Understanding Chemical Imbalance

When I ask my patients why they feel a certain way, why for example they feel depressed or anxious, they sometimes say they don’t know, and in the same breath often add that they were told they have a chemical imbalance. In their minds what that implies is that like the pancreas in diabetes, their brain has some sort of physical deficit that causes the symptom, and that like Insulin, they have to take medication for the rest of their lives to compensate for the deficiency. This way of thinking gets reinforced when they have parents who suffered from similar symptoms, because genes, so the logic goes, must have passed on this problem. In other words, apart from managing the symptoms through medication, there is little that can be done to remedy the situation, since it is a ‘biological’ or ‘physical’ defect that can only be controlled, not cured.

This reasonable train of thought that applies to the pancreas, does not to the brain – or I should say, is far more complex when we deal with the brain. The pancreas could be crassly compared to a hormone factory. It produces a number of hormones and enzymes. That’s it. If it is defective, there will be a lack of hormones, and there is little you can do. Yes, you can change your diet to modify how much Insulin you need or how efficiently Insulin gets metabolized, but if the Insulin cells are defective, there will be less or no Insulin, and the Insulin cannot change the damage in the pancreas.

Not so with the brain. The brain also produces hormones in the hypothalamus, but its main function is much more exotic. It is an information processor and mapper. It processes energy flow that gets picked up by the internal and external senses, maps different energy flows against each other by making maps of what is going on in the body as it interacts with the environment, then maps those maps (called metamaps) in a multilayered process, until this metamapping becomes incredibly complex. At this complex stage we then refer to the processing of energy flow as information processing. When you make a map of your backyard for example, you are creating a relationship between your actual yard and thoughts you have about the yard. As the brain does the same, but in unimaginably more complex ways, it creates relationships between different levels of information processing and different aspects of reality, including itself. The brain is thus a relationship organ, managing the relationships between the organism and its environment, the organism and itself, and the brain itself with itself. We could say that while the pancreas produces Insulin, the brain ‘produces’ relationships between different levels of information processing. