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Understanding Mental Illness as a Chemical Imbalance

Updated on May 6, 2013

What is Mental Illness?

What do you think of when you hear the term "mental illness"? Do you think of the homeless man on the side of the road talking to himself with no place to go? Do you think of the "crazy" woman locked up in a psychiatric hospital with little chance for recovery? Do you think of the child born with little brain function, the person rocking back and forth with no regard for anyone around him, or the psychopath on a killing spree? If so, you're not alone. There are so many misconceptions about "mental illness". Part of my job as a therapist has been to assess patients in a local emergency room when a psychiatric emergency is considered by the attending physician. When I speak with the patient, I often hear, "I don't need counseling because I'm not crazy", or "My doctor suggested medication, but I'm not taking it because I'm not crazy", or even, "I'm not going to a psychiatric hospital because that's the looney bin". This misconception often leads to lack of an appropriate diagnosis, which leads to lack of appropriate treatment, which leads to years of confusion and turmoil for the patient.

Mental illness is often just that, an illness in the brain. I like to use the term "mental health concern" instead because it tends to sound less devastating. So what does this mean? Well, it means that much of the time, a person with a mental health condition is very similar to a person with a heart condition, a thyroid condition, or a kidney condition. This person has a chemical imbalance in their brain that needs to be corrected to become "normal" once again. Putting it another way, just as a person would take medication (Synthroid or something similar) to control a thyroid condition, or take insulin to control diabetes, a person with a mental health condition often needs medication to regulate the chemicals in their brain to control emotional or sometimes physical symptoms. Medication can help a person with any type of mental health concern lead a very normal life.

Let's take a look at some common mental health diagnoses.


Probably the most common mental health condition is depression. Approximately 1 in 10 people suffer from some level of depression, but some statistics show that about 54% of people feel that depression is a personal weakness. 41% of depressed women are too embarrassed to seek help, and about 80% of depressed people are not seeking treatment. However, depression is a very treatable condition, and about 80-90 percent of depressed people can experience relief.

In my opinion, there are two types of depression, situational depression and chemical depression. Situational depression occurs when a person goes through a situation in his or her life that causes significant pain or distress such as divorce, major health issue, loss of loved one, job loss, or the like. People dealing with situational depression may be able to deal with their emotional state by turning to friends, pastors, or individual counseling for assistance, and medication may not be necessary. An antidepressant may be prescribed short term to help the person be able to more readily deal with thier issues. On the other hand, chemical depression occurs when a person is predisposed to depression and often a person feels down or depressed with no known reason. Chemicals such as seratonin and dopamine in the brain are not regulated. Medication, an antidepressant such as a selective seratonin reuptake inhibitor (Prozac, Paxil, Lexapro, Zoloft) may be prescribed to regulate the chemicals.

Bipolar Disorder

Another mental health disorder, Bipolar Disorder, is characterized by periods of severe depression and periods of mania. People with this disorder often engage in reckless behavior, appear irritable, have little need for sleep, have little self control, racing thoughts, and many other concerning behaviors during manic periods. Bipolar Disorder appears to be genetic, and appears to have chemical causes (abnormal seratonin levels). Mood stabilizer medication can drastically improve symptoms and enable a person suffering with Bipolar Disorder to lead a quite normal life. I have a very good friend who is a teacher in an elementary school. She was diagnosed with Bipolar Disorder over 10 years ago. It took years for a psychiatrist to find the right combination of medication for her, but for the last 7 years or so, she has been more than capable of teaching young children to read, add, subtract, and love school. She is not mentally ill, she has a mental health condition that is being treated successfully.

Other mental health diagnoses such as schizophrenia, ADHD, and Obsessive-Compulsive Disorder could also be considered and discussed here.

Famous People with Mental Health Conditions

We often hear of various celebrities suffering from mental illness such as Brittany Spears, but did you realize the following also battled mental health conditions:

John Quincy Adams-- President-- Clinical Depression
Buzz Aldrin-- Astronaut-- Clinical Depression
Ludwig van Beethovan-- Composer-- Bipolar Disorder
Drew Carrey Comedian-- Clinical-- Depression
Winston Churchill-- British Prime Minister-- Bipolar Disorder, Dyslexia
Dick Clark-- TV Personality-- Clinical Depression
Harrison Ford --Actor-- Clinical Depression
Billy Joel-- Singer --Clinical Depression
Margot Kidder --Actress --Bipolar Disorder
Howie Mandel --Comedian --Obsessive Compulsive Disorder
J.P. Morgan --Financier-- Clinical Depression
Donny Osmond-- Singer --Clinical Depression, Social phobia
Marie Osmond --Singer--- Post Partum Depression
Charley Pell-- Former UF football coach-- Clinical Depression
Daryll Strawberry --Baseball Player-- Clinical Depression
Mike Wallace --Journalist --Clinical Depression
Robin Williams-- Actor/Comedian-- Clinical Depression

And there are so many others.


