Mental Health Information
In reply to the discussion: Treatment-resistant depression [View all]HereSince1628
(36,063 posts)Scientific method'S' include surveillance, experimentation, and theoretical efforts. American education emphasizes experimentation, and if asked most Americans would likely explain -the- scientific method in terms of experimentation. For biology this follows from decisions that went into building the BSCS curriculum way back in the late 1950's.
Theoretical methods are a valuable and valid means of study, although like other types of study they can be poorly done and flawed. Published reports of empirical findings accumulate to fill library and server space. Theoretical methods are employed to summarize and construct more general explanations from the various sources of empirical experience. The goodness of theoretical explanations is largely dependent upon the capacity of the theoretical explanations to generate hypotheses particularly critical hypotheses that test the validity of the theoretical explanation. The journal Medical Hypotheses serves the need to communicate these ideas, it's name probably shouldn't be an indication that it is a sham journal. The quality of a scientific journal must be judged on what I'll simply call its meaningful contributions to the discipline it serves.
I'm not familiar with this journal and don't have access to bibliographic tools that would help me assess it. The publisher, Elsevier, produces many journals, my familiarity with the publisher is journals in ecology, the reputations of which are varied.
Al-Malahk et al communicate a hypothesis, a result that emerges from application of theoretical methods... postulating an explanation drawn from details of other studies. Their various suggestions include the notion that the anatomical and functional changes in developing Rattus brains exposed to antidepressants may also occur in humans, as well as the notion that a genetic variation that interferes with serotonin systems may provide a useful model of a neurological system that is unable to respond to SSRI's. The evaluation of those ideas obviously involves expert criticism of the logic and information included in construction of that explanation, as well as the results of studies.
Evaluation of these Al-Malahk et al hypotheses is NOT the purpose of Levine. Levine's purpose appears to be arguing against the use of anti-depressants, and he builds upon the notion that SSRI exposure changes in developing Rattus brains and the obvious implications if similar changes take place in human brains exposed to SSRIs.
IMO, there is still much uncertainty about the details of the role of serotonin in depression. The notion of "chemical imbalance' is too widely uncritically accepted by psychologists, and users. Depression undoubtedly involves biochemistry, anti-depressants are chemicals and obviously have some effects on depression in some/many users.
Even without being an expert it's fairly obvious that there is a risk of making an error in going backwards with that correlation to arrive at the widely uncritically accepted notion that a nebulous something referred to as 'chemical imbalance' is the cause of depression (and many other mental disorders).
That makes consumers very vulnerable to the notion that depression (and many other mental illnesses) can always be mitigated with a proper elixir. It may also push consumers away from useful therapies of professionals who don't supply chemical fixes. In short, this generates many potential conflicts of interest surrounding psychopharmaceutical treatment of depression. IMO, the Levine essay seems to be addressing that.
Yet, all metabolic activity is chemical activity; as attractive as it is, the invocation of chemical imbalance really says very little. Depression may be a single outcome (equiterminus) that variously results from one or multiple effectors on neurological processes, or there may be multiple types of subtle yet different depressions which appear much the same behaviorally but have different causations. How one views that depends largely upon variations in expertise and motivation.
From a practical experience point of view, the trial and error nature of therapy for depression is quite suggestive of the existence of lack of understanding to a degree that impacts therapy.