causality. I wasn't even really able to get a good look at the articles she posted, because I'm suffering from migraine.

Maybe the 'biochemical' model makes some people who suffer from mental illness feel better about the diagnosis, like it's not their 'fault'. I certainly said nothing of the sort, as I'm not an argumentative person and I don't believe that having an illness is anyone's 'fault'. (I believe the person whom I was speaking to suffered from BPD). I never denied that mental illness exists; I was merely claiming that medical science really does NOT know the cause of mental illness. Migraine is a neurological disorder, and medical science cannot even definitively state the cause of migraine.

Thanks for all the replies! Very interesting discussion.

Interesting video, NuttyNut. Yes, I'm well aware of the research that measures levels of dopamine and serotonin in the brain, then attempts to correlate the levels of these neurotransmitters to a certain mental illness (such as schizophrenia or depression). I also know that researchers have identified genetic markers for all sorts of diseases. The problem I have is that I still see nothing definitive in this research that truly supports the biochemical model of mental illness. It looks like researchers are still in the very early stages, and have a LOT of work ahead of them to truly solve these mysteries of the mind.

Note: I've actually worked at UCSF, so that was a little bit trippy!

 

[a dream]

Thanks, that's exactly what I thought. I've had serious doubts about the 'chemical imbalance' theory of mental illness for years. Then when I got my Psychology degree, I learned that medical science really does not know the cause of many disorders.

For example, I suffer from debilitating migraines. For years, 'medical science' told us that migraines were believed to be caused by the constriction (followed by the dilation) of blood vessels in the brain. Now, the 'theory' is a sometimes a different one: "Migraine is believed to be caused by a disorder in the 'electrical activity' in the brain". The second 'theory' is as vague and non-definitive as the first 'theory'. Yet many medical doctors still espouse the 'constriction and dilation of blood vessels' theory of migraine.

Not knowing what's going on is soo frustrating. I am developing various neurological symptoms and so far no doctor has been able to even give my symptoms a label... time to see a neurologist. Doctors were dismissive, too, until things recently got worse.

 

[bees_knees]

I'm the third son in my family of four sons to get schizophrenia, all of us got it from frequently perturbing brain chemistry with speed, MDMA and cannabis, all of us clearly have found no psychological basis for any of it despite trying to 'figure it out' and change our lifestyles etc. and ONLY time and antipsychotics have changed the situation. Seems to be a genetic mutation relating to the brain that causes a 'cascade' of brain chemistry changes (according to my GP) when certain stimulants or cannabis are used. Most prominent for me was/is cannabis which pretty much is a psychotic episode in a bong. I'm definitely in the chemical imbalance camp on this one.

 

[ComfortablyNumb95]

I'm not sure if it's meaningful to measure neurotransmitters in a single person without having another sample from that same person at another time. The normal ranges for other medical blood tests are quite wide, IIRC, and having results outside of a normal range in of itself is not always and indicator of a problem.

i agree. is the imbalance that causes depression or depression that causes the imbalance?
(i don't know shit about the brain so maybe it's a stupid question?)