The “Chemical Imbalance” in Mental Health Problems

Medication

Understanding these four neurotransmitters provides a window to understanding the majority of psychiatric conditions, ranging from depression to schizophrenia. Mental health professionals use psychological testing, interviews, questionnaires, and patient history to determine first, if a change in the neurotransmitter system is present, then second, what neurotransmitters are involved. A proper clinical diagnosis then leads to proper medication treatment.

Medications are prescribed in an effort to return the brain’s neurotransmitter status to normal. Much like a physician may prescribe a medication to lower your cholesterol or increase another body chemical, mental health professionals are concerned with returning your neurotransmitter levels to normal.

Medications for mental health conditions work in several ways:

• Some imitate the neurotransmitter, triggering a response as though the original neurotransmitter were present
• Some block the neurotransmitter from being absorbed by the surrounding neurons, known as blocking the reuptake. Reuptake inhibitors block the reabsorption/reuptake of Serotonin or Norepinephrine and thus make more neurotransmitter available
• Some force the release of the neurotransmitter, causing an exaggerated effect. Cocaine does this to Norepinephrine and Dopamine while MDMA (Ecstasy – a club drug) does this to Serotonin.
• Some increase neurotransmitters known to slowdown or reduce the production of other neurotransmitters.
• Some block the release of neurotransmitters completely
• Some interfere with the storage of neurotransmitters, allowing them to come out of storage and lose potency

Based on the neurotransmitter theory of psychiatric illness, we can plot clinical conditions and see how mental health professionals determine medication treatment by recognizing which neurotransmitters are involved:

Diagnosis: Stress-Produced Depression
Neurotransmitter: Low Serotonin
Medication: Selective Serotonin Reuptake Inhibitor (SSRI)

Diagnosis: Agitated/Anxious Depression
Neurotransmitter: Low Serotonin, Elevated Norepinephrine
Medication: SSRI and Antianxiety Medication or Serotonin Norepinephrine Reuptake Inhibitor (SNRI)

Diagnosis: Major Depression with Psychosis (Severe depression with hallucinations/paranoia)
Neurotransmitter: Elevated Dopamine, Low Serotonin
Medication: Antipsychotic medication, SSRI

Diagnosis: Bipolar Disorder, Mania
Neurotransmitter: Low GABA
Medication: Anticonvulsant or Lithium

Diagnosis: Bipolar Disorder, Depressed
Neurotransmitter: Low GABA, Low Serotonin
Medication: Anticonvulsant or Lithium, SSRI

A variety of conditions and circumstances encountered in life can produce changes in our brain chemistry. These changes can then create mental health problems. We have known for years that chemical and substances in the body can become unregulated as in high blood pressure, high cholesterol, low/high blood sugar, etc. There is no stigma associated with using medications to return these body chemicals/substances back to their normal levels.

It is the hope of mental health professionals that the public can understand the medical and neurochemical nature of various emotional and psychiatric conditions, thus eliminating the stigma often associated with treatment. Modern treatment is very effective and can eliminate years of emotional suffering with very little in the way of intervention or treatment. Mental health treatment is available in every county in the United States.

Written by Joseph M. Carver, Ph.D.,Clinical Psychologist Please visit Dr. Carver's website http://www.drjoecarver.com for more articles.