Big Pharma and the Big Lie – The Chemical Imbalance Theory of Mental Illness

“Big Pharma is one of the largest and most profitable businesses in America, and in order to sell their chemical goods to allegedly treat the mind/psyche, pharmaceutical companies must convince society that people’s mental and behavioral problems are caused by their bodily chemicals.”   Daniel R. Berger, The Chemical Imbalance Delusion 

Academy of Ideas

An epidemic of mental illness has spread across the modern world. According to the National Institute for Mental Health, 25 percent of all American adults suffer from at least one mental illness, as do 15 percent of all children. Many in the field of psychiatry claim that psychiatric drugs are the most effective tool we have to counter this epidemic, and as a result, these drugs are heavily prescribed in the Western world. In this series of videos, we explore the lies and propaganda that are used to justify the use of psychiatric drugs, and we expose the deep corruption that exists at the heart of the unholy alliance of modern psychiatry and Big Pharma.  

In this first video, we expose the “big lie” that supports the millions of psychiatric drug prescriptions written each year and the billions of dollars of profits that pharmaceutical companies earn from their sales. This lie is that chemical (or neurotransmitter) imbalances are a primary cause of mental illness, and that taking psychiatric drugs corrects for these imbalances.  

“If a lie is only printed often enough, it becomes a quasi-truth, and if such a truth is repeated often enough, it becomes an article of belief, a dogma…”  Isabella Blagden, The Crown of a Life

In the late 19th century, psychiatry suffered low status among the medical professions. There were few generally agreed upon treatments for mental illness, and while medical doctors were rapidly improving their capacity to understand and treat disorders of the body, psychiatry was relatively stagnant with respect to understanding the disorders of the mind.  

The fate of psychiatry changed, however, when the German psychiatrist Emil Kraepelin put forth a bold and revolutionary theory. Kraepelin hypothesized that mental disorders such as depression, anxiety, and schizophrenia, are the result of underlying physical pathologies in the brain and body. Kraeplin’s theory caught on like wildfire as it aligned with materialism, the dominant scientific paradigm at the time. Materialism is a philosophical position which claims that matter is the primary, sole, and fundamental element of reality, and that our mind is an emergent property of, and reducible to, the interaction of the material parts of our brain.  

In aligning psychiatry with the materialist position, and hence the scientific community at large, Kraeplin’s theory radically improved the status of psychiatry. Kraeplin became the founder of modern psychiatry, and the widespread acceptance of his theory ushered in a wave of experimental psychiatric treatments targeting the brain and bodily malfunctions believed to underly mental illness. In his book Cracked: Why Psychiatry is Doing More Harm Than Good, James Davies writes:  

“In the 1920s, these [treatments] included…surgically removing parts of the patient’s body—their teeth, tonsils, colons, spleens, and uteri…injecting patients with horse serum, using carbon dioxide to induce convulsions and comas, injecting patients with cyanide, and giving them hypothermia…Another treatment was malaria therapy, injecting the patient with the malaria parasite in the hope that the high temperatures malaria produced would kill the virus then thought responsible for mental disease…many patients failed to recover from the malaria disease.”  James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good 

The ineffectiveness of these early 20th century treatments did not stop psychiatrists from developing new experimental treatments. In the 1930s, insulin shock therapy was invented, which involved giving patients high doses of insulin that would trigger intense seizures and place the patient in a coma. Davies writes that:  

“After this procedure, granted, patients would appear to feel calmer, but they would often show memory loss and other neurological abnormalities such as loss of speech. Five percent of all patients actually died from this treatment.”  James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good 

In the 1940s, lobotomy, or the surgical removal of parts of the brain thought to be responsible for mental disorders, was invented. And by the 1970s one million people in the United States had been lobotomized. Another treatment which grew in popularity in the 1940s was electroconvulsive therapy, or ECT, which involved adminstering electric shocks to the brain of a depressed patient in order to induce severe seizures. In the words of Davies, all these outlandish and barbaric treatments “won impetus and legitimacy from psychiatry’s enduring conviction that there must be a physical basis for mental disorder…this originated with Kraeplin’s assumption: if our emotional maladies are biologically caused, then the body is where our efforts must be directed.”  (James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good) 

After half a century of experimenting with psychiatric treatments that not only proved ineffective but often harmed, handicapped, or killed patients, the field of psychiatry faced a crisis. General medicine was advancing via revolutionary breakthroughs such as the first organ transplants and blood transfusions, as well as the discovery of antibiotics and insulin. Psychiatry, in contrast, had found little success within the materialist paradigm that dominated scientific discourse. This all changed in the 1950s with the development of the first generation of psychiatric drugs.  

