Psycho-Babble Medication Thread 525148

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Re: Regarding the whole Chemical Imbalance thing » linkadge

Posted by ed_uk on July 9, 2005, at 8:06:22

In reply to Re: Regarding the whole Chemical Imbalance thing, posted by linkadge on July 9, 2005, at 0:11:03

>Am also saying that there are a lot of unanswered questions as to how they work, when they work, when they fail, why they fail etc.

Now that's true!

~Ed

 

Maybe I shouldn't have posted... » linkadge

Posted by Racer on July 9, 2005, at 13:20:53

In reply to Re: Regarding the whole Chemical Imbalance thing, posted by linkadge on July 9, 2005, at 0:11:03

Maybe I shouldn't have posted this. I got set off, big time, by a post above that cited a bunch of alarmist articles about how this whole concept of "chemical imbalance" was utterly wrong, that it had no scientific basis, etc -- and that the antidepressant medications of the world were some sort of evil plot against us. That sort of thing does set me off.

I guess what I was trying to say, really, is that it's good to read things like that skeptically, and that whether or not anyone knows the exact mechanism of action, these drugs do work.

Now, you want the qualifiers? Fine. They work for some people, some time. I know that as well as you do, since I've tried so many of them over the years. For a lot of people, though, they work well enough. Just some of us, like you, me, Scott, etc -- well, we're special. How's that? We're special, so we have to try more meds.

Now I'm done with this topic. Mostly because I'm over being worked up about having those other sites cited on this board...

 

Lou's response to aspect of this thread-hrmtolif?

Posted by Lou Pilder on July 9, 2005, at 15:03:45

In reply to Regarding the whole Chemical Imbalance thing, posted by Racer on July 8, 2005, at 19:26:04

> This is prompted by a thread above, which really bothered me. In that thread, several links were posted to a series of websites that are biased against the theory of chemical imbalances as the cause of mental illness, and are oriented away from medications as treatments for mental illness, including depression. I really want to say a few things about web sites like those, and to offer a few pieces of advice about reading such sights.
>
> First of all, because the web sites in question have a very strong anti-medication/anti-"chemical imbalance" theory viewpoint, whatever they write on those sites will support that stance. They are only choosing to write what supports their stance -- or seems to support it. Here's a little secret: much of the information such sites publish is offering half-truths, rather than giving you the full story. Read this sort of thing critically, and you can see that they leave out hard facts and figures, and they also leave out anything that might possibly support other views.
>
> For example, the first site posted above spent several paragraphs expressing the idea that no one can offer up the idea chemical levels of the MAOs in the brain. OK. That's true, the only way to check the levels directly is to slice up the brain in question, which will only show the levels at the time of death.
>
> That site did not mention that you can get a pretty good estimate of those levels by metabolites in the blood stream, or from a spinal tap, etc. And it also neglected another little bit of information: the drugs that are known to raise the levels of the monoaminic neurotransmitters in the brain ACTUALLY WORK! They relieve depression. They don't do much of anything for normal people, but for people with depression, they make a difference!
>
> I didn't look at the date of that site, but I'll be generous and assume that when it says that there is absolutely no evidence for a genetic or inheritible cause of any mental illness, it's because they did not see the article from New Zealand that showed exactly that: an allele directly passed on in a Mendelian pattern that causes vulnerability to depression.
>
> I'm also betting, though, that they're unwilling to recognize family studies that show relationships between family members with related disorders. After all, that's only anecdotal, when you come right down to it, right? There's no hard science there, right?
>
> Weeeellll....
>
> Actually, that is still science, and the studies taht have been done really do show that there's a genetic trait involved in most of these disorders. They just haven't got a specific gene -- or even a specific chromosome -- to point to for it. What's more, it's likely that many of these disorders are multi-genetic, or are caused by a number of related genetic patterns. And most everyone says that having the genes will make you vulnerable to an affective disorder -- NOT that the genes will cause it directly. Environment plays a key role, as does support structures in that environment. If a child suffers a major stressor, but has adequate social and familial support, that child may develop resistance to depression -- no matter what his or her genetic heritage.
>
> So, please, when you read what's written on the web, or in magazines or newspapers, or anyplace -- please question what is written. Many times there is a bias, and many times that bias will affect what information is offered. Don't just read and believe. Use your mind. As well as reading what is said, try to read what isn't said: are they offering hard facts? Numbers are great, although often the percentages that are offered only tell part of the story. Is there a clear bias? That needs to tell you something.
>
> In the case of the web site offered above, the sneering tone in which several paragraphs were written would have tipped me off to a problem -- why sneer, unless you're sure you're making your point? And in science, you're just not supposed to start out with a point in mind.
>
> Besides, this is the medication related board, so I'm guessing most of us here haven't given up on finding a medication that helps us, right? That doesn't mean that we won't also be giving therapy a go, which has been shown to be optimal in most studies -- combination of medications and psychotherapy -- it just means that we're taking a medication. I guess I think it's a bit thoughtless -- at best -- to post links to the scare-mongering anti-medication sites on this board.
>
> OK. I'm done ranting now. Please forgive me for muddying up the board.

