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Talk:Chemical imbalance

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I am tempted to throw this up on VfD. I did a quick check for "chemical imbalance theory" a term I have never heard of in the context of medicine or psychology before. I came up with 510 hits for the term, the vast majority from heavly POV sites with an axe to grind. If anything this is a neologism, and the article should reflect it as such. In the study of medicine, chemicals are widley known to be important, the entire field of biochemistry would be useless without this. The "chemical imbalance theory" is a term applied to talk about a view about a bias in medicine or some such. Certainly, this article does not accurately describe it--Tznkai 22:39, 12 Jun 2005 (UTC)

Thanks, Tznkai, for the feedback. Your critique spurred a search on goofle for '"chemical imbalance" drug', which turned up 54,000 hits. Your recognition of the lack of drug industry perspective helped finding articles which can now be integrated into the article. Part of the problem is that the drug industry presents the theory as fact, rather than the reality that it is just a theory. The term has been used widely in pharmaceutical commercials by the industry, primarily by Pfizer, to promote drug use. The notion of psychiatric 'chemical imbalance' came up just today in a UPN broadcast movie, Murder of Innocence (Valerie Bertinelli as a newlywed descending into madness). Again, your feedback is appreciated. Ombudsman 23:36, 12 Jun 2005 (UTC)
The chemical imbalance theory doesn't exist as a coheisive seperate theory from the idea that biochemistry is important, and that neurotransmitters are important. Furthermore chemical imbalance and chemical imbalance theory are not the same thing at all.--Tznkai 04:41, 13 Jun 2005 (UTC)
This is one of a number of articles that seems extremely lop-sided, much like psychosurgery. Chemical Imbalance is not a theory, but a hypothesised mechanism which stands or falls on its scientific merit on a case by case basis. That is, dopamine appears to have a role in addiction, schizophrenia, parkinsons; and serotonin is sometimes implicated in depression, but that doesn't constitute a "theory". Further, it's not always clear with the change in chemicals is a symptom or a cause.Limegreen 30 June 2005 01:27 (UTC)
Rather than state that here, you should edit the article to include the above. It would be very helpful. Edwardian 5 July 2005 18:07 (UTC)

Contents

[edit] Quotes

This section should be removed. Listing quotes is what people do when people can't be bother to summarize a point of few properly. Would anyone object? Edwardian 5 July 2005 18:07 (UTC)

By all means remove it. I don't think they are very representative either...Limegreen 6 July 2005 01:56 (UTC)
I have removed the Quotes section which consisted of the following three quotes:
"The process of diagnosis is very different in psychiatry. Since there are no clear indications of a specific biological abnormality that causes any of the psychiatric disorders, no laboratory tests have been developed to confirm or refute any psychiatric diagnosis." Richard Keefe and Philip Harvey, Understanding Schizophrenia
In 1996, psychiatrist David Kaiser said, “...modern psychiatry has yet to convincingly prove the genetic/biologic cause of any single mental illness...Patients (have) been diagnosed with ‘chemical imbalances’ despite the fact that no test exists to support such a claim, and...there is no real conception of what a correct chemical balance would look like.”
Elliot Valenstein, Ph.D., author of Blaming the Brain, stated: “There are no tests available for assessing the chemical status of a living person’s brain.” “No biochemical, anatomical, or functional signs have been found that reliably distinguish the brains of mental patients.”
They are noted here in the event that someone would like to reference them in the future. Edwardian 6 July 2005 22:13 (UTC)

[edit] Another option:

Maybe it's "good" to use "chemical imbalance theory," even if no one gets a bunch of search results. I think it's great that someone came up with a term for a perceived issue in society and that for doing so this piece should be worked on and developed. Furthermore, they Italic textareItalic text right about the fact that most times drugs to treat "a chemical balance that may be to blame" are very questionable. (Watch a commercial on one of these sometime.) How do we know it's not placebo effect? I've never even looked-up this subject online before, though I myself watch trends, and drug-companies treating perceived mental "disorders" is one of them; they are, after all, businesses trying to make money; an often left-unspoken rule of business is that you must create and maintain problems to make money; same with politics.

Leave this one alone and let it grow. Hopefully we'll get political scientists, scientists, watch-dogs, etc. to work on it.

Just to be completely open, take me for example: I was diagnosed with "ADHD" when I was very small, drugged-up all the time, and today I take nothing. I still exhibit many "symptoms," but basically just practiced self-control. Read this, for instance, once you're done: http://oldmais on.blogspot.com/2005/09/upside-with-adhd.html I didn't learn anything about this spin on "ADHD" (so maybe it's NOT a disorder?) until I read something elsewhere (I just had to find a site with info real quickly for this topic). Many "disorders" in the U.S., it seems to me, are rising with falling standards of education quality. We usually inform and inundate instead of educate and train people here in America anymore.

Prevalence of disorders (more notably ADHD and autism), based on all evidence known, appears to be rising because of an increased number of diagnostics, not due to a real increase in incidence (see autism epidemic for theories). These behavioral 'abnormalities' are spectrum disorders. That means that basically anyone could be put in those categories. For example, you might be 1% autistic while I might be 70% autistic. So if you wanted to increase the prevalence, you just need to move the goal post. The only ones who benefit are those who receive increased business as a result. -Jose

Good luck, let's WORK ON IT! instead of complaining.

                  John B. B.

[edit] POV

What's up with the POV tag and no discussion about it? -Jose

The article does seem very POV (especially the opening paragraph) and critical of the drug companies. I think the article deserves a good look-over. I'm adding the POV tag. --Muugokszhiion 03:38, 12 April 2006 (UTC)

If (1) the chemical imbalance theory is incorrect, and if (2) chemical imbalance terminology is used by drug companies for marketing, then criticism of the drug companies' marketing is objectively justified. The examples quoted in "Popular culture and advertising" seem to prove (2). There seems to be no evidence for the chemical imbalance hypothesis; if this is the case, then (1) is also true. I've done some rewriting and removed the POV flag. My rewrite is essentially a reorganisation of information already presented in the article, with no significantly new information. The original first sentence seems to be true, but to use it as the first sentence, defining the term, is not appropriate. Pol098 07:30, 24 April 2006 (UTC)

It depends a little on how you define "incorrect". Technically, a simple imbalance in chemicals is no longer considered correct. However, it is possible to make an argument that the more complex suggestions might be simplified for a lay perspective as an "imbalance", in which case you could consider it correct. Any type of simplification or analogy will overlook some of the "truth", and also slightly twist the interpretation. In this case, the debate revolves around whether the simplification makes a pharmaceutical intervention more obvious that the complex interpretation. On the other hand, what other lay interpretation describes the current research findings without that bias (but probably with some other bias). Limegreen 09:06, 24 April 2006 (UTC)
Thanks, Limegreen. I don't claim any particular expertise on the subject; I tried in my recent edit to express the same ideas that were already there more clearly and less controversially. The following sentences, in the introductory section, imply to me that the idea of a chemical imbalance is simply incorrect (though discussion later in the article is more ambiguous). "The concept has its origins in the 'chemical hypothesis', which refers to a series of hypothesised neurochemical changes once thought to partially underly mental illness. The chemical hypothesis does not reflect current scientific knowledge, and the term is most often used by groups critical of the pharmaceutical treatment of mental illness [2]." The intro should summarise available information; maybe it requires a lot of though and a little rewriting? The reference is simply to a Google search; the simple presence of the reference suggests to those who don't follow it that there is some authority behind the statement referenced (I clarified this in my edit).
I am not on any "side" of this disagreement, but am just trying to clarify the article. The POV issue, regarding advertising, hinges on whether there actually is in some sense a chemical imbalance which can be corrected by the drugs advertised. Pol098 11:42, 24 April 2006 (UTC)
Haha. Sorry. Those sentences were mine. There is a lot to read into them. I'm not sure that I have a side on this either. The (rather ambiguous) meaning I was trying to convey is that 1) "chemical imbalance theory" doesn't exist (and never did) 2) the idea of chemical imbalance has its roots in the "chemical hypothesis", and more specifically the monoamine hypothesis of depression 3) the original chemical hypothesis is effectively wrong 4) "chemical imbalance" is a plausible lay interpretation of the more complicated truth (and is, I discovered, used in advertising) 5) apart from advertising "chemical imbalance" is a term most often used by pharmaceutical company critics (I'd never heard the phrase until I found this page, and was surprised to find it advertising). There's a lot of layers in there, and there was quite a lot of editing and re-editing between users for that phrasing to come about.
I agree that it should that the information should summarise available information, but it's a bit tricky where the truth values of most things are uncertain, and you can make an argument that the topic of the article doesn't exist, except in a constructed sense. Finally, it's very geo-centric. Only 2 developed countries allow Direct-To-Consumer-Advertising (DTCA) of prescription meds, and only one of those countries, apparently, allows it for psych meds.
I'm a little concerned that the insulin reference enhances the POV issue. At least for Type I diabetes, insulin is pretty much the only treatment, whereas, while I think psych meds have their place, drugs are not the only form of effective treatment, and the insulin reference (like the "chemical imbalance" explanation), may over-emphasise the role of medication.--Limegreen 01:27, 25 April 2006 (UTC)

Ooh. I might have a week hack. I'm not really sure that 'chemical imbalance' is used in medicine, per se.--Limegreen 01:37, 25 April 2006 (UTC)

[edit] Reinstate the POV flag?

A few days ago the very first sentence of the article said "Chemical imbalance is a term sometimes used by drug companies [1] in the United States in advertising and consumer literature...". I moved this sentence from its prominent place, starting with something summarising what the theory was about (the way every article should begin), and removed the POV flag as the article now started uncontroversially, followed by a discussion of both sides of the issue. After a number of further changes, the opening sentence remains uncontroversial. I'm not in a position to judge whether the POV flag is justified by the general content of the article, so will take no further action; but if others consider it appropriate, perhaps the POV flag should be reinstated. Pol098 12:49, 26 April 2006 (UTC)

[edit] NPOV edit

I just took a fairly major hack at this. A lot of it seemed irrelevant to the topic at hand (like Cautionary Measures for medication). I've tried to add more actual science (ie that there is no 'theory'), but at the same time accepting that the existence of lay conception of a theory exists. Also, it seems that content discussing the pros and cons of medication, diagnosis, and the role of the pharmaceutical industry rate only a brief mention.Limegreen 11:15, 22 October 2005 (UTC)

For some reason, Pfizer has stopped bombarding Americans (and the airwaves that supposedly belong to citizens, rather than corporations) with the patronizing message that poisonous drugs "correct a chemical imbalance in the brain which may be related to symptoms of depression or anxiety." Surprisingly, the chemical imbalance ta gline has not been pulled from website advertisements. After spending untold millions to promote brain damaging drugs for the sake of profit, the industry's use of unscrupulous marketing tactics incorporating the tagline merits further documentation in the article, rather than being downgraded to "only a brief mention." Ombudsman 01:37, 25 October 2005 (UTC)
I used to make the argument that pathologizing human diversity such as ADHD is akin to saying that short and tall people have a disorder that must be treated with drugs. But just the other night in one of those magazine shows (don't remember which) they discussed how short kids are being given human growth hormone injections. It's getting way out of hand, isn't it? Neurodivergent 01:36, 4 November 2005 (UTC)
The Chinese have been doing surgical interventions to increase height for some years! Nasty, painful stuff. Limegreen 02:08, 4 November 2005 (UTC)

[edit] explanation for deletion

I'm taking this sentence out ("These criticisms appear at odds with current research, however, but may be relevant to professionals who were trained less recently.") because there is still no objective test for any mental illness, despite current research. Francesca Allan of MindFreedomBC 02:20, 15 November 2005 (UTC)

I've revised that sentence, as you have misunderstood the intended meaning of it. That is, recently trained professionals should be aware of more recent neuroscience research that does not emphasise chemical (im)balance.Limegreen 02:41, 15 November 2005 (UTC)

I'm revising your revision because you have misunderstood my concern, that is, despite all current research (psychiatric *and* neurological), we still do not have any objective test for any mental illness. Francesca Allan of MindFreedomBC 03:04, 15 November 2005 (UTC)

Never mind. Looks like somebody beat me to it. Francesca Allan of MindFreedomBC 03:07, 15 November 2005 (UTC)

I understand your concern the first time. However, there are two parts to the claim. 1. There are no objective tests for mental illness and 2. that chemical imbalance is used to justify medication. However, my point is that a recently trained graduate will be aware of the science discrediting 'chemical imbalance', but that has no bearing on the objective test aspect.Limegreen 03:10, 15 November 2005 (UTC)

