The general public’s belief in that many mental health disorders are caused by an imbalance is still widespread. (1) This post challenges that belief with quotes from recent major texts. Don’t take my word for it, the links to source material and page numbers are the bottom. These are large scale multidisciplinary texts that are endorsed by the major UK Mental Health Associations.
“The whole ‘chemical imbalance’ theory of depression is now dismissed as overly simplistic by academic Psychiatry” (2)
Take, for example, the common belief that antidepressants replace a particular chemical that one is naturally lacking. There is no consistent evidence that supports this theory.
“High-profile claims for a causal ‘imbalance’ of neurotransmitters such as serotonin remain unproven” (1)
The underlying assumption is that biology is causing mental health issues. However:
“In relation to the great majority of psychiatric diagnoses including those experiences and behaviours labelled as schizophrenia, bipolar disorder, depression or depressive disorder, anxiety disorder, personality disorders and eating disorders, there are no consistent associations with any biological pathology or impairment, and no biomarkers have been identified." (1)
In other words, despite a huge amount of research and investment in exploring these questions, we can't find any quality and consistent evidence of there being imbalances that cause the vast majority of mental health challenges.
Here's a final quote from Professor Irving Kirsch in Johan Hari’s great book “Lost Connections”:
“The idea you feel terrible because of a ‘chemical imbalance’ was built on a series of mistakes and errors. It’s come as close to being proved wrong as you ever get in science” (3)
References (1) Johnstone, L. & Boyle, M. with Cromby, J., Dillon, J., Harper, D., Kinderman, P., Longden, E., Pilgrim, D. & Read, J. (2018). The Power Threat Meaning Framework: Towards the identification of patterns in emotional distress, unusual experiences and troubled or troubling behaviour, as an alternative to functional psychiatric diagnosis. Leicester: British Psychological Society. https://www.bps.org.uk/guideline/power-threat-meaning-framework-full-version Pages 153 & 158.
(2) Rizq, R., Guy, A. with Stainsby, K. (2020) A short guide to what every psychological therapist should know about working with psychiatric drugs. London: APPG for Prescribed Drug Dependence. https://prescribeddrug.info/short-guidance/ Page 38 of the full version.
(3) Hari, J. (2018). Lost connections: Uncovering the real causes of depression-and the unexpected solutions. London: Bloomsbury Circus. https://thelostconnections.com/ Page 36.