“Imagine a society that subjects people to conditions that make them terribly unhappy then gives them the drugs to take away their unhappiness”
— Theodore Kaczynski

FOR decades, a simple and reassuring idea has shaped how mental illness is understood and treated globally — that conditions such as depression, anxiety and schizophrenia are caused by “chemical imbalances” in the brain, and that psychiatric drugs work by “correcting these imbalances”. This narrative has become deeply embedded in public consciousness, medical training and health policy. Yet, as Joanna Moncrieff, psychiatrist and researcher argues in her book Chemically Imbalanced: The Making and Unmaking of the Serotonin Myth, this explanation is more assumption than fact.

Psychiatric medications can alter mental states and some people experience relief while taking them. Moncrieff’s challenge is more fundamental. She questions the claim that these drugs treat underlying biological abnormalities in the same way insulin treats diabetes. She argues that psychiatric medications produce altered physical and mental states like sedation, emotional blunting and stimulation, which may dampen distress but do not correct any underlying chemical imbalance.

The chemical imbalance theory has been powerful because of its simplicity in selling the message to the public. It reassures patients that their suffering is not a personal failure and gives doctors a simple scientific rationale for treatment. In poorly developed health systems, medications are a useful response to distress.

Moncrieff urges us to ask: what exactly are these drugs doing, and what are we promising when we prescribe........

© Dawn