The way you were wording this buries the meaning you describe here. I'm sorry for misunderstanding you. It really appeared as though you were claiming that newer graduates would be up to date on some other method of diagnosis that wouldn't be available to biochemical imbalance theorists. And, as far as I know, psychiatry is proceeding strong with the chemical imbalance theory, regardless of the lack of scientific evidence for it. Therefore, I doubt very much that recent medical graduates will be taught anything other than what psychiatry is fed via the pharmaceutical manufacturers. Francesca Allan of MindFreedomBC 03:16, 15 November 2005 (UTC)

I come from a non-US science perspective, and reading this article it sounds like it's from another planet. I accept that a lot of your concerns may have some very real foundation, however, I think you also need to be aware that there are a lot of very different countries in the world, and in some of them, they may not be so applicable. Where I'm from, medical training is very science oriented, and there is the explicit acknowledgement in the training that the discipline is advancing at such speed that what is taught today may not be relevant in 10 years.Limegreen 03:26, 15 November 2005 (UTC)

I'm certainly aware there are very different countries in the world and what you say here gives me hope things aren't as grim world-wide as I had feared. However, in North America, true psychiatric research has been abandoned in favour of drug company sponsored propaganda. And psychiatry, as a discipline, hasn't advanced much since the days of leeching and beating. Psychiatric patients are routinely punished for speaking out and questioning psychiatric authority. E. Fuller Torrey and the Treatment Advocacy Center promote increased forced drugging and use falsified figures to justify their horrible agenda. In my opinion, psychiatric patients are the last group in North America to gain their human rights. We've got a long, long way to go. If things are better elsewhere, then that's great. Francesca Allan of MindFreedomBC 03:34, 15 November 2005 (UTC)

"E. Fuller Torrey and the Treatment Advocacy Center promote increased forced drugging and use falsified figures to justify their horrible agenda." That's quite an accusation. I'm sure you can substantiate it, right?

You bet I can. Torrey waves around a made-up figure -- that 1,000 murders are committed annually by the untreated seriously mentally ill. To support it, he uses a Department of Justice study. However, the DOJ study doesn't even deal with diagnosis nor whether or not these criminals were undergoing psychiatric treatment at the time of their offences. In the course of his wild extrapolations, he commits grievous "rounding up" errors. Torrey has admitted to MindFreedom International that in fact he "just made up" the figure. Furthermore, Torrey and the Treatment Advocacy Center lie about the mentally ill and violence. TAC appears designed to promote psychiatric assault and nothing else. Any more questions? I'd be happy to answer them. Francesca Allan of MindFreedomBC 19:56, 15 November 2005 (UTC)

Ah, you see, I meant verifiable substantiation, not second-hand claims for which we have to depend entirely on the assertions of a very involved party. -- Antaeus Feldspar 21:59, 19 November 2005 (UTC)

It's completely verifiable. You can check the DoJ study and see for yourself. Please try to keep your tone a little more civil. We can agree to disagree, surely? Francesca Allan of MindFreedomBC 15:23, 25 November 2005 (UTC)

I'll try to find the quote from Torrey saying that an untreated bipolar person is equivalent, in terms of public safety, to someone with untreated tuberculosis sitting in a crowded movie theater. That would be a good example of Torrey's alarmist agenda at work. Francesca Allan of MindFreedomBC 01:45, 1 January 2006 (UTC)

[edit] Disputed

Hey, Ombudsman! Are you still claiming that "chemical imbalance theory" has been "repudiated", based on the compelling clinical evidence that you don't see those commercials anymore? -- Antaeus Feldspar 18:03, 15 November 2005 (UTC)

Your sarcasm aside, it is interesting that pharmaceutical manufacturers (particularly the makers of Zoloft) have been taken to the wall by a grassroots organization. The fact is their SSRI advertising is misleading, bordering on untruthful, and we called them on it. If they've had to adjust their advertising (I wouldn't know, as I don't watch TV), then that's a huge victory. Francesca Allan of MindFreedomBC 20:02, 15 November 2005 (UTC)

[edit] neurochemical basis for mental illness

I took the word "once" out of the following sentence:

The term has its origins in the 'chemical hypothesis', which refers to a series of hypothesised neurochemical changes *once* thought to underly mental illness.

because the vast majority of psychiatrists believe that mental illness is as a result of neurochemistry. That's not *my* view (I believe it's the other way around, i.e. that emotional distress is the cause of neurochemical changes) but it is the prevailing view. Francesca Allan of MindFreedomBC 02:37, 16 November 2005 (UTC)

You need to provide evidence that psychiatrists believe this. Maybe they do, but anybody who has read the recent science shouldn't.Limegreen 02:46, 16 November 2005 (UTC)
What you say is true of some disorders. The neurochemistry of anxiety, from personal experience, I can tell you that it is definitely caused by thinking, and may be 're-balanced' through thinking. But I don't think the same can be said of ADHD or autism, which are basically the result of neurodevelopmental differences which cannot be accounted for in any significant way via psychological factors (based on twin studies). But in these two cases I'd argue they are a form of neurodiversity, not a pathology, whereas anxiety is a pathology, as most anxiety sufferers do want to get rid of their anxiety. Neurodivergent 16:13, 3 December 2005 (UTC) <-WHY IS THIS ONE OUT OF ORDER? (CHRONOLOGICALLY)Aug. 29, 2006

I'm really surprised to read this. Please point me to the recent science because if the biochemical theory is falling down, then I'm thrilled. Every mainstream psychiatrist that I have ever talked to or read talks about chemical imbalances. What has changed? Francesca Allan of MindFreedomBC 03:10, 16 November 2005 (UTC)

And all pro-psychiatry sites like the National Alliance for the Mentally Ill and the like all refer to schizophrenia and bipolar disorder as biologically based brain diseases. How recent is this science you're referring to? Francesca Allan of MindFreedomBC 03:15, 16 November 2005 (UTC)

You might not want to get too excited. Simple chemical imbalances pretty much have been obsolete since the 80s, but that's not to say that they haven't been replaced with other biologically oriented theories. However, newer models don't necessarily view the brain changes as always causal, which you might see as positive. There are a couple of references in the external links [1], which will lead you to the following quote "recent evidence indicates that problems in information processing within neural networks, rather than changes in chemical balance". However, the same authors that said that do still support the use of antidepressants in some instances.Limegreen 03:42, 16 November 2005 (UTC)

Oh, I misunderstood. Chemical balance, neural networks, whatever, it all comes down to pretending it's a brain disorder. Francesca Allan of MindFreedomBC 03:51, 16 November 2005 (UTC)

Some things may well not be 'brain disorders', but so say that nothing is ever a brain disorder is a big call.Limegreen 04:25, 16 November 2005 (UTC)

Parkinson's is a brain disorder. Cancer can be a brain disorder. So far, schizophrenia, bipolar disorder, etc. have not been shown to be brain disorders. They both obviously affect the brain just like our moods and experiences do, however, there's no evidence yet that these psychiatric disorders (or emotional illnesses or whatever you want to call them) originate in the brain. Despite this lack of evidence, psychiatry plows on with its biological treatment with or without patients' consent. That's all I meant. Francesca Allan of MindFreedomBC 04:30, 16 November 2005 (UTC)

If you re-read my post above, I explicitly said 'newer models don't necessarily view the brain changes as always causal'. To my limited knowledge, this would be especially true of depression. I believe there is evidence for a heritable component in some of these things, which is a weak form of evidence suggesting some sort of brain change. Sometimes weak evidence goes on to be confirmed (e.g., smoking>cancer) and sometimes it doesn't (e.g., aluminium>alzheimers). Science does not provide definitive answers, it just develops evidence in one direction or another. However, just because I think there may be a role for brain changes does not mean that I think it's only about brain changes or that I automatically support medication or compulsory treatment.Limegreen 04:41, 16 November 2005 (UTC)

I caught what you said the first time but it does seem to me that the various theories being pushed all boil down to something goes wrong (for biological or genetic or any other reason) somewhere in the brain and mental illness occurs as a result. I agree that the role of science is to develop evidence in one or direction or another. However, psychiatric research doesn't seem to follow the scientific method. The idea that mental illness is a brain disorder is taken as a given and then they try to prove it by measuring differences in the sane vs. the insane and the treated vs. untreated. Evidence running against their theories is simply disregarded (e.g. Dr. Loren Mosher's fabulous work with schizophrenics at Soteria House) because it runs counter to drug companies' interests and psychiatry's delusion that they can heal people of emotional illness. That's not science but it is big business. The forced treatment issue is a human rights one and really is quite separate from any of psychiatry's claims for efficacy. For the sake of an example, even if there were a cure for schizophrenia that was 100% successful and had absolutely zero side effects, it would still be unethical to tie people down and inject them with the cure. Psychiatry has had very, very limited success and has caused a lot of damage. SSRI antidepressants can barely beat a placebo and come with horrendous risks for suicide and psychosis. The "atypical" neuroleptics were heralded as the greatest new thing in schiophrenia treatment. This too turned out to be a failure. There's no indication that these neuroleptics are more efficacious than the old ones. They are, however, substantially more expensive. Francesca Allan of MindFreedomBC 15:04, 16 November 2005 (UTC)

theories being pushed
Drug companies might like to push certain theories, but ultimately a theory will stand or fall on the merits of the evidence for and against it. Thus, a core part of your argument should be providing scientific evidence for no basis for each mental illness in the brain. For example, Dr Mosher's work suggests that medication may not be the best approach for some people. However, that is neutral with respect to whether the 'disorder' exists in the brain or not.
And yes, compulsory treatment is an ethical/human rights issue, not a scientific one.Limegreen 21:50, 16 November 2005 (UTC)

Not necessarily, as shown by psychiatry's insistence that all psychological problems can be cured by the right combination of pills. That theory should have already fallen, due to lack of evidence, but it has not and I'm not expecting it to any time soon. It's quite hard to prove a negative thus it would be tricky to "prove" that mental illness is not a brain disorder. It would probably be easier to prove that mental illness IS an emotional disorder. The work of Mosher, Karon and others already suggests this, however, but psychiatry just isn't interested. Most people do not see your point that forced psychiatric treatment is an ethical/human rights issue but I'm glad that you do. I'm also thankful for your wiki contributions. I'm trying to be more measured in my approach and that is in part from using you as a role model. Francesca Allan of MindFreedomBC 00:59, 17 November 2005 (UTC)


Taken from The APA's website, I don't see where they insist that all mental illness can be cured with pharmacotherapy only. In fact, they list Psychotherapy, Pharmacotherapy, and Electroconvulsive Therapy [2]. DocJohnny 04:46, 19 November 2005 (UTC)


None of the mental health practioners I know in this country beleive that pills are the only/best solution, so I believe there is cause for hope on this front. You are correct that it is hard to prove an absence of a cause, but providing evidence for other non-biological causes is a more workable route. I'm greatful that you've found some positive in my contribution, and I hope that in time that your passion works for constructive change. An analogy that I've just thought of which you might find useful is to consider a scientific theory as a glacier. Evidence is the snow falling at the top of the glacier, and as the evidence ceases to fall or falls less, the glacier will slowly shrink and may eventually disappear. Unfortunately, it takes many years and much snow for a glacier to form, and a similarly long time for one to disappear. The time to change can and will be frustrating, both for the scientists and for those at the business end.
You can also see psychiatry in a similar light. I would hope that recent graduates are better versed in current science and practice based on this, but unfortunately people who trained 40 years ago will still be out there influenced by what they were taught. Psychology and Psychiatry have come a terrifically long way, both in terms of actual knowledge, and less brutal treatment in the last 100 years, and let us hope that this change will continue without too much more injustice (I'd like to say no injustice, but I don't think that will happen).Limegreen 03:00, 17 November 2005 (UTC)

[edit] An attempt at clarity

I made some minor revisions in an attempt to clarify some points. As it stood the article seemed to be more of a rant against the pharmaceutical industry than an attempt to define the issue. This entire "theory" is mostly a "straw-man" argument used by opponents of psychiatry.

