For many years, mental health professionals have used the term “chemical imbalance” to explain the need for medications to treat mental health conditions like depression and anxiety. This commonly used explanation suggests that anxiety is a medical problem and that it can be treated with medication. The “chemical imbalance” explanation also reflects the overall theme of treatment—identifying which neurotransmitters are involved and, with medication, attempting to return the neurotransmitter level back to the “normal” range. Two types of medications commonly recommended for anxiety are minor tranquilizers (e.g., Xanax, Ativan, Valium) and anti-depressants (e.g., Prozac, Paxil, Zoloft). Much like taking medication for any sort of physical problem, anti-anxiety medication is prescribed until the problem (hopefully) goes away.
It’s important to point out that the chemical imbalance approach is a theory and not a fact. There’s no test for chemical imbalance in the human brain. Much about the human brain is still a complete mystery, and there needs to be a lot more research into this area before anyone (including myself) can make absolute statements about the cause of anxiety disorders. Regardless of the lack of evidence, many in the West are absolutely convinced that all anxiety is the result of a chemical imbalance.
This position doesn’t make sense to me. Take the example of a fireman who suffers from panic attacks. He’s able to work as a fireman, in situations of extreme stress, without experiencing any panic symptoms whatsoever. But when he has to sit in the barber’s chair to get his hair cut, he always has a panic attack because he feels trapped and cannot escape. Are the chemicals in his brain causing him to panic? No, obviously not. It’s a behavioral reaction to the situation in which he finds himself. What you see with almost all people who experience regular panic attacks is that they occur in certain situations, and they’re dependent on a range of external and internal circumstances.
For example, if a train suddenly stops on the tracks between stations, anyone on board with a panic disorder might start to feel a bit anxious. The driver announces to everyone that they’ll have to wait in their seats until the problem is fixed. Suddenly the anxious person feels very uncomfortable and may even start to panic. The additional anxiety comes from a mental evaluation of the situation:
Trapped on train = limited mobility = no escape = PANIC
Two minutes later, the driver says it was a false alarm and the journey can continue. Panic stops. This is just one example, but there are many different examples of how anxiety and panic are a result of people’s thoughts rather than a chemical imbalance over which the person has no control.
My feeling is that those who seek to profit from the sale of prescription drugs are responsible for promoting the chemical imbalance theory so aggressively. It may be the case that other more serious mental health issues, such as manic depression or schizophrenia, really are the result of a chemical imbalance, but I don’t believe it to be the case for anxiety disorders. Having said all that, I’m not totally against the use of medication for treating anxiety. Medication can play a role for some individuals who find it very difficult to get started on the road to recovery