Friends,
I am requesting that you consider the following if you are going to post to this thread.
A. My posts of links concerning the chemical imbalance theory of psychiatry are just the start of what I would like to post about here.
You see, if the thread here is innitiated about the post in the thread that I posted the links in question, I am in the other thread mentioned responding to Dr. Hsiung's offer to show:
A. That it may not be exaggerating that psychotropic drugs could shorten one's life or cause harm to those that take them.
B. I also would like to show that the "chemical imbalance theory of psychiatry" is not accepted as fact by many in the psychiatric and psychology fields.
C. Other aspects relevant to this.
Lou

 

Re: Lou's response to aspect of this thread-hrmtolif? » Lou Pilder

Posted by linkadge on July 9, 2005, at 15:35:34

In reply to Lou's response to aspect of this thread-hrmtolif?, posted by Lou Pilder on July 9, 2005, at 15:03:45

I think most of us know that the chemical imballance theory is not a "fact". Though, I don't understand what you're trying to say.

There are many things in life that we do dispite not haveing a full insight into the apparent workings. I guess it comes down to weather you want to suffer or not, there's not much beyond that.

Linkadge

 

Racer, I understand what you're trying to say

Posted by linkadge on July 9, 2005, at 15:54:50

In reply to Lou's response to aspect of this thread-hrmtolif?, posted by Lou Pilder on July 9, 2005, at 15:03:45

There are many people who come on this board and think that they can disuade me from using psychiatric medications.

I have my reserves about psychatric medications, as do many people on this board.

I think there is some sort of false idea, that everyone who uses them is narrow-minded, looking for the quick and easy route out, and that we have no idea about the side effects etc.

We know the side effects.

We know what they can do.

We are able to distinguish between true side effects, and those proposed by anti-psychiatry sensationalists.

Many people come on the board claiming to have some new information about why they should not be used.

I admit I *used* to get offended. But then I said to myself. I know the pros and cons. I know fully what they can, and cannot do. I am prepared to face the consequences. Some people think that I don't have a head on my shoulders, and cannot think for myself.

I think that some people find their own way out, and they *assume* that their coping mechanisms will work for everbody.

If you want to post some new information go right ahead. But, will tell you this. The information had better be scientifically based, or I will brush it off.

Even though I am not on anything right now, I will sit here and stand behind my right to take psychiatric meds.

Understanding this, be my guest.


Linkadge

 

Lou's response to aspect of this thread-nohop

Posted by Lou Pilder on July 9, 2005, at 17:22:11

In reply to Re: Lou's response to aspect of this thread-hrmtolif? » Lou Pilder, posted by linkadge on July 9, 2005, at 15:35:34

Friends,
If you are going to post to this thread, I am requesting that you consider the following before you post.
A. A poster writes here something like,[...there are many things we do in life despite not having a full insight...]. The poster does not give examples of such
B. A poster writes,[...it comes down to weather you want to suffer or not...]. The poster does not write an explanation of what that could mean. Could it mean that if you take psychotropic drugs that you will suffer? Could it mean that unless you take psychotroic drugs that you will suffer? Could it mean that only those that take psychotropic drugs do not suffer?Could it mean that you {must} take psychotropic drugs or you will suffer?
C. A poster writes,[...there is not much beyond that...]. Is that a conclusion based on fact? Is the poster saying that there is no hope to overcome unless you take psychotropic drugs?
Lou

 

Linkadge's Response

Posted by linkadge on July 9, 2005, at 17:39:16

In reply to Lou's response to aspect of this thread-nohop, posted by Lou Pilder on July 9, 2005, at 17:22:11

I'll post the way I choose to post thank you very much. Take it for what it is.


