Let’s avoid talk of ‘chemical imbalance’: it’s people in distress

Thanks for sharing. I've always been firmly grounded and positive person. And then a few years ago riding my bike down the road, I felt a immense wave of anxiety coming over me so intense that I felt like jumping off my bike and running away from myself. As an ex army special forces guy I found this particularly disturbing. And this was just the beginning. My situation continued in that general direction until I started experiencing pain in my liver area. I hoped it would go away but it didn't, so two months ago I decided to face it head on and get full tests done. Xrays, CT scans, ultrasounds, blood work. urinalysis the works. All came back clear. But I just felt it was not me... and searching my symptoms pointed to parasites. So I did a 6 day liver cleans (cant recommend this enough) followed by adjusted diet and two rounds of combantrin I'm please to be back to a very good place.

Depression and anxiety are nasty. I was surprised to learn they are symptoms of parasites. They've evolved in such a way that they can manipulate the host into craving foods that are beneficial for them (not for the host). Symptoms among others include anxiety, depression and irritability.

>This is a pretty big assertion that the piece casually drops without backing

My understanding was that the results of the author's interviews were the backing for this assertion:

>As the interviews made clear, people adopted the biogenetic account because they thought it was based in science. The interviews also show how this account undermines the kinds of introspection and self-examination that can lead to meaningful self-knowledge. >Mental health treatment needs to re-engage with the language of persons. This means suspending the detached, third-person stance toward patients, and attending to their actual experience and circumstances. And it means encouraging patients themselves to avoid this stance and draw on the normal ways that people make sense of their emotions and actions.

Or do you mean that the conclusion the author reaches, that we should be attending to people's experiences instead of using "biogenetic causal language," isn't justified by the results of the interviews?

> However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.

This is hugely compounded by the fact that even when people do decide to go for treatment like therapy, they discover that its painfully inaccessible. As in, if you don't have enough money to afford the 100$+ hour sessions, you feel like you completely run out of options.

There are more services trying to address this cost issue but from my experience (in Canada), they leave a lot to be desired

> That's fantastic you found the right SSRI for you immediately, that's incredibly rare.

It's not accurate to say that it's "incredibly rare". Most people can expect at least some dosage adjustments, if not a few trials of different medications.

However, most people will see some improvements from any antidepressant treatment, even if it's not full remission. Getting to full remission is the challenge that requires fine-tuning.

Practically speaking, antidepressant medication shouldn't be viewed as a one-stop solution to depression treatment. It should be used as a larger treatment regimen involving therapy (ideally professional, but even self-directed with books is helpful) and lifestyle changes to identify and address the source of the problems.

As such, even a minor boost from an antidepressant can help move a person in the right direction, even if it isn't a one-stop cure for the depression. We need to collectively get past this idea that antidepressants are an all-or-nothing cure all and start viewing them as an adjunct to getting back on your feet and staying there.

I'm not sure what to make of this piece. First:

> Psychiatric research doesn’t support the notion of simple cause and effect in mental health, instead uncovering a far more complex and indeterminate picture of vulnerabilities. There is no evidence to justify the continued promotion of one-dimensional theories such as ‘chemical imbalance’.

I wholeheartedly agree with this, and believe that it's a huge problem with the mental health discourse. However, the author then goes on to say:

> Mental health treatment needs to re-engage with the language of persons. This means suspending the detached, third-person stance toward patients, and attending to their actual experience and circumstances. And it means encouraging patients themselves to avoid this stance and draw on the normal ways that people make sense of their emotions and actions.

A problem I've experienced is that "the normal ways that people make sense of their emotions and actions" do not seem to work for me. I haven't found a good description of it, but something in my sensory and cognitive feedback loop seems to be broken such that I don't get any useful sense of things in the moment and need to reverse-engineer my emotional state after the fact when it seems important to do so (NB: I don't just mean that this disconnect occurs when there's some kind of intense moment; it's pretty much constant). So I don't see how it's possible to both hold that up as the standard and also respect my "actual experience and circumstances". In other words, this sure seems like exactly the sort of one-dimensional theory of mental illness that the author decried earlier.