Many depressed people are very resistant to accepting treatment. In a perfect world, people would have no hangups about scheduling an appointment with a therapist and/or trialing antidepressant medication as an adjunct to their recovery.
However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.
Giving people the "chemical imbalance" narrative is a way to short-circuit many of those internal objections. It gives people a notion that the depression isn't their fault, but rather they are a victim of a chemical change in their body not unlike getting the flu or having low testosterone levels.
In terms of getting people to accept treatment, it's a win. Getting past the ego can be surprisingly hard, but the idea that we're treating chemicals instead of treating the person is a clever trick to sidestep that obstacle and shortcut to the treatment.
In terms of giving people the tools to address their problems, it's not so clear. The more we reinforce the idea that depression is simply chemicals in the brain, the longer it takes for people to realize that they do have some power to influence their thought processes and voluntarily replace negative thought processes with positive ones.
However, it's important to remember what a typical course of treatment looks like. If someone is suffering from depression, getting them to commit to weekly therapy sessions with another person as well as following up with the therapy homework (that is, actually implementing what was discussed at therapy) can be a difficult proposition. Getting someone to stop by the pharmacy on the their way home and spend 10 seconds taking a pill every morning for the next 30 days is an easier proposition. The medication is often the jolt that gets people into a place where they're receptive to therapy, or they start making life changes to improve their depression. It's a quick and easy way to give people space to solve their problems, which is why the "chemical imbalance" sales pitch has become the entry point to getting people on board with treating their depression. Get them to lower their guard, get them started on the easiest treatment, and then work on scaling the treatment up to a more intensive, longer-term plan after they've seen hints of success.
I don't particularly like the "chemical imbalance" sales pitch either, but it really does function as a decent hook for getting people over their objections to starting treatment.
The mental health stigma is systemic as well. Did you know that one of the things asked on an application for a CHL in Texas, as an example, is a list of every single time you've received psychiatric treatment and it's a disqualifier. Similarly the Form 4473 has mental health questions required prior to purchasing firearms. If you've ever been admitted for treatment, you're disqualified.
My purpose isn't to re-litigate gun control as an issue, but to point out that our policies and laws reflect our attitudes about mental health directly on access to things which are enshrined as fundamental rights in the US, already. It's a perfectly reasonable supposition to say: "I don't want truly crazy people to have guns.", it's another to say "I think it's acceptable to strip Constitutional rights from millions of Americans because they once had in-patient treatment as a child for their anxiety."
The latter is a matter of policy (regardless of how well it's actually enforced) simply due to the fact we don't understand the human mind or psychology enough to actually draw an objective distinction between those two types of people. Laws and systems work poorly with things which require subjective determination. "I'll know it when I see it" might be an acceptable type of thing to adjudicate, but it's a terrible type of thing to build bureaucratic processes around that are faceless, soulless, with no recourse.
This is just one of many examples where having any history of seeking treatment for mental health can be a disqualifier, or worse strip you of your rights. It's an effective disqualifier for many types of jobs as well in the US, especially government jobs which require a clearance or working at any company which accepts government contracts which would require a clearance.
> However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.
This is hugely compounded by the fact that even when people do decide to go for treatment like therapy, they discover that its painfully inaccessible. As in, if you don't have enough money to afford the 100$+ hour sessions, you feel like you completely run out of options.
There are more services trying to address this cost issue but from my experience (in Canada), they leave a lot to be desired
Often true, but it's also true that many people don't realize how affordable therapy can be under their insurance plans. YMMV, obviously.
Depression is notorious for making people assume the worst. Many depressed people will assume therapy is inaccessible or too costly without even checking. I would encourage everyone to at least take a few minutes to look it up or call their insurance.
For example, I've walked several people through the process of finding a therapist, checking with their insurance, and scheduling appointments to get them started in the past few years (United States, corporate insurance). For most of them, therapy visits were billed with a $20 copay with a limit of 24 visits per year, which is more than accessible.