Linkadge

 

Re: Lou's response to aspect of this thread-hrmtolif?

Posted by SLS on July 9, 2005, at 19:53:41

In reply to Lou's response to aspect of this thread-hrmtolif?, posted by Lou Pilder on July 9, 2005, at 15:03:45

Anyone who is a bipolar ultra-rapid cycler will argue passionately that what they suffer from must be some biological illness beyond their control to modify.

You should only know.

I pray for you that you never shall.

I know.


- Scott

 

The world is still flat.

Posted by SLS on July 9, 2005, at 20:10:19

In reply to Lou's response to aspect of this thread-hrmtolif?, posted by Lou Pilder on July 9, 2005, at 15:03:45

:-(

 

Re: The world is still flat. » SLS

Posted by Phillipa on July 9, 2005, at 20:17:06

In reply to The world is still flat., posted by SLS on July 9, 2005, at 20:10:19

I'm sooooo sorry Scott. Fondly, Phillipa

 

Re: The world is still flat.

Posted by linkadge on July 9, 2005, at 20:47:46

In reply to Re: The world is still flat. » SLS, posted by Phillipa on July 9, 2005, at 20:17:06

You mean that the world is still flat in that our acceptance is still narrow.

Linkadge


 

Re: Maybe I shouldn't have posted... » Racer

Posted by SLS on July 9, 2005, at 21:31:09

In reply to Maybe I shouldn't have posted... » linkadge, posted by Racer on July 9, 2005, at 13:20:53

> Maybe I shouldn't have posted this.

Why not?

Unfortunately, what you have drawn attention to is a ubiquitous topic of debate and contention. There should be none at this point in human history, but there is. To some, the world is still flat. For them, anything that upsets this notion often brings about defensiveness and a panicked attempt at expousing a liturgy without the enlightenment that humanity's objecive investigation into mental illness has demonstrated.

I think you are in agreement with most others along this thread that abnormal biological function contributes to most cases of Major Depressive Disorder (MDD) and Bipolar Disorder (BD). I see that there is some confusion here as to semantics and the descriptions of the details of the varying models of the etiologies of these disorders.

I think there is some confusion as to what a theory is.

Evolution is still a theory. We here this expression used all the time by those who would have us believe that evolution has not been proven. It has. It is a fact that it occurs. However, there are varying theories as to how it occurs. Likewise, it is now a fact that MDD and BD are illnesses involving brain function. However, there are varying theories as to how this occurs. One theory is that there is a chemical imbalance within the synapse between neurons. Other theories try to incorporate recent observations involving the abnormal structure and function of the brain.

Is depression the result of a chemical imbalance?

I don't know. However, I am sure that depression can be a disorder of the brain.

From the NIMH, NIH:

http://www.nimh.nih.gov/publicat/depresfact.cfm

"Evidence from neuroscience, genetics, and clinical investigation demonstrate that depression is a disorder of the brain. Modern brain imaging technologies are revealing that in depression, neural circuits responsible for the regulation of moods, thinking, sleep, appetite, and behavior fail to function properly, and that critical neurotransmitters—chemicals used by nerve cells to communicate—are out of balance. Genetics research indicates that vulnerability to depression results from the influence of multiple genes acting together with environmental factors. Studies of brain chemistry and of mechanisms of action of antidepressant medications continue to inform the development of new and better treatments."


- Scott

 

Re: The world is still flat.

Posted by Phillipa on July 9, 2005, at 22:33:11

In reply to Re: The world is still flat., posted by linkadge on July 9, 2005, at 20:47:46

Again I'm simplistic. Just go to a psych hospital and watch what happens to a schizophrenic or Bipolar once their meds are adjusted. But there is abuse of the system too. Fondly, Phillipa

 

Re: Lou's response to aspect of this thread-hrmtolif? » Lou Pilder

Posted by Sarah T. on July 9, 2005, at 22:37:13

In reply to Lou's response to aspect of this thread-hrmtolif?, posted by Lou Pilder on July 9, 2005, at 15:03:45

Psychotic people should be on medication. They should also be in therapy. Psychotic people with OCD should be on medication. They should also be in therapy. Psychiatry and psychotropic drugs are still deeply flawed, but it is painfully clear that, for some people, the alternative is far worse.

 

Not sure... » linkadge

Posted by Racer on July 9, 2005, at 23:30:55

In reply to Racer, I understand what you're trying to say, posted by linkadge on July 9, 2005, at 15:54:50

I was certainly *not* suggesting that people avoid psychotropic drugs, Link. I was writing about this because I think there are a lot of people -- especially in the depths of depression -- who might read those pages and get freaked out. You said that you had gotten a bit freaked out once or twice yourself, right? Imagine being a newbie to depression, etc, and coming across those pages that say ADs are terrible and dangerous?

I doubt anyone still remembers when I first posted here -- maybe SLS? -- but I had just been prescribed Serzone, and was too worried to take it. (As it turned out, I was right to be concerned, but that's another topic...) I wanted more information about whether or not it would be safe for me before I took it. If I had been greeted by something that told me that psychiatric medications were dangerous, would shorten my life, were the wrong way to go, etc, well, I would have taken the acepromazine cocktail that I was already considering.

And you're right: too many people assume that those of us who choose to take psychiatric medications are doing it as a shortcut. They don't realize how many of us either are in therapy, or would like to be in therapy as well.

We're on the same team, Link. And I owe you a long email, but have gotten smashed lately with a couple of things...

 

Re: Not sure... » Racer

Posted by linkadge on July 9, 2005, at 23:57:10

In reply to Not sure... » linkadge, posted by Racer on July 9, 2005, at 23:30:55

I definately agree with you and see where you're coming from.

I throw out a lot of ideas, essentially to learn more. But by no means am I condeming psychiatric meds as a whole.


Linkadge

 

Good rant (nm) » Racer

Posted by gardenergirl on July 9, 2005, at 23:57:29

In reply to Regarding the whole Chemical Imbalance thing, posted by Racer on July 8, 2005, at 19:26:04

 

And by that I mean... » gardenergirl

Posted by gardenergirl on July 10, 2005, at 0:05:33

In reply to Good rant (nm) » Racer, posted by gardenergirl on July 9, 2005, at 23:57:29

Critical thinking is a valuable skill to have, especially when evaluating treatment choices for your health.

I think one would do well to develop a good understanding of what the problem is, perhaps in collaboration with a consultant/professional; carefully and critically evaluate all treatment options, again perhaps along with a professional; make and implement a treatment decision; and then evaluate your decision, adjusting if necessary.

I think if I only read one side of an issue, I am cheating myself of data that likley would be useful in making my decision.

gg

 

Re: please be civil » Lou Pilder

Posted by Dr. Bob on July 10, 2005, at 8:43:44

In reply to Lou's response to aspect of this thread-nohop, posted by Lou Pilder on July 9, 2005, at 17:22:11

> A. The poster does not give examples of such
> B. The poster does not write an explanation of what that could mean.

Please don't post anything that could lead others to feel accused or put down.

If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:

http://www.dr-bob.org/babble/faq.html#civil

Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.

Thanks,

Bob

 

Re: Racer, I understand what you're trying to say » linkadge

Posted by Sarah T. on July 10, 2005, at 13:03:18

In reply to Racer, I understand what you're trying to say, posted by linkadge on July 9, 2005, at 15:54:50

>> If you want to post some new information go right ahead. But, will tell you this. The information had better be scientifically based, or I will brush it off.>>>> Linkadge>>>>>>

Hi, Linkadge,
I agree with you. When I was a teenager, someone gave me some excellent advice that I have repeated to myself many times over the years. I was very upset about something that someone else had said to me, so I discussed the problem with an older friend. He said, "Whenever something like this happens, look where it's coming from. Look at the source." This is so important in many areas of life, particularly when it comes to medical and scientific issues; however, even medical and scientific information should be examined carefully. For example, whenever I read a drug study, I always look to see who funded the research. If the company that is manufacturing the drug funded the study and stands to profit from the marketing of the drug, I know that I should approach the article with even greater scrutiny.

"Look where it's coming from," should also be applied to any advice dispensed by movie stars and other celebrities. There has been a lot in the press lately about Tom Cruise, $cientology, and Cruise's advice to Brooke Shields and others to avoid antidepressants, which ignorant Mr. Cruise referred to as "antipsychotics." It's disturbing that so many people value what movie stars have to say about everything from health care to politics. Tom Cruise has absolutely no medical or science background, and his behavior reveals that he desperately needs medication.

It's sad that, often, those with the severest forms of mental illness, those most in need of medication, are the ones who are most opposed to treatments that could help them lead fairly normal, productive lives.