DocJohnny 20:45, 18 November 2005 (UTC)

As should have been clear from the discussion above, there is no specific "chemical imbalance theory." What the phrase refers to is psychiatry's insistence that schizophrenia, depression and bipolar disorder are brain disorders that require drugs for treatment. "Chemical imbalance" as a phrase was brought to the public by drug manufacturers. Francesca Allan of MindFreedomBC 02:06, 19 November 2005 (UTC)

A search for "Chemical imbalance" leads primarily to sites critical of pharmacotherapy for mental illness[3]. While the phrase "chemical imbalance" does sometimes appear in drug company websites [4], this is in language which agrees with majority scientific opinion [5]. As our primary goal should be a neutral point of view, we should attempt to make value neutral assertions and provide relevant information, including the fact that medical professionals generally accept the biological basis of disease. I agreed with the causality statement, which is fairly neutral, so I have placed it back in the text with the word uncertain rather than unknown, which I feel better describes the state of research today. DocJohnny 05:03, 19 November 2005 (UTC)

[edit] Scientology links

I feel that given the prominent role of Scientology in anti-psychiatry, it is responsible to mention it. My paragraph was neutral in tone and cited other wikipedia articles which expand on this fact. If you feel it could be more neutral please expand upon it rather than simply deleting it. In fact I am puzzled by the commentary, especially as it cited other Wiki articles. Also, a search on "Chemical imbalance" will bring at least one scientology website on the first page, which demonstrates the relationship between the two subjects. There are at least 4 citations within the paragraph. I remain puzzled by how this could be viewed as either uncited or POV "pure and simple"

Please revisit it. DocJohnny 13:53, 19 November 2005 (UTC)

Sure, mention it, by all means. But please don't do what the pro-psychiatry editors do which is attempt to paint all anti-psychiatrists as scientologists. Scientologists are minor players in the fight to question biomedical (and often forced) psychiatry but they do get a lot of press because of Tom Cruise, etc. Francesca Allan of MindFreedomBC 01:26, 22 November 2005 (UTC)

[edit] About Vast

Not all opinions have equal validity. The use of pharmaceuticals to treat mental illness is taught by every licensed medical school both allopathic and osteopathic. I think that qualifies as vast. Clinical guidelines for the treatment of depression all mention psychopharmaceuticals. Even minority opinions within psychiatry talk only of reducing the use of pharmaceuticals, not eliminating them. The idea that drugs are not effective is a fringe opinion, not a minority one. This is what I was trying to accomplish with the word vast. If you see a better way to do that, please do so.

One problem that I have seen here is that often in the attempt to present all sides of an issue we don't give appropriate weight to the arguments involved. If we keep presenting fringe opinions as having the same validity as prevailing scientific thought, we are doing a disservice to the reader. DocJohnny 14:43, 19 November 2005 (UTC)

Well-spoken, Doc. Jimbo has made very clear that WP:NPOV is not false balance. -- Antaeus Feldspar 17:55, 19 November 2005 (UTC)

On the contrary, many psychiatrists promote drug-free therapy. Certainly, this point of view is in the minority (for obvious financial reasons) but that doesn't make it "fringe." Let's not forget that "prevailing scientific thought" once brought us leechings, beatings and near drownings, among other gruesome "treatments" and all of those treatments were peer-reviewed. Just because mainstream psychiatry promotes something, doesn't make it scientific nor ethical nor safe. Francesca Allan of MindFreedomBC 01:25, 22 November 2005 (UTC)

I don't see any "obvious financial reasons". I don't know of any monetary incentives to use pharmaceuticals in any aspect of medical practice. I certainly get no checks from Pfizer :P. I agree that being mainstream does not necessarily mean anything, but the burden of proof lies with the minority opinion. And as for pharmaceutical treatment of mental illness, while there are lively discussions concerning their specific roles, the idea that none should be used at all is very much a fringe opinion. And keep in mind, being in the minority certainly does not guarantee being right. A lot of people including physicians have reservations concerning current psychiatric practice, specifically legal aspects that infringe on civil liberties. But attention from these concerns is often diverted by fringe statements like "there is no biological basis for any mental illness" and "drugs do not work for any mental illness", both of which are demonstrably false. DocJohnny 08:07, 22 November 2005 (UTC)

Hi, DocJohnny. I'm not sure where you're from but in Canada psychiatrists do have a financial incentive. Doctors don't receive checks from Pfizer but they receive lots of other goodies. Other incentives are less direct but it's quite obvious that a large group of lifelong psychiatric consumers is in psychiatrists *and* drug companies' best interests. I don't know of anyone who thinks that psychiatric medication should never be used and I believe you're misrepresenting the anti-psychiatry position. What we do tend to believe is that psychiatric treatment should *never* be forced and that far, far too many people are hooked on psychotropic drugs. We also feel that psychiatry tends to pathologize all human emotions and often creates disorders (e.g. ADHD) where none exist. Psychiatry also masquerades as a branch of medicine when it clearly is not. Drugs often do help for acute distress in the short term and I don't think you'll find many people disputing that. However, a biological basis has never been proved for any mental illness and that's just a scientific fact, not a fringe statement. Francesca Allan of MindFreedomBC 02:20, 23 November 2005 (UTC)

Hello, Ms. Allan. I am not all that familiar with the Canadian health system, so I cannot comment. I can assure you that the free pens do not influence my prescribing patterns.:) Actually I have read a lot of commentary from anti-psychiatry who think drugs should never be used. I agree that forced treatment is not a good thing and that there probably are too many people on psychotropics. Certainly the pressure that lay educators have placed on the medical community to medicate children for ADHD is inappropriate. I think that psychiatry can pathologize *some* human emotion, I think saying all is inaccurate. And I have found people who dispute the use of psychotropics in even acute situations. As for the biological basis of mental illness, the reason for what you cite is a change in definition. Every time a biological basis is found, the disorder is reclassified as a medical illness. Of course under such circumstances, the term "mental illness" will always be reserved for those that we know the least about. Keep in mind that hypothyroidism, hyperthyroidism, dementia of all types, autism, and many more were once classified in whole or in part as mental illness. Multiple sclerosis was once thought to be "Creeping paralysis" a mental illness. So I disagree. It is not a scientific fact. The biological basis of mental illness has been proven over and over. Those disorders are just conveniently reclassified. Given that a biological basis for thought and emotion is not in dispute, how can you dispute a biological basis for disorders of thought and emotion? Now I will agree that the exact biological basis of most disorders that we still call "mental illness" remains uncertain and more research needs to be done. DocJohnny 04:46, 23 November 2005 (UTC)

Hi, DocJohnny. Thanks for your response. You made me laugh with your reference to free pens but in fact the problem is much more serious than that. Indeed some people think drugs are always bad but that is not reflective of the anti-psychiatry movement as a whole. I agree with you that diseases cease to be called mental illness when a biological basis is found but schizophrenia and mood disorders have been studied for hundreds of years now and they *still* haven't found a biological basis for them. The net is so wide that they likely never will. They are simply trying to classify and pathologize too many symptoms. When I say the biological basis of mental illness has never been proved, I am referring to what we currently refer to as mental illnesses, i.e. depression, bipolar disorder and schizophrenia. If these were true brain diseases, then we would consult neurologists not psychiatrists. Francesca Allan of MindFreedomBC 15:27, 23 November 2005 (UTC)

Hi again, Ms. Allan. It is a pleasure to have reasonable discourse. And I do agree that these "disea ses" that we call schizophrenia and mood disorders are really syndromes and probably describe a variety of states that include both benign variations of normal function and actual pathology. It would not surprise me at all if we find that some var iations are biological and some are not. And I agree that psychotropics are probably overused. As a hospitalist, I am constantly pressured by family, social workers, and nursing to prescribe antidepressants for patients who are having a normal reaction to bad news. DocJohnny 17:23, 23 November 2005 (UTC)

Hi, DocJohnny. I too enjoy this dialogue. Too much of the psychiatry debate dissolves into mud slinging when really, at the heart of it, we have advocates AND professionals and both sides want to do what they believe (rightly or wrongly) is best for the mentally ill. To be honest with you, though, most doctors aren't as empathetic as you are. Psychiatrists tend to sneer at advocates, most of whom know firsthand what psychiatric treatment entails, and many of them have an authoritarian, even abusive, manner with their patients. If, in the future, some of these conditions were found to be merely variations of normal function (as you suggest might happen), what might be the implications of that for biomedical psychiatry? Would it mean, for instance, that forced treatment could only happen to those whose conditions had been proved to have a biological basis? It's hard to imagine a category as broad as bipolar disorder, for instance, being split into two subcategories: biological and emotional (for lack of a better word). If at least some patients were proved to have no biological disease, I would think (hope) that would cast doubt over the entire category we call bipolar. Francesca Allan of MindFreedomBC 02:06, 24 November 2005 (UTC)

[edit] What do we need to do to remove the NPOV?

eh? DocJohnny 21:02, 21 November 2005 (UTC)

[edit] recent deletion

I took out the following:

"Critics have, by and large, offered only personal anecdotes, and have not offered empiric research to defend their views."

because it is untrue. There is substantial evidence against the biomedical psychiatric model and there are serious flaws and biases in Big Pharma's testing protocols. What the editor refers to as "only personal anecdotes" are very, very important and should not be disregarded. Francesca Allan of MindFreedomBC 01:18, 25 November 2005 (UTC)

Ditto this statement:

"Research has suggested, however, that this approach often does identify individuals who, statistically, are likely to report subjective benefit and reduced suffering as a result of medication therapy."

If you want it included, please cite this research and define how you are using the words "statistically" and "likely" here. Subjective benefit is also reported after placebo. This proves nothing about chemical imbalances. Francesca Allan of MindFreedomBC 02:02, 25 November 2005 (UTC)

And the following is coming out:

"The author of the study, psychiatrist Mark Gold, remains a strong advocate that addiction and psychiatric disorders are rooted in complex chemical imbalances and effective treatment is available from various drug treatments, an opinion that he shares with the majority of the medical community."

because it is irrelevant to the issue being discussed, which is that many psychiatric patients are misdiagnosed due to underlying physical illnesses. Francesca Allan of MindFreedomBC 02:05, 25 November 2005 (UTC)

Guess what? It is all relevant and it is all going back in. A representative from mindfreedom.org has a POV that would prevent neutral editing on this article.--24.55.228.56 15:16, 25 November 2005 (UTC)

No, actually it's not at all relevant, just another stab at the Anti-psychiatry movement. It's coming out and if you put it back in, I'll bring in a moderator to freeze the page. If anti-psychiatrists aren't neutral enough to edit then pro-psychiatrists aren't either. Francesca Allan of MindFreedomBC 15:22, 25 November 2005 (UTC)

we don't have moderator's. I'm pretty certian on this point. If you mean admins then I susspect they would take the view that at the present time page protection isn't needed. An article RFC might be of use though.Geni 15:25, 25 November 2005 (UTC)

Yes, thanks, I did mean an admin. However, I've changed the wording and hope we can come to common ground on the issue. Francesca Allan of MindFreedomBC 15:27, 25 November 2005 (UTC)

[edit] The Study as it were

Despite the study, the author, psychiatrist Mark Gold, like most of the medical community, retains his belief that most psychiatric disorders are rooted in complex chemical imbalances which require drug treatment, sometimes involuntarily.

vs.

The author of the study, psychiatrist Mark Gold, remains a strong advocate that addiction and psychiatric disorders are rooted in complex chemical imbalances and effective treatment is available from various drug treatments, an opinion that he shares with the majority of the medical community.

The latter edit is my work originally. My reason for making the edit was due to my feeling that the original sentence's use of the word despite was based on several suppositions not supported by the text. For despite to be accurate, you have to assume the study contained some reason for him to abandon belief that psychiatric disorders are "rooted in complex chemical imbalances". As the actual study is never referenced in the text, the specifics are uncertain, but the text itself

For example, in a Florida psychiatric hospital study from the 1980s, one hundred patients diagnosed with a mental illness were subsequently given a complete medical exam, after which it was discovered nearly half of the patients’ psychiatric problems were secondary manifestations of an undiagnosed medical problem

states that nearly half the patients had psychiatric problems based on physical problems, which would hardly lead a reasonable person to abandon the idea that a biological basis exists for psychiatric disorders. This study on its face is an indictment of sloppy psychiatric practice but also very supportive of biological psychiatry, after all over half of these patients had a biological basis for psychiatric symptoms.