There should not be a stigma to mental health conditions. Because of the stigma, so many people who experience symptoms of various mental health issues do not seek treatment, and therefore live with their conditions, but could have a much better quality of life. It seems so much more palatable to seek treatment for a thyroid condition, heart condition, or diabetes than it is to seek treatment for a mental health condition, but the stigma needs to be removed and more people need to understand that a "mental illness" is just that, an "illness" that needs medical attention the same as any other "illness".


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    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      Meloncauli, I agree with you that not everyone that suffers from depression requires medication. Like I said earlier in a comment, when I assess a patient at first, I ask many questions including physical questions to determine whether there is a phsiological cause to the depression or psychological issue (hypothyroidism, low iron, etc can mimic psych symptoms). This is the first thing to address. Then, therapy needs to be initiated to see if this will be beneficial. Many times if a patient can work through their past issues and are ready and determined to get well, this will be beneficial and the only treatment necessary. Only if symptoms are so severe that they hinder progress will medication be necessary. I have noticed in OCD patients that often a patient is so busy obsessing about their form of the condition that behavioral interventions won't work until they can focus on the treatment. A mild antidepressant has been known to be beneficial so that the obsessions can be managed and behavioral interventions have a chance to be put into place and work.

    • meloncauli profile image

      meloncauli 5 years ago from UK

      And so say all of us! It's a heavy debate that sadly the survivors of the psychiatric system will rarely if ever win! I only had depression as a teenager, but an asylum, psychiatric meds ( that never made me well), and ect wrecked my life until I helped myself to recover...naturally without pills. I gave nearly 30 years of my life to trusting and believing in the system. I believed in the countless different tags I ended up with because I thought the experts knew a whole lot more than me. I found out that I understood me a lot more than any of them ever did, bought self help books and cured myself. My life is now dedicated to helping those who are suffering within the system.

      It is hard though. A scared person is a vulnerable person and wants to believe that they have an 'illness' because it's better than thinking they have failed in some way or are useless. Neither are true of course but being branded can make some feel justified in needing help.

      The trouble is there are the lesser disorders and the severe mental health problems but they are all lumped together as a psychiatric illness. 50% of psychiatric illness, in my opinion, is reaction to life experiences. Reactions can be changed and the instigating factor addressed. Therapy is the way forward.

    • Insanity Inc profile image

      Insanity Inc 5 years ago from Vermont, USA

      I must open my comment with an expression of appreciation for the fact that you have followed this vocation. However, the myths about "chemical imbalance" are just that-myths! Try reading "Mad in America: and "Anatomy of an Epidemic" by Robert Whitaker. I personally know of quite a few mental health professionals who have had their own worlds turned upside down by the detailed, researched information put forth in these books. Big Pharma has duped us all...those in need of help, and those dedicating their lives to providing it. I have said for way too many years that, just like policemen being required to expose themselves to experiencing the effects of a taser, so should prescribing doctors be required to take the pills they prescribe to their patients.

    • gsidley profile image

      Dr. Gary L. Sidley 5 years ago from Lancashire, England

      We're clearly not going to agree. So let's call a truce for now. We'll no doubt resume battle on a future hub!

      Best wishes.

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      gsidley-I appreciate your opinion, but I still disagree. I know many others affected by mental health concerns that would also disagree, and many who have decided to seek treatment because the medical model made more sense than the thought that they were "just crazy". People's lives have been changed because they decided that it was OK to be treated for this condition much like a person with diabetes or a heart condition. Like I said, not all depressions require meds, but when you are dealing with bipolar disorder or something to that level, I don't see how you can deal with your past issues and get rid of your symptoms.

    • gsidley profile image

      Dr. Gary L. Sidley 5 years ago from Lancashire, England

      TripleAMom - we are all striving to reduce stigma, but "educating" the public that mental illnesses are caused by a chemical imbalance in the brain increases stigma rather than reducing it.

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      Thanks schoolgirlforreal- appreciate your nice comments. It's amazing how many people deal with mental health issues, some successfully and some not. MOst of the ones that are not successful are refusing to seek treatment due to stigma. I really feel more people need to be educated.

