Psychiatry misleading the public about chemical imbalance in depression

Awais Aftab has responded (see his blog post) to the Sunday Times magazine article about Joanna Moncrieff (see eg. previous post). He raises various useful questions about Jo's position but tends to be very critical of her perspective. It's possible some of the questions he raises may be answered in Jo's new book, due to be published this week. Nonetheless, Awais accepts that the "chemical imbalance story as it existed in the public imagination has little scientific legitimacy".

However, Awais seems to want to exclude psychiatry from any responsibility for people believing the chemical imbalance theory of depression. This seems difficult to justify (see eg. previous post). Awais admits that the chemical imbalance theory has been so vague that it has been left "up to patients and the public to make of it what they want". Why has psychiatry allowed this situation to continue? It must have suited its interests. I have always argued that psychiatry allows, even perpetuates the myth, because it wants people to take their medication (see eg. my BMJ eletter). Psychiatry is so wedded to the notion of antidepressant effectiveness that it allows people to be misled by how antidepressants work (if they do).

Of course psychiatry will say that even though the chemical imbalance theory is too simplistic, then antidepressants still work by correcting some brain problem. Even this claim needs to be challenged (see last post).