Prior to the 1950s, sedatives and stimulants were commonly prescribed in psychiatric institutions to subdue and control a psychotic or heavily depressed patient. However, psychiatrists were not publicly open regarding how they were using these drugs. 

“Official reticence about the old drugs conveys the impression that they were a source of embarrassment.” Joanna Moncrieff, The Myth of the Chemical Cure 

However, in the 1950s, after a new collection of psychiatric drugs were discovered, psychiatrists started to publicly embrace their use.   

Chlorpromazine, the first neuroleptic or anti-psychotic which was marketed under the name Thorazine, was discovered when researchers, searching for anti-malarial drugs, discovered that chlorpromazine functioned as a “major tranquilizer” which induced in patients a “euphoric quietude…. Patients are calm and somnolent, with a relaxed and detached expression.” The first anxiolytic, or anti-anxiety drug, was a minor tranquilizer which was discovered by researchers searching for a drug to treat gram-negative microbes. While the first antidepressant was a psychological stimulant that was discovered by researchers searching for a drug treatment for tuberculosis. These discoveries initiated what is called the Psychopharmacological Revolution, and in the words of Moncrieff, these drugs “were greeted with immense enthusiasm, verging on zeal. One contemporary observer noted…that the atmosphere at conferences on the new drugs was akin to religious revivalist meetings… From this time on, textbooks started to cover drug treatments in detail and proclaimed their transformative effects.” (Joanna Moncrieff, The Myth of the Chemical Cure)      

Pharmaceutical companies realized that psychiatric drugs could be marketed and sold not only to institutionalized patients, but to the general public, and so they began investing heavily in the research and development of psychiatric drugs. In 1955, Wallace Laboratories brought meprobamate to the market, selling it under the name Miltown, and marketing it as a minor tranquilizer that could ease anxiety and worry. Following an extensive marketing campaign, demand for Miltown soared.  

“The public rush to obtain this new drug was such that Wallace Laboratories and Carter Products, which were jointly selling meprobamate, struggled to keep up with the demand.”  Robert Whitaker, Anatomy of an Epidemic 

Following the success of Miltown, in 1963 the drug maker Hoffmann-La Roche brought Valium, the first benzodiazapene, to market. Valium was marketed primarily to anxious housewives and from 1965 to 1981 it was the best-selling drug in the West and the theme of the Rolling Stone’s song “Mother’s Little Helper”.  

“In 1967, one in three American adults filled a prescription for a “psychoactive” medication, with total sales of such drugs reaching $692 million.” Robert Whitaker, Anatomy of an Epidemic 

This first generation of psychiatry drugs were not only highly profitable for pharmaceutical companies, they also granted the field of psychiatry the status and legitimacy it had long been seeking. For as Joanna Moncrieff writes: 

“[These first generation drugs] were an intervention on the body and as drug treatment grew in importance in other areas of medicine they confirmed the desired parallels between psychiatry and physical medicine.” Joanna Moncrieff, The Myth of the Chemical Cure 

However, the success these drugs conferred on psychiatry and pharmaceutical companies was short-lived, as the public soon became aware that consuming these drugs produced negative side effects.  

While Hoffman-La Roche claimed that Valium provided “pure anxiety relief” and was “safe, harmless and non-addicting”, many users reported physical dependence, terrible withdrawal effects, as well as insomnia, panic attacks, and heightened levels of anxiety. In 1975, the U.S. Justice Department classified benzodiazepines as schedule IV drugs under the Controlled Substance Act. Prescriptions for Valium, as well as other psychiatric drugs, plummeted, and a growing public awareness of the harmful nature of psychiatric drugs led to the development of an antipsychiatry movement.  