 

Re: Racer, I understand what you're trying to say

Posted by linkadge on July 10, 2005, at 15:38:49

In reply to Re: Racer, I understand what you're trying to say » linkadge, posted by Sarah T. on July 10, 2005, at 13:03:18

I agree with you fullt. The people who are the most "well" are the ones who are the most accepting, and openminded.

When somebody comes to me and makes some careless remark such as this, I simply say to myself that "this says more about them, than it does about me"


Linkadge

 

Re: Regarding the whole Chemical Imbalance thing

Posted by FredPotter on July 10, 2005, at 23:59:06

In reply to Regarding the whole Chemical Imbalance thing, posted by Racer on July 8, 2005, at 19:26:04

Kidneys go physically wrong. So do livers. Chemically too. Why should the most complex organ in the body not go wrong too? Of course the mind/brain is in a complex functional relationship with behaviour and the world. Everything cuts 2 ways each set 180 deg to each other. To me the world is a sense experience. To the world I am a complex bunch of chemicals
Fred

 

OZZY OSBOURNE HAS NO CHEMICAL IMBALLANCE » Racer

Posted by paulbwell on July 11, 2005, at 0:51:09

In reply to Regarding the whole Chemical Imbalance thing, posted by Racer on July 8, 2005, at 19:26:04

> This is prompted by a thread above, which really bothered me. In that thread, several links were posted to a series of websites that are biased against the theory of chemical imbalances as the cause of mental illness, and are oriented away from medications as treatments for mental illness, including depression. I really want to say a few things about web sites like those, and to offer a few pieces of advice about reading such sights.
>
> First of all, because the web sites in question have a very strong anti-medication/anti-"chemical imbalance" theory viewpoint, whatever they write on those sites will support that stance. They are only choosing to write what supports their stance -- or seems to support it. Here's a little secret: much of the information such sites publish is offering half-truths, rather than giving you the full story. Read this sort of thing critically, and you can see that they leave out hard facts and figures, and they also leave out anything that might possibly support other views.
>
> For example, the first site posted above spent several paragraphs expressing the idea that no one can offer up the idea chemical levels of the MAOs in the brain. OK. That's true, the only way to check the levels directly is to slice up the brain in question, which will only show the levels at the time of death.
>
> That site did not mention that you can get a pretty good estimate of those levels by metabolites in the blood stream, or from a spinal tap, etc. And it also neglected another little bit of information: the drugs that are known to raise the levels of the monoaminic neurotransmitters in the brain ACTUALLY WORK! They relieve depression. They don't do much of anything for normal people, but for people with depression, they make a difference!
>
> I didn't look at the date of that site, but I'll be generous and assume that when it says that there is absolutely no evidence for a genetic or inheritible cause of any mental illness, it's because they did not see the article from New Zealand that showed exactly that: an allele directly passed on in a Mendelian pattern that causes vulnerability to depression.
>
> I'm also betting, though, that they're unwilling to recognize family studies that show relationships between family members with related disorders. After all, that's only anecdotal, when you come right down to it, right? There's no hard science there, right?
>
> Weeeellll....
>
> Actually, that is still science, and the studies taht have been done really do show that there's a genetic trait involved in most of these disorders. They just haven't got a specific gene -- or even a specific chromosome -- to point to for it. What's more, it's likely that many of these disorders are multi-genetic, or are caused by a number of related genetic patterns. And most everyone says that having the genes will make you vulnerable to an affective disorder -- NOT that the genes will cause it directly. Environment plays a key role, as does support structures in that environment. If a child suffers a major stressor, but has adequate social and familial support, that child may develop resistance to depression -- no matter what his or her genetic heritage.
>
> So, please, when you read what's written on the web, or in magazines or newspapers, or anyplace -- please question what is written. Many times there is a bias, and many times that bias will affect what information is offered. Don't just read and believe. Use your mind. As well as reading what is said, try to read what isn't said: are they offering hard facts? Numbers are great, although often the percentages that are offered only tell part of the story. Is there a clear bias? That needs to tell you something.
>
> In the case of the web site offered above, the sneering tone in which several paragraphs were written would have tipped me off to a problem -- why sneer, unless you're sure you're making your point? And in science, you're just not supposed to start out with a point in mind.
>
> Besides, this is the medication related board, so I'm guessing most of us here haven't given up on finding a medication that helps us, right? That doesn't mean that we won't also be giving therapy a go, which has been shown to be optimal in most studies -- combination of medications and psychotherapy -- it just means that we're taking a medication. I guess I think it's a bit thoughtless -- at best -- to post links to the scare-mongering anti-medication sites on this board.
>
> OK. I'm done ranting now. Please forgive me for muddying up the board.

The Ozz man has no brain chemical imballance, only a family inhereted tremble-YER RIGHT

You don't do over 1000 LSD trips, snort Cocaine daily, and remain almost constantly drunk (4 bottles of Congac daily at worst) for 25 years and expect the brains chemistry to return to normal when you quit the drugs n Booze?

Cheers

 

Life is a chemical imbalance

Posted by so on July 11, 2005, at 12:00:04

In reply to Re: Regarding the whole Chemical Imbalance thing, posted by FredPotter on July 10, 2005, at 23:59:06

I won't weigh in here regarding the propriety of various psych drugs, though basic research will show that historically drugs once touted as the best of the best have later fallen in esteem. Drugs once presumed to be the best available have later been recognized as not the best approach, and such evolving understanding is likely to continue, even regarding some drugs in wide use these days.

It's just that I've never felt too persuaded by this chemical imbalance assertion. Which chemical is imbalanced? Is it a deficiency or an excess of that chemical? What is it imbalanced against? If there is too little serontonin to satisfy an increased number of receptor sites, are the chemicals imbalanced or has the architecture of neurons become "imbalanced"? Is diabetes a "Chemical imbalance"? Is liver disease a "chemical imbalance"? What about Alzheimers, with its atropy of neural networks? We can accurately describe the atropied networks as assemblages of imbalanced chemicals.

If most diseases result from some sort of deficiency or excess of various chemicals, how is "chemical imbalance" any more descriptive of diseases related to a particular organ such as the brain? As one writer points out, the term "Chemical imbalance" seldom if ever appears in scientific literature. It more often appears in contexts intended to encourage clients to comply with medical advice, or to encourage associates of a client to support medical advice. For the majority of clients and families it might be useful rhetoric, but for me, it hints that someone is offering a remedy they cannont fully explain, and it tends to alert me that there is more to the explanation than I am being offered in a cursory reference to a "Chemical imbalance". Without a more detailed explanation of how a drug is expected to cause an intended effect, I am unlikely to swallow any drug intended to alter my mental outlook.

 

About the phrase Chemical Imbalance

Posted by Racer on July 11, 2005, at 12:35:39

In reply to Life is a chemical imbalance, posted by so on July 11, 2005, at 12:00:04

OK, since Scott pointed out that you won't find the phrase "Chemical Imbalance" in the scientific literature, I figured it was worth offering another two cents worth on the phrase itself...

I believe that it's used because of the stigma surrounding mental illness. Rather than a doctor trying to convince a patient that a mental illness like depression or bipolar is *not* just a character flaw, which might involve hours of discussions that lead nowhere, I think a lot of energy has been focussed on reinforcing the belief that these disorders are "real" in the sense that something like diabetes is real. Saying that there's an imbalance in the brain's chemical messengers can make it easier to convince someone to take a medication, even if that person wouldn't ever agree to take a "happy pill" or an antidepressant, simply because he or she won't cop to a mental illness.

Now, those of us on this board are not the average psychotropic drug takers, and certainly not the average SSRI takers. We are a sub-group who have chosen to educate ourselves about our medications, for whatever individual reasons we have for that choice, and we are generally not people who respond adequately to the first anti-depressant tried. (Or, in some cases, to the eighth anti-depressant tried, but that's another story...) I don't think we can use our own experiences as the norm.

Years back, I told a doctor that I needed to understand what was being prescribed to me, because depression was complex, and just being given a pill didn't work. She told me that, for most of her patients taking anti-depressants, they didn't *want* to know anything more than "take this pill daily" -- they didn't want to be involved in their care beyond taking their pills. That was a real shock to me, as you can imagine. It's worth keeping in mind, though, that a lot of people don't want to be involved in decision making about their care, and don't want to know anything beyond how many pills to take and when.

So, "chemical imbalance" is a handy phrase to be trotted out for many patients who can benefit from anti-depressants, and even handier for those people who know they need the meds, but can't bring themselves to try to explain it to others, because of the stigma attached.


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