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by unknownsky 1423 days ago
I cannot overstate how much harm this myth caused me. I first got sent to a doctor for depression when I was 12. They asked nothing about my life or my home, just gave me a test with a checklist of symptoms and then told me I had this chemical imbalance. If they had asked anything about my home, they would have discovered that my father was abusive. Then they could have told me that my father's behaviour was abuse and my depression was a natural reaction to abuse. By ignoring my life, the doctors implicitly communicated to me that the way my father treated me was normal and to be expected, and in fact his behaviour was so obviously normal that experts don't even bother asking about it.

I spent the next 20 years taking drug after drug after drug trying to find one that really and truly worked, while I was in a string of abusive relationships. Every one of the frequent trips to the doctor further cemented the idea that my relationships were normal and had nothing to do with my depression, and that this was so obvious it wasn't even worth looking into.

I finally figured it out 5 years ago. I turned instead to a domestic abuse counsellor who trained me in how to identify the difference between abusive and healthy relationships. I applied those principles and was finally depression-free.

If I had never been told this myth, then I would have reflected on what in my life might be causing the way I feel and I would have "cured" it decades earlier. The myth actively stopped me from ever doing that.

3 comments

So much of this, the chemical imbalance narrative has been incredibly harmful. SSRIs can be helpful for people but should never be given in a vacuum. People are usually are depressed because of something
> the chemical imbalance narrative has been incredibly harmful.

Yet beneficial for others. I know several people who only sought help, and came to terms with their depression, after understanding that it was not their home life, not their fault, and that it was, in their case, just a physiological imbalance (seemingly inherited for most), and where helped tremendously by ingesting chemicals.

I also have examples of people who were told that antidepressants should be avoided, and it's better to "just change" and "be happy", who are no longer with us. I think the most harm comes from oversimplifying complex topics that we barely understand, which appears to be what happened in your case, and what you appear to be approaching now.

As someone else posted, some expert opinions that are worth reading: https://www.sciencemediacentre.org/expert-reaction-to-a-revi...

You can't know that it was the chemicals that helped them.

There are studies suggesting SSRIs work better than placebo- but only slightly. Placebo works extremely well.

What I am saying is that if a doctor gives a depressed patient a sugar pill with no chemicals in it, there is a very high chance they will make a significant recovery and credit the pill. Almost as high as if they are given an actual drug.

Telling people to "just change" and "be happy" are not solutions. That's just ignoring the problem. Real help involves significant attention, resources and social support, which is expensive.

> There are studies suggesting SSRIs work better than placebo- but only slightly.

> but only slightly

I can't imagine telling someone, who's at the lowest part of their life, that they shouldn't take a medication because it will help "only slightly", especially if one is simplifying depression, and not considering context, which can result in different efficacy [1].

There are also studies that suggest that the most at risk, for certain types of depression, aren't appropriately represented in the studies [2].

> Real help involves significant attention, resources and social support, which is expensive.

I will stand by my perspective that simplifying depression is harmful, as you experienced. For some, chemicals are the best, even sometimes temporary, solution, especially when there are studies suggesting that genes play a role in some forms of depression [3], which social support probably doesn't influence.

I think it would be worth putting more value into the expert opinions, rather than simplifications/anecdotes/speculation.

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073803/

2. https://jamanetwork.com/journals/jama/article-abstract/22932...

3. https://www.nature.com/articles/s41398-021-01270-5

Totally agree, for some people chemicals are life saving, for others they are actually life ending. I think we just need to do a deeper analysis of the individual and ongoing therapy. Challenge is the economics of that
Thanks for sharing your experience. Glad you're living better now
Now who could have possibly benefited from you buying into this myth?

I’d say selling mass produced drugs on a subscription basis is a lot easier money than to talk through one patients’ problems, one at a time.

(It’s also the fault of us consumers. We do often prefer the magic pill over doing the work. This is one more story that perhaps will make us wiser.)