Is depression a chemical imbalance in the brain?

Hi everyone,

I just started with a new therapist last week. She's a holistic psychotherapist. She told me that depression is not caused by a chemical imbalance, and that we have to work together to find the root cause of my depression and anxiety. She said that that theory has really been debunked and that it was a narrative made up by the drug companies to sell their pills and get people to be on pills for the rest of their lives.


I've been offf and on meds since I was 18 but most recently on meds for a solid ten years. I live in a Specialized mental health rehabilitation facility where I believe you have to be on meds to live here. But I'm not intirely sure on that one. Anyway I'm just wondering if others have heard of that and if that made you question being on meds as it has for me.

I had heard that that theory was debunked. But I don’t pay much attention because I’m bipolar and meds do help me. I’m much more stable but I’m only on two meds and do believe less is better.

I’d be very surprised if a housing situation forced people to be on meds. I think the criteria would be that you suffer from a mental health problem and are actively seeking treatment. Which you are.

There was a paper published last year that reviewed 17 studies and concluded that there is not sufficient evidence to prove that depression is caused by a chemical imbalance. It also looks at the efficacy (or lack there of) of SSRIs.
You can read it here if you're interested.

I read this too but I wonder whether there are some people, I think I’m one, who do have a genuine imbalance issue with their serotonin at stages of their life. I’m saying this because I also get migraines which are also linked to lower serotonin. When I was on Zoloft (increases serotonin) I stopped getting as many migraines and now I’m on propranolol (also increases serotonin to a lesser degree) for migraines I don’t get as many migraines and my mood has been stable. I’m no expert of course.

I agree with Nammu, the important thing is that we address the issues, be it therapy, meds or a combination. It wouldn’t be right to insist someone follow one treatment path above others in order to get housing, that sounds discriminatory.

I am not a neuroscientist, but I do know that saying depression is caused by a "chemical imbalance" is a gross oversimplification at best. The human brain is incredibly complicated, and we don't understand nearly as much about it as we might expect, given all the amazing things humans have explored and discovered. Do antidepressants work? I don't know, but I've had enough success with mine to keep taking it (not an SSRI, for what it's worth).

I do think therapy can have a huge impact on how your brain functions and how you interact with your environment in order to feel safe and get your needs met. Your brain is astonishingly plastic and learning changes its structure and function. That being said, I would be cautious about ditching medications in the advice of somebody you just met, especially if you haven't talked to whoever prescribes the medication too. Of course it's your choice to determine your own treatment, but it seems prudent to maintain healthy skepticism all around.

If you want a neuroscience-based explanation of depression and how various treatments and experiences impact the neural circuits implicated in depression, I highly recommend reading The Upward Spiral by Alex Korb. It has helped me understand why certain things you're "supposed" to do for depression work better for other people than for me (and vice versa).

Not sure how this even relevant as not only is this purely anecdotal, the review had nothing to do with migraines. It stands to reason that if you are feeling better physically your mood will improve but that still doesn’t mean the low mood was caused by a chemical imbalance.

I agree we need to be addressing the core issues but medication is not the way to do that. Also, SSRIs don’t work by increasing serotonin, they work by rationing the serotonin that you already have.

Sorry I was giving my experience only. Yes it was anecdotal I’m not a researcher.

I saw a holistic pdoc once. She told me she wouldn't treat me if I was taking western medication. I never went back.

Whether it is or isn't a chemical imbalance, I don't know. The theory that it's not a chemical imbalance is new to me. I do know that medication works for me, my sister, and my mom. My dad takes supplements that work for him (he doesn't trust doctors). I do, however, believe that depression can be relational and not have a component of chemical imbalance. While my meds work, they don't take away the issues themselves. The goal isn't to numb yourself out, just to cope better. You don't want to numb out because then you can't be present to deal with the issues.

There was a study that indicated that the chemical imbalance theory was inaccurate. However, in my view that is not the same as saying meds are not useful. If you find them useful then that's what is important.

Based on discussions with my T and others, my impression is that meds can be helpful in improving mood and reducing anxiety in a short term way, but of course they can't fix the problems in your life. They might help you out of a hole so you can get to work on your problems, but ultimately you have to do the work, in whatever form that takes.

Yes, for some people it is a chemical imbalance.

Please link to a study that actually proves this.