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Ask the Mental Health Expert Archives 2001-2004

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Chemical Imbalances with Depression

Q. Can you provide me with a list of resources for treating chemical imbalances that relate to severe depression? Are there any clinics or treatment centers anywhere in the country?

A. I am not quite sure what you mean by chemical imbalances, but I'll try to be of help. First off, most psychiatrists view clinically severe depression as a bio-psycho-social disorder, with a strong bio component. I mean by this that severe depression usually has biological, psychological, and social roots. For example, Mr. A. loses his job, and finds that his wife no longer speaks to him because she feels he has failed the family. If Mr. Jones is of a particular biological and genetic predisposition, there is a high risk of his developing a significant depressive episode. In contrast, the same stressors might not lead to significant depression in another individual with a different genetic and biochemical make-up.

When psychiatrists speak of a chemical imbalance in depression, they are usually referring to theories about certain brain chemicals, such as serotonin and norepinephrine, which are believed to be out of kilter in most cases of severe depression. In simplest terms, severely depressed people do not have enough of these neurotransmitters in their brains. There is good evidence that antidepressant medications can help restore the brain's natural balance of these chemicals. But, as strange as it may sound, there is evidence that talk therapy (psychotherapy) can also restore normal brain function. In fact, for severe depression, the most effective treatment is probably a combination of medication and some form of psychotherapy (perhaps especially cognitive-behavioral therapy).

You do not need to seek out special treatment centers to get adequate help for depression, though there are many academically-affiliated mood disorder clinics throughout the country. Any competent psychiatrist should be able to treat most cases of depression, and many family and general practitioners can do so, too--often with the assistance of a mental health professional acting as the psychotherapist.

If you want to learn more about depression and resources to treat it, I suggest you contact the National Depressive and Manic-Depressive Association (NDMD) at 800-826-3632 or www.ndmda.org. For more research-oriented information, try the National Alliance for Research on Schizophrenia and Depression (NARSAD) at www.mhsource.narsad.html. Or, contact any department of psychiatry at a near-by medical school and ask for a referral.

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April 2002

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