    • schoolgirlforreal profile image

      schoolgirlforreal 5 years ago from USA

      "She is not mentally ill, she has a mental health condition that is being treated successfully."

      Nice hub, good information! Loved hearing about Billy Joel, and the others! "It takes a little crazy to make a genius"~Schoolgirlforreal


    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      meoloncauli-I agree with you that not everyone who suffers from depression has an "illness". As I said in the article, I truly believe that there is situational depression and chemical depression. Situational depression is due to the events and conditions a person is going through, and the ONLY time a person in this category would need medication is if the depressive symptoms are so severe that they can't function in everyday life. I totally agree that the person needs to be looked at wholistically. When I begin to see a person in therapy, I do an assessment and ask such questions as what has happened recently, background info, medical conditions, if the person has had bloodwork recently (thyroid conditions, low iron, etc can mimic depressive symptoms). I send them to their primary doc if they haven't had a physical or bloodwork in a while, then initiate counseling first before referring for a psychiatric eval for medication. Medication should always be a last resort. Thanks for reading and commenting.

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      I could see that people who don't understand the concept of mental health could feel that people with a mental health disorder could be "more dangerous" than others, but I feel that this is where the general public needs to be educated. As I do counseling with others, they are very resistent to treatment until they understand that they have a chemical issue that needs to be addressed. Then it makes sense to them. I completely believe that counseling is the first step in any situation, and the practice I am in supports this. I refer to the psychiatrist when we feel it is necessary. I work on issues first and assess whether we feel we need to refer for meds.

      Here's my other thought. I deal with depression and have taken medication for 12 years. Sure, I've had my share of events in my life that could easily result in situational depression, But, I don't want to believe, and I don't believe, that these things are still causing my depression. I have been through counseling and have learned to deal with thise things effectively and move beyond. Right now I have a great family, awesome church that I love, great profession and jobs, amazing friends. There's nothing going on now. But, I have tried in the past to go off the medication and have gone back into serious symptoms of depression. I alwo had a period of time about 6 months ago where my GP and the pharmacy were having a mix up with my medication and I didn't have it for a period of time. There was a significant difference in mood. Symptoms returning. I would love to not take the medication, but my family deserves for me to be "healthy". Others in my life, most of my friends have no idea that I deal with this. I coordinate VBS, fall festival, children's christmas programs, have a case load of patients, am very involved in my children's school, and so much more. Most people tell me I need to slow down.

      I see your point, but my opinion is that people need more education about mental health issues. I think there is a stigma on any side of the coin.

    • gsidley profile image

      Dr. Gary L. Sidley 5 years ago from Lancashire, England

      Hi TripleAMom

      Thanks for your response. You are right in highlighting that there are many theories relating to mental health problems; this contributes to making it such an interesting topic. But some assertions arising from these theories have more evidence to support them than others. You are probably correct in saying that biochemical imbalance explanations of causation are the "most commonly recognized," at least among professionals (although, interestingly, not among the general public where psycho-social explanations predominate) as it is the explanation that psychiatrists and drug companies have been peddling for over half a century. There is, however, little evidence to support the idea that psychosis and depression have a specific biochemical cause.

      This is not to say that medications do not have a role to play; they clearly reduce symptoms for many people. But I reject the notion that it achieves this by rectifying an illness-specific biochemical imbalance.

      Your article from the American Psychological Association seems sensible and balanced; I could not see any assertion of the "illness like any other" argument within it.

      As for the links with stigma, a series of research studies has demonstrated that people who adhere to biological explanations are more prejudiced and rejecting of people with mental illness, seeing them as dangerous and having a stronger tendency to avoid them. A useful reference is the book:

      "Models of Madness: Psychological, Social & Biological Approaches to Schizophrenia" (Eds: Read, J., Mosher, L.R. & Bentall, R) (2004). Chapter 11 p138 - 140.

    • meloncauli profile image

      meloncauli 5 years ago from UK

      Hi TripleAMom. Interesting article. I see it like this: In the UK we don't get any testing whatsoever for any mental 'illness' apart from checking lithium levels for bipolar. In medicine generally, there are tests to diagnose before treating. Only when an illness has been medically proven through investigation or tests will medication be given.. (obviously not for pain etc). If we term ALL mental problems as 'illnesses' we take away any other factors as being causes or instigating possibilities and so medication will seem as though it is the only solution.

      I look forward to the day when a person is looked at holistically where their mental health is concerned, their spiritual feelings, their social situations which often have a huge effect on their mental equilibrium.