The intellectual father of the antipsychiatry movement, Thomas Szasz, argued that psychiatrists were agents of social control and that the diagnosis and medication of the mentally ill was a way to subdue individuals who are reacting, in an undesirable manner, to life in a sick and oppressive society. In 1975, Szasz’s idea found legitimacy when a highly publicized government investigation into the use of neuroleptics in juvenile institutions was hijacked by ex-patients who testified that the drugs caused “excruciating pain” and turned them into “emotional zombies”. One patient said that such drugs “are used not to heal or help, but to torture and control. It is that simple.” This antipsychiatry movement reached popular consciousness via the Oscar winning movie One Flew Over the Cuckoo’s Nest, which portrayed mental hospitals as facilities of torture and control.  

The antipsychiatry movement, as well as the drop in the sales of psychiatric drugs, led the director of the American Psychiatric Association, Melvin Sabshin, to state in 1980 that “the profession is under severe siege.” A solution was needed to save psychiatry, as well as the profits of pharmaceutical companies. And a solution was found. Pharmaceutical scientists gave Emile Kraeplin’s theory a modern spin. They claimed that mental illness is caused by neurotransmitter imbalances in the brain, and that psychiatric drugs correct for such imbalances, fix a broken brain, and cure mental disorders. This idea became known as the chemical imbalance theory of mental illness. Regarding the researcher who is credited with popularizing this theory, James Davies writes:  

“In the early 1960s, a young medical researcher…stumbled upon an idea that would launch a paradigm shift in psychiatry. The researcher was called Joseph Schildkraut, and the idea he advanced was rather simple: fluctuations in our moods may be due to chemical imbalances in our brains. To be sure, Schildkraut was not the first person to entertain this compelling idea. It had been floating around the psychiatric community in one form or another since the mid-1950s when the first antidepressants started to be used. But for some reason when Schildkraut published his hypothesis in the American Journal of Psychiatry in 1965, his views took the community by storm.”  James Davies, Cracked: Why Psychiatry is Doing More Harm Than Good 

Although Schildkraut admitted his theory was “at best a reductionist simplification” that could neither be rejected nor confirmed “on the basis of data currently available”, pharmaceutical scientists and psychiatrists ran with this theory and started to act as if it were true not only for depression, but for all mental disorders. Yet as they lacked hard evidence to support it, the chemical imbalance theory of mental disorders was advanced through a line of reasoning that is illogic, unscientific, and bordering on absurd. For example, with respect to depression, pharmaceutical scientists identified how drugs to treat depression increased levels of norepinephrine and serotonin in the brain, and thus they claimed that depression is caused by low levels of norepinephrine and serotonin. Similarly, they noticed that neuroleptics, or antipsychotics, decreased dopamine transmission in the brain, and hence they proposed that schizophrenia is due to excessive levels of dopamine. Or as Robert Whitaker explains.  

“This became the storytelling formula that was relied upon by pharmaceutical companies again and again: Researchers would identify the mechanism of action for a class of drugs, how the drugs either lowered or raised levels of a brain neurotransmitter, and soon the public would be told that people treated with those medications suffered from the opposite problem.”  Robert Whitaker, Anatomy of an Epidemic 

The following passage by the psychiatrist Robert Taylor hammers home just how absurd and pseudoscientific this line of reasoning is.  

“In the absence of any real progress (in psychopharmacology), psychodrug makers have relied on marketing gimmicks. By far the most successful one portrays psychodrugs as treatment for specific chemical imbalances in the brain. Since psychodrugs alter brain chemicals, so the pitch goes, the conditions they target must be caused by chemical imbalances… A similar line of illogical reasoning would have us believe that aspirin deficiency causes headache, since when we take aspirin the headache gets better.”  Robert Taylor, Finding the Right Psychiatrist 

Or as Joanna Moncrieff explains regarding the chemical imbalance theory of mental disorders that took off in the 1970s.  

“The drug companies were trying to capture that huge market of people who once took tranquilizers. But because the old model of how drugs work had been tarnished, they needed a new model to reassert their value and necessity. So now these drugs were cast as curing us rather than changing us. And that’s where the idea of the chemical imbalance came in. It was perfect because it implied that these drugs actually corrected a defect in the brain. If you have a brain disorder, a chemical imbalance, and this pill is going to correct that imbalance, then obviously you must take it… And this unthinking acceptance of the disease-centered view has dominated mainstream psychiatry for the last twenty or thirty years.”  Joanna Moncrieff, The Myth of the Chemical Cure 

To convince the public of the chemical imbalance theory of mental disorders, one of the biggest propaganda campaigns in history was conducted. The major parties involved included the American Psychiatric Association, or APA, Big Pharma, the non-profit organization National Alliance on Mental Illness, or NAMI, as well as the National Institute of Mental Health, or NIMH. Or as Robert Whitaker writes:  

“…a powerful quartet of voices came together during the 1980s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH put the government’s stamp of approval on the story. NAMI provided a moral authority. This was a coalition that could convince American society of almost anything…”  Robert Whitaker, Anatomy of an Epidemic 

This propaganda campaign initially focused on convincing the public that depression is caused by a chemical imbalance. Depression was likely chosen as the initial target of this campaign because of the fact that most people experience depression at some point in life and so a massive market exists for drugs promoted as “antidepressant”. In 1984, the NIMH launched an educational program called Depression Awareness, Recognition, and Treatment, or DART, whose stated purpose was “to change public attitudes so that there is greater acceptance of depression as a disorder rather than a weakness.” The NIMH director Lewis Judd in 1990 unequivocally claimed:  

“Two decades of research have shown that [psychiatric disorders] are diseases and illnesses like any other diseases and illnesses.”  Quoted in Anatomy of an Epidemic by Robert Whitaker 

Newspapers, magazines, and books by renowned psychiatrists, were also used in this propaganda campaign. In 1989, New York magazine placed the antidepressant drug Prozac on its cover with the headline: “Bye, Bye Blues. A New Wonder Drug for Depression.” One year later Newsweek Magazine’s cover read: “Prozac: A Breakthrough for Depression.” In the same year, one of America’s most famous science writers at the time, Natalie Angier of the New York Times, wrote that antidepressants “work by restoring the balance of neurotransmitter activity in the brain, correcting an abnormal excess or inhibition of the electrochemical signals that control mood, thoughts, appetite, pain and other sensations.” In 1993, the Brown University psychiatrist Peter Kramer published the book Listening to Prozac, which spent 21 weeks on the New York Times bestseller list, and in which he stated that Prozac was making some patients “better than well” and ushering in a new era of “cosmetic psychopharmacology”.  

The United States was not the only country to spread Big Pharma’s propaganda. The Royal Colleges of Psychiatrists in the UK set up a Defeat Depression Campaign, which was funded by the pharmaceutical company Eli Lilly, the makers of Prozac. 

“The campaign sought to persuade General Practitioners that they should diagnose more people as depressed and prescribe more antidepressants…The campaign also aimed to reduce the general public’s resistance to taking drugs for depression.”    Joanna Moncrieff, The Myth of the Chemical Cure 

In both the UK and America, these propaganda campaigns were enormously successful.  

“This selling of depression, which was being done under the guise of a “public education” campaign, turned into one of the most effective marketing efforts ever devised.” Robert Whitaker, Anatomy of an Epidemic 

Between 1992 and 2002, the number of prescriptions issued for antidepressants in the UK increased by 235%. In 1992 sales of Prozac in the United States reached $1 billion dollars. Pharmaceutical companies were swimming in profits, and patients flocked to psychiatrists to be told which chemical imbalance was responsible for their mental distress, and which drugs would fix their brain. The widespread acceptance of the chemical imbalance theory gave the field of psychiatry the legitimacy it was looking for, for as the psychiatrist David Healy explained, it “set the stage [for psychiatrists] to become real doctors.” Or as Robert Whitaker writes: 

“Doctors in internal medicine had their antibiotics, and now psychiatrists could have their “anti-disease” pills too.”  Robert Whitaker, Anatomy of an Epidemic 

The problem with this public relations campaign is that the chemical imbalance theory that was sold to the public is false. It is a “big lie”.     