However, even if it's not, it's important to put the costs in perspective. How much would you pay for a magic pill that improved your problems? Does $1000/year sound worth it? That's 10 x $100 therapy sessions.
If professional therapy is out of reach, self-directed CBT using books or self-help resources have been shown to be effective as well. Not as fast or effective as professionally-guided therapy, but certainly a worthwhile starting point.
When I had serious depression a while ago trying to find treatment was a seriously depressing experience. I went through several therapists which I didn’t click with and made me just feel worse. When you are already down it‘s very hard to do these attempts because they require a lot of effort and building of trust Every disappointment takes you down even further then . I know people who have had great success with treatment but I also know quite a few people who got more depressed trying to find therapy unsuccessfully.
I've had a similar experience. I think one of the biggest problems with the current approach to mental illness is that practitioners (irrespective of modality) act like unsuccessful treatments are harmless. They're not; they can very credibly reinforce a patient's belief that treatment can't help them. It's easy to say "you just haven't found the right treatment yet, keep trying", but that argument rings pretty hollow after the fifth failure or so.
> However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.
Or, you know, it's a lot of time and money being spent on something that the medical industry has very little success in dealing with.
Yes, it's like the illness affects the ability to ask for help to treat the illness. Something like expecting people who fall down a cliff to walk to the doctor with broken legs. If there is nobody there to help them it's very hard to do it themselves, and even if there is someone it's harder to help a "broken" brain than a broken leg.
It seems like anybody familiar with the history of the profession would be wise to not so easily “accept treatment.” But then again, even insiders like Jordan Peterson will “accept treatment” that nearly kills them. The hubris isn’t unique to any one branch of medicine, but consider that not very long ago shock treatment for homosexuals was the accepted treatment. That should give you pause if nothing else.
> It seems like anybody familiar with the history of the profession would be wise to not so easily “accept treatment.”
It's amazing how mainstream the anti-psychiatry movement has become. Please ignore it and focus on the modern science. The attempts to dismiss modern science with questionable historical references is non sequitur.
> But then again, even insiders like Jordan Peterson will “accept treatment” that nearly kills them.
Jordan Peterson is not an insider. He's not even a good representative of the industry. Please don't interpret anything he says or does as representative of the field. He's a social media star, not a recognized expert.
However, in the real world many people are resistant to the idea of therapy and/or medication as it feels like admitting defeat. Or perhaps they've read cherry-picked horror stories of bad therapists or medication side effects on the internet.
Giving people the "chemical imbalance" narrative is a way to short-circuit many of those internal objections. It gives people a notion that the depression isn't their fault, but rather they are a victim of a chemical change in their body not unlike getting the flu or having low testosterone levels.
In terms of getting people to accept treatment, it's a win. Getting past the ego can be surprisingly hard, but the idea that we're treating chemicals instead of treating the person is a clever trick to sidestep that obstacle and shortcut to the treatment.
In terms of giving people the tools to address their problems, it's not so clear. The more we reinforce the idea that depression is simply chemicals in the brain, the longer it takes for people to realize that they do have some power to influence their thought processes and voluntarily replace negative thought processes with positive ones.
However, it's important to remember what a typical course of treatment looks like. If someone is suffering from depression, getting them to commit to weekly therapy sessions with another person as well as following up with the therapy homework (that is, actually implementing what was discussed at therapy) can be a difficult proposition. Getting someone to stop by the pharmacy on the their way home and spend 10 seconds taking a pill every morning for the next 30 days is an easier proposition. The medication is often the jolt that gets people into a place where they're receptive to therapy, or they start making life changes to improve their depression. It's a quick and easy way to give people space to solve their problems, which is why the "chemical imbalance" sales pitch has become the entry point to getting people on board with treating their depression. Get them to lower their guard, get them started on the easiest treatment, and then work on scaling the treatment up to a more intensive, longer-term plan after they've seen hints of success.
I don't particularly like the "chemical imbalance" sales pitch either, but it really does function as a decent hook for getting people over their objections to starting treatment.