This is the reason I feel the use of the word despite is unwarranted. I see no reason based on the presentation of the facts in that section that the author should change his view. And use of the word despite implies that he should have. My change was an attempt to remove that bit of POV and to address a bit of the false balance.DocJohnny 22:51, 25 November 2005 (UTC)

DocJohnny, although I certainly appreciate your explanation (and agree with you that "despite" is a POV word), the fact is that about 1/2 of these people were misdiagnosed and thus incorrectly treated. That is truly shocking and it's also shocking that a researcher would make this acknowledgment and then go on blindly pushing the theory that allowed that to happen. Francesca Allan of MindFreedomBC 02:51, 26 November 2005 (UTC)
Ms. Allan, I applaud your fair mindedness in not making blanket reversions. But, I disagree that the theory is what allowed it to happen. I think sloppy psychiatric practice allowed it to happen. The take home message for that study is that more thorough evaluation for psychiatric patients is needed, which has been addressed by medical practices that make the physical assessment of psychiatric patients compulsory. The reality of the situation is that those people who were misdiagnosed did have "chemical imbalances" in their brain caused by the medical illnesses which then caused their psychiatric symptoms. Now, if you take issue with the sometimes haphazard way in which inpatient mental health can occur, I can agree with that. I agree that the misdiagnosis of such a large portion of patients is shocking and must be addressed, but I really cannot agree that there is no basis for a biological basis for mental illness. Considering that the scientific view of the mind is biological, how can you possibly expect a scientific view of of mental disorders to be otherwise? That is one big problem that I have with some of the anti-psychiatry movement. I agree that the exact biological basis of depression, schizophrenia et al. is not well understood, but to blithely state they are not and cannot be biological in basis is irresponsible and antithetical to logic. If the mind is not biological, what is it? spiritual? Do you see how your movement loses those of us who agree that psychiatry should be more evidence based?DocJohnny 03:34, 26 November 2005 (UTC)
I just ordered Gold's book where he explains the hospital study he did 20 years ago. Although I think the study is too dated to be used as an authority on chemical imbalance, I still think its findings are being mistated here. I know Gold, like virtually every psychiatrist on the planet, believes clinical depression is a neurobiol ogical brain disorder. If half of his subjects did not have a major mental illness, I am sure he would say the ones that did have a chemical imbalance. I will edit that section as necessary as soon as I consult the original source.-- 24.55.228.56 15:51, 26 November 2005 (UTC)

The prevailing view of mental illness simply isn't supported by the science and that's why we question it. The "mind" doesn't exist so it's folly to speak of "mental" illnesses. If these conditions are brain diseases (such as Alzheimer's and Parkinson's), then they should be treated by neurologists. There is simply no evidence that depression is a neurobiological disorder and there's lot of evidence against the theory, e.g. the amazing success of placebo treatment. In antidepressant studies, the placebo successes are often taken out of the study. That's fraudulent medicine and the FDA condones that. Gold's study isn't terribly surprising -- mental patients routinely have their physical condition ignored. Gold's study suggests that people are being wrongfully diagnosed and treated. As a medical professional, that should concern you. As a mental patient, that terrifies me. Psychiatrists keep insisting that this is all a matter of brain chemicals but the fact is they don't have a clue *which* brain chemicals nor can they establish what levels of various chemicals are present in a "healthy" brain. Try this analogy: you're out in the woods and you're confronted by a bear. Is the bear causing you fear which causes your adrenaline level to rise? Or would you say that adrenaline is causing your fear? The latter scenario is the equivalent of what psychiatrists do: they ignore causation. Now, if they want to be honest and describe the true risks and benefits of psychiatric treatment and people decide to try it, then that's fine, that's great, that's wonderful. But psychiatry doesn't believe in informed consent. Mental patients are deemed incompetent often solely on the basis of refusing treatment. In fact, that's considered a psychiatric disorder of its own. Involuntary psychiatry treatment is a severe human rights violation. And all of it is based on a biochemical theory that has yet to be proved. Francesca Allan of MindFreedomBC 16:16, 26 November 2005 (UTC)

Ms. Allan, I am a bit confused as to the overall position of your movement on mental illness. There are people who are significantly impaired and unable to function due to altered mood(what we call depression), or hallucinations both visual and auditory(what we call schizophrenia). If known medical illnesses are ruled out, what do they have? You state that it is not biological, but you also don't believe in the mind, so I am at a loss. If their problems are not psychological or biological, what are they? In essence I am asking if depression is not neurobiological, what is it? DocJohnny 16:29, 26 November 2005 (UTC)

Fair enough, DocJohnny. Anti-psychiatry includes a lot of positions. Some people don't believe there are mental disorders, that is, they are artificial social constructs. Some people (like myself) believe there is such a thing as mental illness but that it is not a true disease, in the sense of having a biological basis. Others believe that it does have a biological basis but that psychiatry treats people very poorly. Those are just three broad categories among many others. The mind doesn't exist independently of the brain. If you believe otherwise, can you answer where the mind resides? What we term "mind" are our moods, emotions, thoughts, inclinations, instincts, etc. All of these phenomena are reflected in our brain chemicals, no question about that, but that's not to say that these phenomena originate there. Clinical depression is merely a reaction to a person's situation, often a logical and realistic one. It takes counselling, not chemicals, to figure out what makes a person depressed. More importantly, counselling and self-awareness give a patient the skills to avoid depression in the future. Drugs, on the other hand, only promote lifelong dependency with no insight into the cause of the disorder in the first place. Schizophrenia can also be thought of as a reaction rather than a disease. I'm sure you know that a large percentage of people labelled schizophrenic are actually abuse (sexual or otherwise) survivors. Schizophrenia can be an alternate reality for these people when their actual reality (confronting memories) is too painful to contemplate. Francesca Allan of MindFreedomBC 18:45, 26 November 2005 (UTC)

Thanks for your response. The word mind is just a convenient label for for the software that runs on the hardware that is our brain. I agree that often depression is a response to external stressors. But everyone's response is different. And a lot of us in the medical profession feel that antidepressants are erroneously prescribed in situations in which depression is natural and perfectly justifiable such as grieving after the loss of a loved one. However, I don't think we can say with any assurance all depression is of external origin. In fact, the long term efficacy of counseling is less well known than that of pharmaceuticals.DocJohnny 21:25, 26 November 2005 (UTC)

Actually, according to the researchers at the University of British Columbia, the long-term outcome of counselling is far superior to drug treatment when it comes to treating depression. Antidepressants tend to have a positive impact in the short-term but it's not sustainable. I'm sure you've heard the phrase "Prozac poop out" in that regard. Also, as you know, withdrawal from SSRIs is very difficult. I'm pleased that many of you see antidepressants as being overprescribed, especially in situations were depression is quite natural. Most psychiatrists don't have that POV, however, and whip out their prescription pads without even a cursory investigation of possible external causes for the depression. This is certainly true of people with pre-existing psychiatric labels. In fact, I know several patients who have had legitimate (and sometimes dangerous) physical complaints, but they were just deemed delusional and prescribed more psych drugs. Of course we can't say absolutely that all depression is of external origin but we can say absolutely that we have yet to find any internal cause of depression. You seem to be agreeing that the mind is part of the brain, i.e. not a separate entity. If that's the case, would you agree that "mental illness" is a misnomer? Why a separate category for mental disorders? These disorders are either diseases or they're not. If psychiatry wants to contend that they're diseases, then let's see the research and the objective diagnostics on that. Until then, we have a bunch of unproven theories which is fine but it's not enough to force treat people based on a bunch of theories. Francesca Allan of MindFreedomBC 23:45, 26 November 2005 (UTC)

This is a slightly related point, but how much overprescription is being done by psychiatrists? As far as I'm aware, most SSRIs are prescribed by people other than psychiatrists, and as a sort of notable example, I'm aware of an overprescriber of methyphenidate who was an obstetrician (Methylphenidate was restricted to being prescribed only by a specialist, *any* specialist). Having said, that, I presume that your ultimate concern relates to the forced-use/over-presription of anti-psychotics?
Another related point is that for the most part, psychiatrists don't do research, and what research they do do, tends to be directly related to treatment. Coming up with biological theories of mental illness is the purview of neurologists and neuroscientists. This is in the same was as a normal doctor doesn't usually do their own research, but rather is taught current best practice based on research.
My final random point for this afternoon is to point out that belief in some sort of biological basis and belief in forced treatment are completely independent. As such, I think it's useful to try to keep the arguments for each separate. You might perceive that psychiatrists' belief in forced treatment is based on a biological belief, but ultimately, involuntary treatment comes from a political/parliamentary authority, and I suspect those who draft those laws have relatively little interest in whether or not there are biological causes.Limegreen 01:55, 27 November 2005 (UTC)

Hi, Limegreen. No long time no hear. You make an excellent point. I believe most SSRI prescriptions are actually from family doctors, not psychiatrists. Our concerns in order of importance are:

(1) forced drugging (e.g. throwing hospitalized people down and injecting them); (2) coerced drugging (e.g. take this drug or we'll have to commit you); (3) lack of *informed* consent for voluntary patients (e.g. take this harmless SSRI).

Of all the psychotropic drugs, so-called antipsychotics are certainly the nastiest and most dangerous. I happen to agree with you that the forced treatment issue and the biological theory issue are separate. However, many people go along with the forced treatment issue solely because they're fooled into thinking these are biological illnesses. Thus the issues remain intertwined, rightly or wrongly. Just for the record, I'd like to make it clear that even if it were 100% proven that for example schizophrenia was a biological disease and even if drug treatment were 100% effective with absolutely zero side effects, then I *still* would believe that forced psychiatric drugging is wrong legally, morally and ethically. It's a legal/philosophical issue, not a medical one. Francesca Allan of MindFreedomBC 02:10, 27 November 2005 (UTC)

Ms. Allan, If that is your belief, then your dispute is really with the legal system rather than with psychiatry. The idea of competence is a legal one, not a medical or psychiatric one. What is your stance on forced treatment of any kind? Are suicidal patients to be allowed to kill themselves? What about children? Forced treatment occurs in other areas as well. Children are routinely "forced" to accede to treatments for medical illnesses because their guardians agreed. The elderly who have severe dementia are often "forced" to accept lifesaving treatment at the behest of their relatives. When relatives or other guardians are not available, the state steps in and "forces" treatment. The idea of competence is well established outside of the domain of mental illness. The antipsychiatry movement really should consider the effects of their proposed reforms. Keep in mind that records of mental illness (schizophrenia et al) has predated psychotropic medication by hundreds of years, so these illnessess are not caused by these drugs as some in the anti-psychiatry movement claim. And the treatment of the mentally ill was much much worse before the advent of these drugs. And I cannot agree that there is no evidence. The preponderance of the evidence is that these illnesses are biological in nature. It is only the specifics that elude us for now. And if they were caused by external factors, why is it that the proposed mechanisms aren't readily reproducible, and why don't the effects fade once the stressor is removed? And even these distinctions are illusory. Whether your cancer was caused by genetic inheritance and or by external factors such as radiation exposure, it does not change your need for surgery and chemotherapy. It seems you believe there is some massive conspiracy between doctors and drug companies to use unnecessary treatment. DocJohnny 05:02, 27 November 2005 (UTC)

Unfortunately, my dispute cannot be contained to the legal system because the legal system defers to psychiatrists on the issue of mental illness. I am 100% against forced drugging and electroshock. I would support hospitalization in rare circumstances, such as a suicidal patient, but that's quite a different issue from forced drugging and electroshock. We certainly do consider the effect of anti-psychiatry proposed reforms. The drugs aren't the only cause of mental illness (and I don't know anybody who believes otherwise) but they certainly prolong it as evidenced by the World Health Organization studies. As for the alleged neurobiological mechanisms, the specifics have been eluding psychiatry since the branch of medicine was born. In answer to your query, if an external factor is causing an illness it would be highly unethical to reproduce that (although I note with disgust that E. Fuller Torrey has been involved with research where psychotic episodes are actively encouraged). And, in many cases, the effects do in fact fade once the stressor is removed. Your cancer example is quite different from any mental illness because it's not clear at all that treatment improves the outcome for psychiatric patients. And it *does* matter what caused the disorder. If somebody's struggling with memories of sexual abuse, is it effective or humane to drug those memories away? Psychiatry only treats symptoms and that's its main failing. And, seriously, I don't believe in conspiracy theory. I think psychiatrists for the most part actually think they're doing some good but the research they rely on is extremely tainted. NAMI is basically a front for the pharmaceutical industry. Now the drug companies, however, are a different story. It's quite clear where their interests lie. Are you aware of Traci Johnson's suicide during an antidepressant trial? GlaxoSmithKline tried to suppress her death until they were forced to disclose it. Traci Johnson had no prior history of depression. Even leaving the issue of forced psychiatry aside, we still have some trouble. Typically, when a patient is newly diagnosed, she is taught that she has an incurable biological disorder for which she will need lifelong treatment. These statements are both invalid. Sadly, many patients believe their psychiatrists and they're set up for a lifetime of disability. I really disagree with your statement that the evidence shows there is a neurobiological basis. How do you explain the dismal drug outcome rate? How do you explain people like myself who turn their backs on psychiatry and do just fine unmedicated? How do you explain spontaneous remission? Francesca Allan of MindFreedomBC 05:26, 27 November 2005 (UTC)

I think those factors that you mention are due to the lack of precision in psychiatry. I believe there are factors that need to be addressed since psychiatry compared to medicine is in its infancy. I just don't think we can generalize from these factors to the conclusions you have reached. While there are people who have done well such as yourself, there is ample evidence that there are others who do very poorly without medication. But I suspect that we will not come to a consensus. This discussion remains informative, and I invite you to message me with literature supportive of your position.DocJohnny 17:48, 27 November 2005 (UTC)

But doesn't it concern you that I was locked up and force drugged and electroshocked, all on the basis of cutting edge psychiatric theories? That I was later coerced into taking four or five psychotropic medications? That I was told I had an incurable brain disorder and when I questioned this declaration I was accused of "lack of insight" and made an involuntary patient? I am not alone. There are thousands of us who have been terribly harmed by this euphemistically described "lack of precision." Some have been killed by psychiatry. The fact is that psychiatry is pseudo-medicine, more comparable to a religion than a science. Certainly some people do better on their medication and I can't imagine any reasonable person would argue otherwise but that proves nothing about the origin of their disorders. And even though some people are helped, how do you get from there to being so confident in psychiatry that you're willing to participate in a branch of medicine that inflicts human rights violations on its patients? I disagree that we cannot reach a consensus. We could certainly come to an agreement on what informed consent means. I believe we could even agree on the involuntary treatment issue. We could agree on the status of current neurobiological research although probably not on the implications of that research. Did you see on my talk page where I listed some resources in answer to your question there? I'd like to add Dr. Grace Jackson, the author of "Rethinking Pyschiatric Drugs" to that list. Francesca Allan of MindFreedomBC 18:11, 27 November 2005 (UTC)

Those things do concern me. As I have stated before, I am concerned over the civil liberties implications of mental hygiene laws. But I am also concerned over throwing the baby out with the bathwater. DocJohnny 18:20, 27 November 2005 (UTC)

But in this instance it's the insistence that psychiatry is a legitimate branch of medicine and that all mental illness can be boiled down to brain chemicals gone awry that allows us to even *have* mental hygiene laws. You know what I wish psychiatrists would work on? Practical short-term solutions to alleviate suffering. I wish psychiatrists could make people comfortable when they're in an emotional crisis and need to figure out what's going wrong in their lives. There's certainly a need for that kind of assistance. But lying to patients, coercing them, forcing them, incarcerating them and setting them up for a lifetime of disability is definitely not the right way to go. Francesca Allan of MindFreedomBC 19:41, 27 November 2005 (UTC)

Mental hygiene laws date back to 1339[6], possibly much earlier, which long predates the idea of brain chemicals. In fact, back then a lot of people thought the brain was a heat dissipating organ.DocJohnny 23:16, 27 November 2005 (UTC)

Sure, you're right on that. But right from the beginning, psychiatry dealt with mental illness as if it were a disease even back when they were talking about the four humours, right? The idea was always that the lunatics were evil and sick and had to be treated. The language has changed, the science has sharpened, but basically society still views the mentally ill in the same light. It is only people's fear of madness (fear which is promoted and magnified by "doctors" such as E. Fuller Torrey and outfits such as the Treatment Advocacy Center) that allows an entire subgroup of our population to suffer ongoing human rights violations. With the possible exception of a positive HIV status, I can't think of any more profound label that could be saddled on a person. Francesca Allan of MindFreedomBC 03:31, 28 November 2005 (UTC)

The remark that "there is simply no evidence that depression is a neurobiological disorder" is an example of either stupidity, dishonesty, or denial. See a list of studies here that prove that depression (and other serious mental illnesses) are neurobiological in nature: [7].--24.55.228.56 03:00, 27 November 2005 (UTC)
Is this tone really necessary?DocJohnny 05:02, 27 November 2005 (UTC)

Please try to remain civil when you debate issues. I am neither stupid, nor dishonest nor in denial so I suggest you retract your above remark. The Stanley Research Institute is not a credible source of research for the same reason that the Treatment Advocacy Center isn't. Stanley bankrolls E. Fuller Torrey's fraudulent work. Depression has not been proven to be a neurobiological disorder. The alleged link between serotonin and depression has now been all but disproved. Likewise, where structural abnormalities have been shown, causation has never been proved, i.e. it's not clear whether the disorder causes the changes or if it's the other way around. And, in all cases, irregularities do not apply to all sufferers which casts further doubt on the neurobiological theory. If you believe that any mental illness is a neurobiological disorder, please answer why there is no objective test for same. Your ignorance is forgivable; your rudeness is not. Francesca Allan of MindFreedomBC 04:23, 27 November 2005 (UTC)

24.55.228.56, you've been reported. Francesca Allan of MindFreedomBC 04:27, 27 November 2005 (UTC)

If I have offended you, I apologize. It is frustrating for me to deal with an editor who admits to being a member of an organization that has extreme POV on psychiatry issues, but edits those articles nonetheless. The sources I listed are scientific journals. list of publications The Stanley foundation lists them on their website but they do not publish those peer reviewed journals. You can also go directly to their websites if you choose. Biological Psychiatry is found here: Biological Psychiatry journal. Here is a search of depression related articles in Neuropsychopharmacology journal:epression&image.x=8&image.y=4 Neuropsychopharmacology search. Articles on the neurobiological basis of mental illness can also be found at Biological Psychiatry journal and Journal of Neuroscience. THere are many more publications that specialize in publishing scientific papers on the biological basis of mental illness. As you can see, there are literally hundreds of papers documenting the connection. Again, I apologize. Please also remember that while civility is very important, NPOV is the top priority in wikipedia.--24.55.228.56 10:08, 27 November 2005 (UTC)
P.S. I am not "ignorant."--24.55.228.56 10:19, 27 November 2005 (UTC)

Just because I question psychiatry, doesn't mean I can't contribute well to an article. If you look at some other editors' comments, I think you'll find I'm welcome here. Yes, I'm quite aware of the prevailing view that mental illness is biological. But the connection has never been proved. People diagnosed with mental illness can't be distinguished from anybody else based on objective tests. There is no study in the world that says otherwise and it is my belief that there never will be. Francesca Allan of MindFreedomBC 15:30, 27 November 2005 (UTC)

Interestingly enough, there are also no laboratory tests that can identify people with chronic fatigue syndrome, fibromyalgia,or autism. Or for that matter, essential hypertension.DocJohnny 17:36, 27 November 2005 (UTC)
The problem with autism is that it's a catch-all name for a number of different genotypes and phenotypes, but certain tests are plausible, just not done. Still, there's no proof autism (or ADHD for that matter) are pathological in nature in a majority of cases, except for for atypical behavior being considered pathological in a subjective way. Neurodivergent 16:36, 3 December 2005 (UTC)

True enough but the difference is that nobody is subjected to forced drugging for any of those conditions. Francesca Allan of MindFreedomBC 17:42, 27 November 2005 (UTC)

[edit] NPOV rules

It's unclear to me why the NPOV tag is there. Here's how this should work. If someone believes there's something NPOV, they should state that specifically in the talk page (or better yet, just fix it). If someone adds an NPOV tag with no explanation, the tag should be removed. I'll remove it for now for a clean start. Neurodivergent 15:22, 22 December 2005 (UTC)

The NPOV tag was here because this article has been used mainly to attack mainstream psychiatry and the pharmaceutical companies (See also biological psychiatry). I will try to keep an eye on it so it doesn't get too out of hand. --65.87.105.2 00:10, 23 December 2005 (UTC)
Where do your POV interests lie? Are you in the pharmaceutical industry, or psychiatry? It sounds like you support the pill-pusher industry to some degree. Is this why you are so adamantly opposed to seeing your precious "medications" side by side with "street drugs"? Drugs are drugs, patented or unpatentable. Without the original substances which have been blacklisted as "street drugs" by the pharmaceutical industry, there would be no pharmaceutical industry. Get over it, and get off your high horse of deception. --Thoric 00:22, 23 December 2005 (UTC)
Funny to see a POV discussion with such POV language. Please promise now to never seek out us "pill pushers" for help. And promise to never take any of our precious "medications", not antibiotics, not blood pressure medication, nothing. What irks me is that someday, all of you conspiracy theorists will come crawling into our ER's and the only thing that will save you from death is our "high horse of deception". --DocJohnny 04:33, 23 December 2005 (UTC)

DocJohnny, you have my word. I will never seek out medical help again as long as I live. Francesca Allan of MindFreedomBC 02:59, 30 December 2005 (UTC)

You're assuming that the "conspiracy theorists" (that's funny) are against all medicines. While in general I'd be cautious about popping pills as a first course of action for any little thing that comes up, I'll definitely take them if they are required to stop pain or prevent death. Neurodivergent 17:41, 29 December 2005 (UTC)
Perhaps, but NPOV disputes should be more specific than saying "hey, some guys are posting things I don't agree with." Point out the specific statements that are in dispute, note that they are not notable/citable, or add your own POV is so needed. Neurodivergent 00:24, 23 December 2005 (UTC)
This guy 65.87.105.2 (talk • contribs) has taken it upon himself to vandalize all articles with which he disagrees. --Thoric 00:36, 23 December 2005 (UTC)

[edit] Removing a statement of the evidence to replace it with a description of a different standard

The edits today by 172.135.213.125 (talk • contribs) changed the following:

Changes in levels of neurotransmitter metabolites are detectable in urine and cerebrospinal fluid and have been associated with certain mental illnesses, but are not sufficiently predictive for successful diagnosis.

to:

Changes in levels of neurotransmitter metabolites are detectable in urine and cerebrospinal fluid and have been claimed to represent certain mental illnesses, but have not been scientifically proven and confirmed to be objective diagnoses of any abnormality representing any mental illness listed in the (DSM-IV).

I have reverted this change, because a true fact which explains why many rational people would find the role of chemical imbalances in mental illness plausible, namely the fact that these quantifiable changes in neurotransmitter levels have been associated with mental illnesses, has been removed and replaced with the fact that these indicators have not been "scientifically proven and confirmed to be objective diagnoses," etc. This is not an NPOV change; you cannot remove evidence which you do not personally find convincing merely by removing it entirely and replacing it with the nearest-most stringent standard which the evidence doesn't meet. Please keep in mind what Jimbo Wales says at WP:NPOV about the mere accumulation of facts not equalling NPOV.

Also, 213.125, please keep in mind that we have no way of knowing whether you are, as you say you are, "an expert in Neurology". We must base our conclusions on whether your edits are NPOV and, as you claim, "based purely on scientific fact and not personal POV", except based on the merits of the edits themselves, particularly what citation and reference you can give us to check your edits. -- Antaeus Feldspar 23:41, 28 December 2005 (UTC)

[edit] argumentum ad verecundiam

This is an encyclopedia on the internet where anonymous editors whose credentials cannot be verified collaborate. The only way this can succeed is if the statements have independent verification. Your credentials must be proven by good consistent editing not just by merely asserting your expertise. Frankly merely asserting being "an expert in Neurology" is suspect. What exactly are you? neurologist? neurosurgeon? neuroanatomist? neurophysiologist? --DocJohnny 08:33, 29 December 2005 (UTC)

I'm guessing you're referring to 213.125... Which are the statements in dispute? The way Wikipedia works, as I see it, is that its statements should be citable and relevant to the article in question, and written in a way where they are clearly true, e.g. So and so claims such and such. It doesn't really matter if the statements are mainstream or non-mainstream, although generally articles will present more of the mainstream view. In this particular case, if statements are not citable (e.g. they are 'original research' by 213.125) then you do have an argument for exclusion of those statements, regardless of the validity of the statements. Neurodivergent 17:58, 29 December 2005 (UTC)
In other words, Wikipedia disputes should be resolved on the merits of the content, not on the perceived intentions or credentials of the editors. Neurodivergent 18:04, 29 December 2005 (UTC)

The particular editor in question made some changes which were very hard to identify since his edit also inserted spaces randomly in words throughout the article. I was not responding specifically to any particular portion of his edit but rather to his edit summary.

172.135.213.125 (As an expert in Neurology I have added statements based purely on scientific fact and not personal POV. If you revise or delete please explain the scientific basis for the change. Thank you.)

I feel this type of appeal to authority is pointless and immediately suspect. --DocJohnny 18:11, 29 December 2005 (UTC)

And I agree completely with Neurodivergent which is why I wrote "The only way this can succeed is if the statements have independent verification." i.e. cite sources. --DocJohnny 18:16, 29 December 2005 (UTC)

Ok, I see it's the new content in the intro. I'm guessing User:172.135.213.125 is new to Wikipedia. I would not delete the contributions (which sound like they could be right) before failing to find a citation. Neurodivergent 18:29, 29 December 2005 (UTC)

[edit] I Agree Let's Have Citations Please

Yes, I am new to Wiki. I thank -- Antaeus Feldspar for the changes made and instruction. If stating I am an expert in Neurology has upset and/or threatened anyone here I apologize. That was not my intent. I can no more prove I am an expert in Neurology than DocJohnny can prove he/she is a Psychiatrist that actually works in an emergency room practicing genuine medicine on patients.

However I do agree that making medical scientific factual statements shoul d be supported by citations. That's why I only changed statements that did not provide citations and meet the burden of proof as is the standard in medical science. In medicine, in particularly when claiming the existence of a disease/abnormality the burden of proof is always on those making the claim, and not on those being asked to believe that the claim of the disease/abnormality is real.

For our purposes there was no citation in the article that proved PET scans detected a biological abnormality in the brain, such as a chemical imbalance, that represents any mental illness listed in the (DSM-IV).

There were also no citations to support the implied assumption that mental illnesses listed in the DSM-IV, which includes chemical imbalances, are objectively confirmed abnormalities in the brain. So I made the appropriate changes to let the reader know in a clear, concrete, and concise fashion. Until such citations can be made statements that imply or assume otherwise should not be included in an encyclopedia based on fact and verifiable sources and especially in an article dealing with a topic on medical science.

I'd agree that the statement "There is no evidence that DSM-IV classifications correspond to brain abnormalities" is a citable claim. I'm not sure that's what's in dispute, but probably the other info about neurology merging with psychiatry and so on, which is not common knowledge. Neurodivergent 16:43, 2 January 2006 (UTC)

Therefore I again ask that those who which to revise my statements please honor the request to provide scientific citations that prove your changes, are based purely on scientific fact and not personal POV. If there is anything else I can address regarding my edits please let me know.

Thank you. —The preceding unsigned comment was added by 172.141.18.245 (talk • contribs) .

It would be difficult for me to prove that I am "a Psychiatrist that actually works in an emergency room practicing genuine medicine on patients" since I am not a psychiatrist, do not work in an emergency room, and have never made claim to either. You miss the point, sir/madam. No one is "upset and/or threatened" by your assertion of expertise in Neurology. We merely wish to point out that such assertions carry no weight and in fact make your edits more suspect. Good informative edits carry citations, not assertions to personal expertise. Pleaser refer to Wikipedia:Citing sources for more information. There is a reason you will not find any claims on my part to authority based on my profession. No one cares. My edits will either stand or fall on their own merit, not based on a vague unsupported declaration of expertise. Also, please be careful when you are editing, it seems your browser likes to add random spaces to the entire page. --DocJohnny 23:50, 29 December 2005 (UTC)
Oh but you do care DocJohnny or you would not keep harping on the subject nor would you have asked so many questions about my profession. Personally I do not care whether you can prove, or not prove your claims about your profession. Nor have I asked anyone to accept any statement I made based on my own expertise. I only stated what that expertise was. I do not regret stating it, I only regret that it upset you so much that you have repeatedly focused on this one little comment instead of the more relevant fact that I made an improvement to the article by removing scientific claims that have no citations. Which is ironically what you continue criticizing me for not understanding needs to be done. Now if you wish to add a scientific fact to this article then please do so and cite the proof as I have requested. Otherwise, thank you for your attention and good day.—The preceding unsigned comment was added by 172.132.40.7 (talk • contribs) .
Obviously it was problematic to state your credentials the way you did. There probably would not have been a dispute if you hadn't. Neurodivergent 16:45, 2 January 2006 (UTC)

Please take the time to read Wikipedia:Citing sources. You have yet to cite a single source for your edit. It is your responsibility to cite sources to support your own edit. And please fix your browser, since it tears up the formatting with your edits. Neither argumentum ad verecundiam nor argumentum ad hominem are substitutes for citations. Take a page from your own book and cite the proof as I have requested. --DocJohnny 05:15, 30 December 2005 (UTC)

[edit] Please Be Specific!

DocJohnny there is much written in the entire article that has no proof or citations. But I have let them go unchallenged for now. So what is it EXACTLY that you require proof of? And please be specific. Remember I can't help you if you dont actually read the article or if you do not know how to articulate what you want. And please do not suggest I read the Wikipedia:Citing sources page again. I already have read it thank you very much. Now good day to you. —The preceding unsigned comment was added by 172.153.222.207 (talk • contribs) .

Mr./Ms. Anon, it is not the other editors' responsibility to identify your edits. If you cannot recall your own contributions, I suggest perusing the history. Select a change that you have made and click (last). Your changes will be highlighted in red. Please go back to Wikipedia:Citing sources until comprehension occurs. Let me provide you with some assistance. If you add any information to an article, particularly if it's contentious or likely to be challenged, you should supply a source. If you don't know how to format the citation, others will fix it for you. Simply provide any information you can on the source. If you prove incapable of locating your own contributions, please let us know, I am sure someone will be able to help. --DocJohnny 09:21, 30 December 2005 (UTC)

DocJohnny I have not added any information that is contentious, is being challenged, or is likely to be challenged. So no action on my part is required at this time. Thank you once again for your contribution..—The preceding unsigned comment was added by 172.141.19.97 (talk • contribs) .

Please read Wikipedia:Citing sources again. Your above comment indicates you still lack comprehension. Perhaps you are confusing the word particularly with the word only? --DocJohnny 21:25, 31 December 2005 (UTC)

[edit] Arbitrary Deletions With No Explanations

I reverted the deletion by user DocJohnny because there was no explanation or specific challenge or contention to the previous statements deleted. I —The preceding unsigned comment was added by 172.146.139.174 (talk • contribs) .

Mr./Ms. Anon, please just take the time to add sources to your edits. Stop this endless series of justifications for your lack of sources. Stop the appeals to authority. Stop the ad hominems. Stop trying to make this personal. And most of all, stop tearing up the articles with random spaces. And please take the time to read Wikipedia:Citing sources. --DocJohnny 21:36, 31 December 2005 (UTC)


Mr./Ms. Anon, please just take the time to add sources to your edits. Stop this endless series of justifications for your lack of sources.

DocJohnny|DocJohnny I have currently made no new additions to this article, nor have I attempted to revise those that were deleted by yourself. I did make deletions and there is an online space on this website for justifying deletions. I used this space appropriately.

                    Stop the appeals to authority.

I made no initial appeal to authority. Although you continue to appeal to the authority of Wikipedia:Citing sources for your justification in deleting statements. So I too have made deletions based on the authority of Wikipedia:Citing and thank you for referring me to it.

                   Stop the ad hominems.

I have made no ad hominems. The very fact that you continue to accuse me is a personal attack which I believe is an ad hominem itself. And if I may point out the fact, it is you DocJohnny, that has the dubious record of being the only editor on this talk page reported for viciously, verbally, attacking other editors for having different points of view. Do I need to cut and paste your attacks on the Mind Freedom Editor? I believe you called her stupid or was it some other nasty word? Or would you like me to cut and paste the crude and mean statements you made to anyone daring to challenge your views. I paraphrase but I believe you called them "Conspiracy Theorist" and implied that if they visited your emergency room they would not get medication. Isn't this true DocJohnny?

               Stop trying to make this personal.

Oh the contrary I have only sought to make scientific contributions and avoid the further debasing of this article with personal points of view and contest of ego mania. Again I do believe you are the only editor on this page that boasted of being a " Hospitalist" and having a job of prescribing anti depressants as part of the rational for your edits. Again if necessary I can cut and paste your exact words to prove I am not personally attacking you but merely reporting facts. (By the way, prescribing antidepressants would make you a medical doctor in the USA since only MDs can write prescription drugs.) Yet you insist on claiming I am the one appealing to authority and that I am trying to make my contributions something personal.

       And most of all, stop tearing up the articles with random spaces.

I have a browsers problem which I plan to correct. To imply I am willfully defacing the article is again an example of your ego involvement and desire to make this some type of personal contest. Other editors have been insightful enough to realize this is a technical problem and in the spirit of being neutral editors have corrected these changes without deleting my contributions. The page was entirely formatted properly before you arbitrarily deleted my contributions, presumably for not having citations, and then added statements without citations that met your approval. By the way DocJohnny, what gives you the right to add statements without citations while admonishing others for doing the same thing?

      And please take the time to read Wikipedia:Citing sources. --DocJohnny 21:36, 31 December 2005 (UTC)

Thank you. I did read them and have deleted all contributions without citations. Now we truly have a NPOV article. And any further contributions can be based on scientific fact, and if necessary a consensus arrived through scientific discussion, and debate as opposed to personal ideology and dogma. Which I may add has no place in a medical science related article. I do hope this have been helpful. Good day to you.

[edit] Explanation For Deletions.

I removed all scientific statements without cited sources according to the Wikipedia:Citing sources guidelines. While there are no doubt editors with strong personal points of view regarding Chemical Imbalances, the article needs to be based on pure science and not biased personal philosophy. Therefore let's all agree that any contributions to this article, especially those declaring medical scientific facts, be referenced with verifiable, objective, scientific sources. And if the science of any contribution is in dispute let's discuss it here on the talk page and debate it based purely on the merits of science. Can we all agree to this?

Statements need to be citable, but it's not necessary nor desirable to cite every single sentence in every article, obviously. I believe the policy is to cite statements that are very likely to be challenged frequently. Now, you may have a point about the statements below, but deleting all at once is probably not a productive approach. Someone will revert your deletions, even editors who're not working on this article. I'd suggest you challenge them one by one. They may be deleted if they are completely unnotable or completely uncitable ('original research'). You should note that statements don't have to convey true information to be included. For example, someone could definitely put a statement that says "Some doctors assert chemical imbalances are testable" even if they are not. Neurodivergent 17:47, 2 January 2006 (UTC)

Explanation of Deletions

Removed because there is no citation to prove this statement. A search on google does not show a majority of the mentioning of this term as being contributed to groups critical of psychiatry but shows its use in a wide variety of groups pro and con regarding psychiatry.

--This term is most often used by groups critical of the pharmaceutical treatment of mental illness theory.

Removed the following statement because no citation to objective scientific research that proves it is factual.--Current research in neuroscience does indicate roles for changes in the operation of neurotransmitters in the brain, and changes in neurons and neural structure in the pathophysiology of mental illness, but current models are more complex than simp le chemical balances/imbalances.

This tag sentence is a POV and not from the objective scientific research cited so it was removed. --Such findings implicate more complex mechanisms, such as changes in neurotransmitter production, transmission, re-uptake, and neural sensitivity.

No citation to objective scientific research that proves this statement is true so it was removed.--In addition to depression, changes in levels of neurotransmitters have also been implicates in anxiety disorders, bipolar disorder (manic depressive disorder), schizophrenia, and Parkinson's disease. As well as changes in serotonin and norepinephrine, dopamine systems have also been considered.

No citation to objective scientific research that proves this statement is true so it was removed.--So, while all biology is essentially chemical in nature, rather than being caused by simple chemical imbalances, mental illness is now widely recognized to be caused by complex and, in many cases, as-yet unknown factors.

No citation to objective scientific research that proves this statement is true so it was removed.--The 'chemical imbalance' hypothesis is not wrong. It's just not entirely correct."

No citation to objective scientific research that proves this statement is true so it was removed.--Because neural mechanisms imply a physiological difference underlying mental illnesses, they appear to justify the use of medication in treatment.

No citation to an objective source that proves this statement is true so it was removed.-- an opinion that he shares with the majority of the medical community.

No citation to objective scientific research that proves Borderline Personality Disorder or autism is a mental illness, as opposed to Neurological diseases/disorders so it was removed. ---Some mental illness, such as some patients with 'pure' Borderline Personality Disorder, may not have a significant biochemical basis underlying it; these patients will typically not find that their symptoms are usefully treated with drugs. Similarly, when significant neuroanatomical differences are involved, the effectiveness of drugs is limited. For example, autism researchers have found differences in gray and white matter volumes, neuron size, brain mass, and locus of brain function; differences which may be accounted by unknown factors, perhaps involving the interaction of 15 to 100 different genes.

No citation to objective scientific research that proves this statement is true so it was removed.--There are advanced imaging techniques such as Positron Emission Tomography (PET Scans) that can test for chemical imbalances.

No citation to objective scientific research that proves this statement is true so it was removed.--An important consideration with regard to chemical intervention is the potential for relapsing into depression or other psychiatric conditions when medication is discontinued abruptly or without medical supervision. —The preceding unsigned comment was added by 172.150.44.195 (talk • contribs) .

[edit] State of evidence

I think there's much dispute over whether "brain abnormalities" are associated with DSM-IV classificiations, and the dispute is notable enough to be mentioned in the intro, as I believe the IP user intended. I realize there are some studies that have linked neurological differences with persons diagnosed with DSM-IV disorders. These are disputed on various grounds. In ADHD, for example, I believe it is claimed that studies only include people undergoing Ritalin treatment. (It also occurs to me that the reverse placebo effect of receiving a brain disease diagnosis is never considered either). But more importantly I think, it has never been shown that these brain differences are pathological in nature. I bet if they did a PET scan of a person who is tired, they'd find some differences. This does not mean that being tired is a disease. This might be what people actually mean when they dispute the evidence. Arguments along these lines are notable and citable. I believe they are already somewhere in the article, but they can probably be put in the intro as well. Neurodivergent 17:01, 2 January 2006 (UTC)

Seems like there are a disproportionate number of critical views in the links section, and most seem like blogs or possibly spam. Fuzzform 21:29, 22 February 2006 (UTC)

[edit] POV

There's a POV issue concerning the external links. There's 13 critical links and 5 proponent links. To make it NPOV, there should be approximately the same amount for each side. See scientology for example. 71.96.234.140 07:15, 17 March 2006 (UTC)

Why should the # of links indicate a bias? If there are more interesting websites on one side of the debate, why not list all of them? I would think the criteria for listing something as a link is that it provides useful additional information.

[edit] Requested move

Chemical imbalance theory → Chemical imbalance … Rationale: "Chemical imbalance" is a lay term describing more complex neurochemical changes, and isn't in a scientific sense, a theory. Further "chemical imbalance theory" yields 878 hits (including a number on wikipedia), but "chemical imbalance"+depression yields 311,000. The term is also effectively unused in scientific databases. … Limegreen 02:14, 25 April 2006 (UTC)

[edit] Survey

Add *Support or *Oppose followed by an optional one-sentence explanation, then sign your opinion with ~~~~
  • Support. --Limegreen 02:24, 25 April 2006 (UTC)
  • Alternative: I suggest renaming this article to Chemical imbalance (mental health) and create a separate article for general Chemical imbalance. Barrylb 06:12, 26 April 2006 (UTC)
  • Alternative: I withdraw (and have deleted) my previous "Oppose slightly" and now support Barrylb's alternative. As it happens, I had already created a Chemical imbalance (this text revised; had incorrectly typed "balance") article exactly as proposed above; just a stub for now. Pol098 09:53, 26 April 2006 (UTC)
  • oppose: This article started out as Chemical imbalance theory, and that is what it still covers. If there is a need for an article on the 'respectable' concept of 'chemical balance', then so be it. There are numerous other meanings that chemical imbalance may denote. But that isn't what this article is about, nor was it ever meant to be about. The drug industry has been touting a theory, which it misleadingly presents as a given fact, to promote their psychotropics. This article should address the science, or lack thereof, that has been at the root of advertising campaigns promoting drug sales. The US allows direct to consumer drug advertising, and has probably spent hundreds of millions if not billions of dollars cramming the idea of chemical imbalances into the media without disclosing that the notion is theoretical. There is a great need for hard facts and knowledge about the unscientific justifications behind the flood of deceptive pharmaceutical advertising, and obscuring the facts with a misleading article title doesn't help at all. Ombudsman 12:24, 20 May 2006 (UTC)

[edit] Discussion

Add any additional comments

Whether or not the article is moved, "chemical imbalance" is a perfectly respectable term in general medical and other usage, not associated with any specific theory, and the merged article or separate articles shouldn't lose sight of this. See topic Chemical imbalance in general usage on this page. As it happens I pre-empted this discussion (which I hadn't seen) a while ago by changing the entry for "chemical imbalance" from a simple redirect to a separate article. Pol098 00:43, 26 April 2006 (UTC)

It seems to me this article has always been about the usage of the 'chemical imbalance' concept as it relates to depression and related conditions. This topic still is deserving of its own article. If we try to make it into an all-encompassing article of the use of the term in all general medical and other usage, it will become less clear. Perhaps we should rename this article to "Chemical imbalance theory (mental health)" and have a separate article for general usage. -- Barrylb 01:13, 26 April 2006 (UTC)

Or perhaps just "chemical imbalance (mental health)" as I still think that it is not a theory. --Limegreen 01:44, 26 April 2006 (UTC)
I agree it is not a theory, but it is treated as such by some people and that is what this article is about. -- Barrylb 03:51, 26 April 2006 (UTC)
I think the google hits are fairly compelling in that "chemical imbalance" is a concept, whereas "chemical imbalance theory" is not.--Limegreen 04:02, 26 April 2006 (UTC)
I consider adding "theory" to this article's name simply as a clarification that "chemical imbalance" is a (supposed) theory. Nevertheless, since some people will treat it as a whole concept, I would be happy have this article renamed to "Chemical imbalance (mental health)". -- Barrylb 06:05, 26 April 2006 (UTC)

21May06: we seem to be getting into a mess with renaming - the "ci theory" article was recently moved to "ci" (overwriting existing content, which was valid); then someone moved this article back to its original place, "ci theory", and made "ci" point to it, which is arguably incorrect. Could I repeat what is said in the previous paragraph, which I thought was the consensus at the time: <*** call the article with all the stuff about mental health "ci (mental health)", and _also_ have a short article on "ci" which covers general use of the term ***>, with a brief reference to point people to "ci (mh)". This is actually the way it was in early May, with "ci" plus "ci theory" (instead of "ci (mh)"). I hope this is comprehensible and, if so, acceptable. In the meantime I will reinstate "ci" as a free-standing brief article. Pol098 01:28, 21 May 2006 (UTC)

I agree with Pol098's summary of the consensus. I will now move this article "Chemical imbalance theory" to "Chemical imbalance (mental health)". -- Barrylb 02:02, 21 May 2006 (UTC)

Consensus? There needs to be a bit more input, especially since the article has developed directly from the title, not from any facts that would justify any pharmaceutical company's lame excuse for using a simplistic marketing tag line. Taking the theory out of the title is quite misleading, just like the advertising campaigns that use the phrase without disclosing that the notion is only that, a theory. If there were clearly discernable pathologies associated with chemical imbalances, the politically correct title might, just might, make sense. But that isn't the case, so as a spade must be called a spade, so too must a theory be called a theory. Ombudsman 02:20, 21 May 2006 (UTC)
I don't see this move as an attempt at political correctness. I share your feelings about pharmaceutical company usage of the concept. Since there is no sound basis for a chemical imbalance explanation of mental illness I don't think there will be any problem about making that clear. Just using 'chemical imbalance' as the title means the article is about that term as it is used in practice which still should lead to the same conclusions. One of the problems with using 'theory' in the title is that it does not even meet the standards of a scientific theory. -- Barrylb 02:52, 21 May 2006 (UTC)

Well, ramming this name change through makes even less sense than the fact that pharmaceutical industry has evidently shot itself in the foot by hinging their credibility upon a theoretical claim that is purely devious. Chemical imbalances don't refer to mental health, anyway, since the palliative, neurotoxic weapons that are used to combat what often cannot even be described as mental illness (e.g., adhd), and tend to exacerbate mental disorders over the long term. Remission rates plummet with prolonged use of psychotropics, period, end of story. So the fact is, the fraudulently described 'imbalances' are usually just manifestations of non-compliance (rather than actual illness), and the mind bending drugs are not generally beneficial to the victim, and certainly not in the long term in the vast majority of cases. Who benefits? Typically, either well meaning family members or abusive disciplinarians, oh, and the pharmaceutical companies that love their bottom lines and shareholders far more than they care about the welfare of their victims. Perhaps the article could be renamed Chemical imbalance (mental illness) or Chemical imbalance (pseudoscience), but again, these alternatives do not accurately describe what the article is about. Ombudsman 03:31, 21 May 2006 (UTC)

Perhaps we should change the title to chemical imbalance (marketing). In science, there is a hierarchy of certainty. A "theory" has a greater degree of certainty and evidence than a "hypothesis". When this concept was in vogue (ie, the 80s), it was referred to as the "chemical hypothesis" or "serotonin hypothesis of depression". Now that it is not in vogue, the last thing it needs is the credibility of being entitled "theory", which puts it in the same league as evolution or relativity. --Limegreen 05:59, 21 May 2006 (UTC)
The problem with that reasoning is that it goes against the grain of colloquial usage, and what seems to be happening all too often at the Wiki is that, even though disagreements over usage have been well explained in introductions or lead sections, articles get shunted away from their true focus for dubious reasons, e.g., autism epidemic and vaccine critics have been hijacked to alternative titles for reasons revolving around political correctness. Similarly, the Kaiser Permanente and Wal-Mart articles have been subjected to intense cleansing efforts by agents of the giant corporations. Another manifestation of gaming the system is the shunting of criticism and controversy into separate articles, leaving the main article sterile, sans any hint of the true context, and the sub articles are then either neglected or cleansed. In this case, when backed to the wall, the pharmaceutical companies admit that their marketing is based on a theory, and trying to excuse retitling the article because it doesn't meet up with some convoluted definition of a theory just doesn't even come close to passing the smell test. The chemical imbalance theory will stand or fall based on whether or not it is falsifiable or not, so it does at least meet that basic requirement of a theory. Ombudsman 08:28, 21 May 2006 (UTC)
I suggest you read hypothesis and theory carefully. "[A] hypothesis refers to a provisional idea whose merit needs evaluation" viz "[a theory] is supported by experimental evidence". A theory is, in scientific usage not "an unsubstantiated guess or hunch". Therefore, if you say that chemical imbalance is a theory, then you are saying that there is evidence that chemical imbalance is true. --Limegreen 11:55, 21 May 2006 (UTC)

Sorry, but since it is an oxymoron, there is absolutely no justification for having moved this page to Chemical imbalance (mental health. Only slightly better would be Chemical imbalance (drug marketing), but the real problem is that the topic at hand is the unfounded theoretical basis upon which the drug industry has staked its shameless marketing campaigns. As a theory that which leverages hundreds of millions of dollars in marketing expeditures to prop up billions upon billions of dollars in revenues from neurotoxic substance (ab)use, the article should undoubtedly be titled in a manner that conforms with common usage, rather than some nonsense title that so obviously obfuscates the actual nature of the topic. Ombudsman 06:32, 22 May 2006 (UTC)

I'm not justifying moving this page to Chemical imbalance (mental health). I'm merely pointing out that Chemical imbalance theory is a poor title. Of the 840 hits for "chemical imbalance theory"[8] on google, almost half of them are content from this page[9]. Thus, the concept called "chemical imbalance theory" could just about have been created by you. It seems almost bordering on original research, and it seems odd that you are creating an air of scientific credibility around something you don't believe in. --Limegreen 06:48, 22 May 2006 (UTC)
Goofle hits sometimes obscure the actual usage of a term, especially when the medical establishment and corporate media are so anxious avoid the subject matter and so much advertising revenue at stake. Guess it's time to take a harder look at the quality of the hits, and terminology variations. Ombudsman 10:51, 22 May 2006 (UTC)


Re name of article: everyone seems agreed on the validity (or otherwise) of the idea that mental problems are due to ci repairable by a pill, but there is controversy over the name of the article. I had taken the view that this notion belonged to a separate article than the bonafide, very long-standing, and sane concept of a chemical imbalance that makes the fish in your fishtank die, say. But if there is irresoluble dispute about the name of the article, maybe we would be best off with a single article on ci, with a brief description of the general meaning of ci (it doesn't need more than a brief description), followed by all the stuff about the brain imbalance idea. This was in place until I changed it to separate the particular from the general idea; we can go back to it.

Personally I don't favour a vote, which will choose the most popular but not necessarily the best name, but it's another way of resolving the issue, if a few people do vote.

Best wishes, Pol098 11:26, 22 May 2006 (UTC)

It is quite clear this article is about the use of the concept of 'chemical imbalance' by pharmaceutical companies etc. I think we have agreed that this belongs in it's own article and the general idea of a chemical imbalance belongs in a separate article. The question is whether to call the article "Chemical imbalance (mental health)" or "Chemical imbalance theory" or "Chemical imbalance (drug marketing)" etc. I share Limegreen's concerns above that "Chemical imbalance theory" seems almost like it is a term that has been invented on Wikipedia. I like the current title of "Chemical imbalance (mental health)" because it simply says this article is about the concept of "chemical imbalance" in the field of mental health. -- Barrylb
THis article is clearly about mental health, and therefore the title should reflect that. Chemical imbalance is a really bad title. As for the conspiracy theories being propounded by Ombudsman, I suggest a wikibreak. Midgley 22:29, 22 May 2006 (UTC)
Actually the article is about "chemical imbalance". -- Barrylb 09:16, 23 May 2006 (UTC)

[edit] Opening paragraph

The opening paragraph is incorrect: "Chemical imbalance is a term used used by drug companies in the United States in advertising and consumer literature for psychoactive drugs after the deregulation of pharmaceutical advertising"

It is not just used by drug companies. And not just in United States. And not just after regulation of pharmaceutical advertising since we don't have direct-to-consumer advertising in Australia. It is a term I have also seen used in Australia by drug companies and by non-profit "mental health" organisations.

eg

-- Barrylb 03:09, 25 April 2006 (UTC)

I revised it again. I'd include websites in "consumer literature", and it's clear that is not limited to the US (while the advertising is).
As an aside, you may be interested to know that the ANZAC drug regulations are in the process of being harmonised. Hopefully this will entail NZ adopting Australia's DTCA policy rather than vice-versa. --Limegreen 06:07, 25 April 2006 (UTC)

[edit] Chemical imbalance in general usage

Everything associated with "Chemical imbalance" in Wikipedia seems related to neuroscience. I don't want to jump in that debate, but to ensure that the perfectly respectable term keeps its original meaning. I wrote a modified introduction to the chemical imbalance theory article (since reverted) which began (slightly edited):

Chemical imbalance is a term used, particularly in medicine, to describe a situation where different substances required for correct functioning are not present in the required proportions. An uncontroversial example is ketoacidosis, a dangerous chemical imbalance in the body which affects sufferers from diabetes[10].
The term is very often used in a more restricted sense as a lay explanation for the more complex neuroscience explanations…

I've had correspondence with Limegreen (thanks) in which he is of the opinion that chemical imbalance refers specifically to neuroscience (see my message on his Talk page for details, and in case I have misrepresented what he said). The term is used in many areas of medicine and elsewhere: [11], [12], [13], [14], [15], [16]

The term is not only not restricted to neuroscience, but not even to medicine, as one of the links illustrates.

My point is to ensure that the article, whatever its name and merge status, recognises "chemical imbalance" as a respectable term used in many areas of medicine and elsewhere. This is likely to require no more than a brief introductory paragraph (e.g., my draft above).

Best wishes, Pol098 00:37, 26 April 2006 (UTC)

[edit] References

http://members.fortunecity.com/siriusw/Biochemical-Imbalance.htm does not look to me like a reference which fulfills WP:RS or WP:EL. SOme of the referecnes within it look as though they might, may I suggest that if they are useful they be used instead, and that reference be removed in a day or two? Midgley 22:34, 22 May 2006 (UTC)

[edit] Record corrupted by move?

Where is the history of the article? After Ombudsman's move it appears to have been started yesterday, and by Ombudsman. Surely this artile is more like a year old? Does this need some admin or sysop involvement to rebuild that? Midgley 22:37, 22 May 2006 (UTC)

I am not sure about how to fix the history but you will find a it at http://en.wikipedia.org/w/index.php?title=Chemical_imbalance_theory&action=history. -- Barrylb 09:15, 23 May 2006 (UTC)
OK, it was the history of the redirect I was looking at. Still odd. Midgley 20:48, 23 May 2006 (UTC)
The history of the article is messed up as well. The old history is still here [17], as is, curiously, this talk page. It looks like a copy-and-paste move was used at one juncture, rather than the "move" procedure. --Limegreen 22:35, 23 May 2006 (UTC)
The following discussion is an archived debate of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the debate was Move. —Wknight94 (talk) 22:13, 26 August 2006 (UTC)

[edit] Requested move

Chemical imbalance theory → Chemical imbalance – From what I can tell, "Chemical imbalance theory" seems to be a pejorative term used by psychiatry opponants, but not in medicine. Even if some don't accept the term or concept as real, "Chemical imbalance" should be the title and the debate about the term can be explored in the article (altho the article already has an anti-psychiatry slant that needs to be fixed). Some suggestions were made in the talk page to DAB (Chemical imbalance (mental health)), but some suggestions were POV and the psychiatry term seems to be the primary topic. Crumbsucker 04:43, 16 August 2006 (UTC)

[edit] Survey

Add "* Support" or "* Oppose" followed by an optional one-sentence explanation, then sign your opinion with ~~~~

[edit] Discussion

  • While I agree in principle (having proposed such a move above a couple of months ago), you might want to address the arguments that were presented then (here and on the other chemical imbalance XXX pages). --Limegreen 05:29, 16 August 2006 (UTC)
The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

[edit] Personal experiences with mental health system

Hello, I just thought I'd add to this discussion by relating some of my own experiences with the mental health system. Just for the record, I am a complete newbie to editing Wikipedia articles, so if I make any "mistakes" in my editing, feel free to correct me. Anyhow, I was recently very moved by an article by Francesca Allan of MindFreedomBC, where she said

    ...Doesn't it concern you that I was locked up and force drugged and electroshocked, all 
    on the basis of cutting edge psychiatric theories? That I was later coerced into taking 
    four or five psychotropic medications? That I was told I had an incurable brain disorder
    and when I questioned this declaration I was accused of 'lack of insight' and made an  
    involuntary patient? I am not alone. There are thousands of us who have been terribly 
    harmed by this euphemistically described 'lack of precision.' Some have been killed by 
    psychiatry."

Well ok, so I wasn't killed by psychiatry. And I wasn't subjected to electroshock, (although I can't immagine what it was like for Francesca to go through with that, assuming she wasn't in agreement at the time with them using it on her.) I can however, confirm that they will force drug you. As in, you object to the meds and they throw you on a table, hold you down, and inject you with the "cure."


The nurse came with my meds one night (risperidol) and I told her (these were, I believe, my exact words) that I would like to have a "philisophical discussion with her" about whether or not I should have to take the risperidol. We did talk for a while, but she soon grew tired of the conversation (I'm sure she had a lot of other things to do, really) so she gave me a choice. Take the pills or get an injection against my will. Instead of chosing one or another, I said that we should continue our discussion untill we could reach an agreement, and presented the obvious alternate choice wherin she realize that she didn't have to make me take the meds in any form (although in truth I can't really say if this was a "choice" available to the nurse since she would probably have to answer to her supperiors.) Instead of continuing the discussion, she called security. Three men in uniforms showed up promptly, guided me to my bed (ok I lied it wasn't a table) pushed me down onto it, and injected me in the butt with a liquid form of the drug risperidol (yes, this is the correct location for injecting risperidol. Trust me, I know.)


When they finally released me from the hospital after a month of trying different drugs and stuff, I was put on a commitment for six months. This meant that for six months I had no choice but to get injected, yes, in the butt, with risperidol every two weeks. Otherwise I would be sent back to the hospital and locked up again, and injected (in the butt) with risperidol if I continued to dissagree with treatment. Also, and you really won't believe this part, but part of the commitment terms stated that me, a twenty one year old at the time, I had to live at my mom's house (I couldn't even stay with my dad overnight. (parents divorced) I get along better with him, but I think the medical people didn't like the idea that my dad didn't like the idea of them forcing drugs on me. Seriously.) I had to, get this, be home at my mom's house by 8PM every night, and couldn't leave untill 8AM the next morning. So much for my social life. There were other violations of my rights that I won't mention at the moment. Risperidol has documented side effects, many of which I experienced over those six months. I gained 30 pounds, slept about 12 hrs a night, and felt a lot slower, physically and mentally (all common side effects.) I could have developed tardive dyskinesia, a permanent and currently INCURRABLE neurological dissorder, from the meds. Luckly I didn't.


After the six months were over, the county tried to have the commitment extended, and my father and I took it to court. Luckly the jury saw through the prosecution's arguments that I was unable to make my own decisions regarding health care, and the commitment was ended. I then, with the help of my psychiatrist, slowly weaned off of the meds. (If you wean off too fast there is a VERY good chance of having very unfun withdrawal symptoms/relapse.)


I feel much better now (off the meds), am sleeping well, have re-lost those 30 pounds, and have not relapsed. Oh, and my social life made a full recovery. :-D --I will be attending UW Madison in the fall, and will keep you guys updated if I do happen to relapse, although even my psychiatrist says that the fact I've been doing so well so far seriously calls into question the diagnosis of schizophrenia in the first place.


Ok guys, one other thing before I sign off... sorry for making this entry so long! I don't know if that makes it a canditate for deletion, but if someone wants me to shorten it up a bit (or a lot) I could do so. Also it would be cool to hear about other peoples' experiences with the mental health system! Ok, so thanks for considering my story! Feel free to post questions about it here, or to contact me directly on my user page.--MeEricYay August 29 2006

[edit] Mental Illness

Hey everybody... if you haven't checked out the wikipedia article on mental illness, I HIGHLY reccomend you check it out. To tell the truth, I think that, at the moment it is in fact BIASED. Biased towards those who believe in the "chemical imballance" theory, to be correct. I'm especially weary of the second paragraph under "causes:"

The most popular explanations for mental illness, currently, are biological explanations; that 
is, a person with a mental illness may have a difference in brain structure or function or in 
neurochemistry, through either genetic or environmental vulnerabilities (such as in utero 
alcohol exposure). For example, many people diagnosed with schizophrenia have been shown to 
have enlarged ventricles and reduced grey matter in the brain. Additionally, some argue that 
neurotransmitter imbalance may cause mental illnesses. Finally, many genetic studies or twin 
studies have shown strong evidence that mental illnesses such as bipolar disorder (manic 
depression) and schizophrenia can be inherited.

Interestingly, between the dates of Aug. 24 2006 and today, Aug. 31 2006, the majority of the article becamed biased in the OTHER direction, with what I would call an overly anti-psychiatry stance. (Yes, even I believe there is such a thing.) Check out the page durring those dates in the history through this link: http://en.wikipedia.org/w/index.php?title=Mental_illness&oldid=72931752 if you're interested. (Sorry I'm not very good with links yet, someone else can feel free to clean that up and delete this sentence if they want.) Oh, and check out the talk page on the 31st for more info on why it was changed back. I did however, kinda like the way the author of the anti-psychiatry biased article changed that last paragraph I just pasted. Here's what it read under "Causes" on the 25th of August '06:

Thus, while the most popular explanations for mental illness, currently, are biological 
explanations; that is, a person with a mental illness may have a difference in brain structure 
or function or in neurochemistry, through either genetic or environmental vulnerabilities 
(such as in utero alcohol exposure) this has not been borne out. For example, it is often 
cited in support of this theory that many people diagnosed with schizophrenia have been shown 
to have enlarged ventricles and reduced grey matter in the brain, however, these are people 
who have been medicated with drugs that cause this enlargement. It is really the "treatment" 
(the drugs) that have created the brain difference. Similarly, those who argue that 
neurotransmitter imbalance may cause mental illnesses have no evidence to support this 
hypothesis. Finally, the many genetic studies or twin studies cited as showing strong evidence 
that mental illnesses such as bipolar disorder (manic depression) and schizophrenia can be 
inherited do not hold up under scrutiny

I think what was written about the medication causing the enlarged ventricles, and the part about genetic and twin studies not holding up to scrutiny may acutally be true facts. At least, I personally have heard those same arguments from a psychologist who is a friend of my fathers, named Toby Watson. I don't know where HE got the info from, but he's a pretty intellegent and knowledgable guy in my experience. I think I'll contact him and maybe I can re-introduce the Aug. 24th-31 "Causes paragraph #2" to the mental illness page WITH SOURCES!! Unless someone else has heard of these same arguments and can source them themselves saving me trouble. Some of the other stuff in that anti-psychiatry biased version may also have been true, or contained some truth in them, and maybe others can re-introduce pieces of it with sources and such to back it up. Just a thought. Oh, and yes I wrote something similar to what I am now writing on the talk page under Mental Illness as well. Ok later! MeEricYay 05:10, 1 September 2006 (UTC)

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