“Many professionals and the public have been falsely convinced that biochemical imbalances in the brain drive mental suffering, such as the serotonin theory of depression or the dopamine theory of so-called schizophrenia. Yet the evidence for any biological basis for ‘‘psychiatric disorders’’ is utterly lacking.”  Peter Breggin, Journal of Contemporary Psychotherapy, 2016 

Or as the psychiatrist Joanna Moncrieff echoes in the introduction to The Myth of the Chemical Cure:    

“This book exposes the traditional view that psychiatric drugs target underlying diseases, or correct chemical imbalances, as fraud. It traces the emergence of this view and suggest that it was adopted not because there was any evidence to support it, but because it served the vested interest of the psychiatric profession, the pharmaceutical industry and the modern state.”  Joanna Moncrieff, The Myth of the Chemical Cure 

Some studies, funded by the pharmaceutical industry, have concluded that low serotonin levels are implicated in depression, which seems to suggest that drugs that raise these levels may improve depressive symptoms. But the methodology of these studies has been revealed as highly flawed, Moncrieff notes that “contradictory evidence has been overlooked or reframed as supportive”, follow up studies have found no connection between serotonin levels and depression, and meta-analyses of studies have further dispelled the myth that serotonin is implicated in depression. And as Johan Hari explains:  

“If depression and anxiety are caused by a chemical imbalance, and antidepressants work by fixing that imbalance, then you have to account for something odd that [scientists] kept finding. Antidepressant drugs that increase serotonin in the brain have the same modest effect, in clinical trials, as drugs that reduce serotonin in the brain. And they have the same effect as drugs that increase another chemical, norepinephrine. And they have the same effect as drugs that increase another chemical, dopamine. In other words—no matter what chemical you tinker with, you get the same outcome.”   Johan Hari, Lost Connections

Or as Nassir Ghaemi, a psychiatrist and neuroscientist at Novartis Institute, one of the largest pharmaceutical companies in the world, explains:  

“Our best-selling psychopharmacology textbook consists of pure speculations presented as pretty pictures . . . which we mistake for science. We have a huge amount of neurobiology research now to conclude that… neurotransmitter theories of psychopharmacology basically are false. The dopamine and [serotonin] hypotheses of schizophrenia and depression are wrong…”  Nassir Ghaemi, One Step Back, Two Steps Forward 

One of the problems with studies that seek to prove the chemical imbalance theory of mental illness is that we possess no real understanding of how neurotransmitter levels influence or impact human experience. Furthermore, neurotransmitter levels in the brain are constantly fluctuating and there is no agreed upon standard of what constitutes healthy levels. As there is no known “normal” balance of neurotransmitters, there is no way to know what an imbalance would look like, and no way to test if a brain is chemically imbalanced. Or as professor of psychiatry at Northwestern University Hospital, David Kaiser, writes:  

“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 balance would look like . . . . Yet conclusions such as “depression is a biochemical imbalance” are created out of nothing more than semantics and the wishful thinking of scientists/ psychiatrists and a public that will believe anything now that has the stamp of approval of medical science.”  David Kaiser, Commentary: Against Biological Psychiatry 

While the chemical imbalance theory of mental disorders is what the Professor Emeritus of Psychiatry Ronald Pies called an “urban legend”, this theory continues to be widely promoted as an undisputed truth by the psychiatric industry, big pharma, government agencies, and the mainstream media. For example, in 2005, the American Psychiatric Association stated that: “antidepressants may be prescribed to correct imbalances in the levels of chemicals in the brain.” While in 2019, Channon Hodge, a correspondent for CNN, which receives millions of dollars each month in advertising for Big Pharma, stated that:  

“Researchers identified the chemical imbalances that correlate with problems such as depression, for example, and use treatments such as Prozac or Zoloft which block the reabsorption of serotonin so more of it can remain floating around in the brain. The more serotonin floating around, the happier we feel.”  Channon Hodge, CNN Online, April 4, 2019 

In an article titled Psychiatry’s Incurable Hubris, the psychotherapist Gary Greenberg notes how the widespread acceptance of the chemical imbalance theory of mental disorders has been an act of mass-deception perpetuated on an unsuspecting public.  

“The chemical-imbalance theory…may fail as science, but as rhetoric it has turned out to be a wild success.”Gary Greenberg, Psychiatry’s Incurable Hubris 

Or as Joanna Moncrieff echoes:  

“It appears that recent propaganda has been effective enough to persuade a large section of the population that their biochemistry is awry and that they need drug treatment to correct it.”  Joanna Moncrieff, The Myth of the Chemical Cure 

But if the chemical imbalance theory of mental disorders is a big lie, and there is no known neurotransmitter imbalances for psychiatric drugs to fix, then what are psychiatric drugs doing to the brain and mind? In the next video, we examine this question. 

Further Readings