      I am not a scientologist nor have anything to do with all that!

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      Hello gsidley. I do welcome different opinions. I would like to see what you are referring to. As a Licensed Clinical Social Woker with a BA in Psychology and an MSW in social work I have done a lot of research and study. There is really no "established" research, just theories, some more recognized than others. The most commonly recognized include the fact that those who are severely depressed have an imbalance in the amount of seratonin and norepinephrine (sp?). This is why for those significantly depressed, medication is helpful to regulate the chemical imbalance. I do agree that for some, "sadness" or "being depressed" can be a situational issue and I address it in the hub. For these issues, just an acknowledgement that choices can be made, life will go on, or time can heal all wounds is all that is necessary.

      I am not just addressing depression though. Other mental health issues fall into play here as well. Bipolar disorder, schizophrenia, and so many others don't have to do with environment but chemicals and require medication to regulate.

      Here is an article with American Psychological Association:

      I also saw that someone has been awarded 5000 dollars to study the stigma associated with chemical imbalance vs. environmental factors, but there are no results yet in the study I saw. Would like to see info you have.

    • gsidley profile image

      Dr. Gary L. Sidley 5 years ago from Lancashire, England

      I have a very different viewpoint when it comes to making sense of mental health problems (life would be very boring if we always agreed with each other!).

      I'll raise just one point here. Research has established that viewing mental health problems as having a primary biological cause is associated with much more stigma than making sense of it in terms of difficult life experiences. The "illness like any other" argument has little evidence to support it and is associated with a number of negative consequences.

      I look forward to a lively debate!

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      Thanks for sharing Peter. YOu have truly overcome your dyslexia and become successful. Congrats. My son has a best friend that dealt with dyslexia. His parents took him out of school and homeschooled him so that he would not face the stigma of not being able to achieve like his friends, especially in early grades. Now he is in 9th grade and reads like other kids, is very brite, and does well. He never had to worry about mainstream gradesa and being compared to others, so he was able to thrive.

    • Peter Geekie profile image

      Peter Geekie 5 years ago from Sittingbourne

      Dear TripleAMom

      Thank you for a very informative hub. I grew up with my dyslexia undiagnosed and consequently was considered stupid. I never considered myself stupid but became frustrated and consequently very disruptive. Despite the condition I compensated in other ways becoming a pharmaceutical and industrial chemist and eventually the Technical Director of a multimillion pound chemical company. It is important to overcome your problems and concentrate on your abilities. My greatest asset these days is the spell checker !!

      Kind regards Peter

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      BethDW, I wholeheartedly agree. It is so frustrating to have people not seek help and stay in turmoil because seeking treatment for a "mental illness" would mean they were crazy. What a false myth. Particularly when taking a pill each day can lead to such a higher quality of life. Thanks for your comments and for sharing. This is something I would love to get out to as many people as possible so that the stigma of mental health would be deminished.

    • profile image

      BethDW 5 years ago

      Such a well researched and informative hub, and such an important topic! The issue of stigma around mental illness is so pertinent, and there is a definite need to shift the paradigm of thinking in our culture around 'health' to include mental health issues, to make it more acceptable for people struggling with these issues to seek medical care as they would for any other medical problem. Voted up and shared!

    • Melovy profile image

      Yvonne Spence 5 years ago from UK

      An interesting hub. I agree that the stigma attached to ‘mental illness’ is a deterrent to some seeking help. I have a sibling with a mental health condition who is very resistant to help and I think this is partly because of fear of stigma.

      One thing I find interesting is that psychiatrists do not agree on her condition - one has said it is an illness and would respond to medication, another that it is a condition and may not respond to meds.

      I also have known many others who have experienced ment

      In my view 'mental illness’ is just an extreme version of a continuum that we are all on, and is a reflection of how poorly the human race communicates with each other. The more we can learn to communicate compassionately the fewer people will be affected by mental illness.

      Thank you for a thought provoking hub.

    • thebestyou profile image

      thebestyou 5 years ago

      Thank you for spreading the knowledge about mental health issues. Most people do not understand the disease

    • TripleAMom profile image

      TripleAMom 5 years ago from Florida

      Thank you for commenting. So many people have a mental health condition, but there is such a stigma that it is still a "secret condition". This should not be. More people could be "stable" if they felt they could seek treatment.

    • profile image 5 years ago

      I am bipolar and take medication to keep me stable. If I were not on these meds I would be dead. I learned a long time ago that mental illness is compared to any other disease. Thank you for bringing more attention to the public so more people with mental illness will come forward and get help.