It is critically important not to confuse and conflate the hypothesized role of serotonin in depression with a bogus "chemical imbalance theory", or with the efficacy of antidepressant treatment per se.
The only thing I disliked about this article is the paragraph which begins with “On the other hand, I think arguing against biological basis for mental disorder gives unnecessary ammunition” because, as you pointed it out yourself, science is about pursuing truth not optics. The arguments in this entire paragraph seem very akin to the argument that chemical imbalance theory should not be pursued because it makes patients feel worse.
It’s funny that in his twitter thread Horowitz (correctly) points out that SSRIs working does not mean depression is caused by low serotonin — in the same way that headaches are not cause by low aspirin —, but doesn’t realize the argument also goes the other way around: showing depression is not caused by low serotonin does nothing to disprove the efficacy of SSRIs.
He may have other reasons to not believe in SSRIs, but there is no point in bringing them up when talking about the recent paper unless you want to suggest there is a relation.
"I’ve lived with someone who had a schizoid break and had to be involuntarily hospitalized because they were threatening other members of the household. I watched their personality completely change overnight. I can’t believe that no biology was involved in those events..."
To me, that isn't science and you too betray your bias for studies, which are very inconclusive and confounded, that various mental illnesses are "genetic." For example, the twin studies are subject to many criticisms, on which critical psychiatrists have written.
There is also the as yet unresolved causation question. We know PTSD can cause psychosis like symptoms, voices and other disturbances. So, when "proto-schizophrenics" start hearing voices around the usual coming-of-age timeframe, is that really due to a genetic or purely biochemical factor? Or if genetic, are we splitting hairs, but saying that yes, some people have weaker personalities or lower thresholds for pain, so they don't cope well? The response to this sort of thing is that drugs or "fixing imbalances" isn't the right approach. It calls for a psychological one.
As Peter Breggin surmises, I find there is much to the idea that many psychotic breaks start with a break in the coping mechanism - his "failure of nerve." I don't care if that blames the victim--which it doesn't--the truth is that autonomy and personal will are a part of psychiatric disorders.
Hi, Mr. Logan. I have been following your comments with great interest! You may already know this, but Dr. George Dawson and I have published a detailed critique of the Moncrieff et al review, on the Psychiatric Times website, FYI:
Thanks for the thoughtful posting, Mr. Logan.
Please see the paper by Dr. George Dawson and me, at this link:
https://www.researchgate.net/publication/361537710_An_%27urban_legend%27_remains_an_%27urban_legend%27
Also, for further reading, please see:
https://return.life/2022/03/17/the-myth-of-the-chemical-imbalance/
It is critically important not to confuse and conflate the hypothesized role of serotonin in depression with a bogus "chemical imbalance theory", or with the efficacy of antidepressant treatment per se.
Ronald W. Pies, MD
The only thing I disliked about this article is the paragraph which begins with “On the other hand, I think arguing against biological basis for mental disorder gives unnecessary ammunition” because, as you pointed it out yourself, science is about pursuing truth not optics. The arguments in this entire paragraph seem very akin to the argument that chemical imbalance theory should not be pursued because it makes patients feel worse.
I very much appreciate this post, as well as the exchange with Dr. Pies in the comments, introducing new sources, all of which I found clarifying.
It’s funny that in his twitter thread Horowitz (correctly) points out that SSRIs working does not mean depression is caused by low serotonin — in the same way that headaches are not cause by low aspirin —, but doesn’t realize the argument also goes the other way around: showing depression is not caused by low serotonin does nothing to disprove the efficacy of SSRIs.
He may have other reasons to not believe in SSRIs, but there is no point in bringing them up when talking about the recent paper unless you want to suggest there is a relation.
You write:
"I’ve lived with someone who had a schizoid break and had to be involuntarily hospitalized because they were threatening other members of the household. I watched their personality completely change overnight. I can’t believe that no biology was involved in those events..."
To me, that isn't science and you too betray your bias for studies, which are very inconclusive and confounded, that various mental illnesses are "genetic." For example, the twin studies are subject to many criticisms, on which critical psychiatrists have written.
There is also the as yet unresolved causation question. We know PTSD can cause psychosis like symptoms, voices and other disturbances. So, when "proto-schizophrenics" start hearing voices around the usual coming-of-age timeframe, is that really due to a genetic or purely biochemical factor? Or if genetic, are we splitting hairs, but saying that yes, some people have weaker personalities or lower thresholds for pain, so they don't cope well? The response to this sort of thing is that drugs or "fixing imbalances" isn't the right approach. It calls for a psychological one.
As Peter Breggin surmises, I find there is much to the idea that many psychotic breaks start with a break in the coping mechanism - his "failure of nerve." I don't care if that blames the victim--which it doesn't--the truth is that autonomy and personal will are a part of psychiatric disorders.
Hi, Mr. Logan. I have been following your comments with great interest! You may already know this, but Dr. George Dawson and I have published a detailed critique of the Moncrieff et al review, on the Psychiatric Times website, FYI:
https://www.psychiatrictimes.com/view/the-serotonin-fixation-much-ado-about-nothing-new
I hope this will be of interest.
Best regards,
Ron
Ronald W. Pies MD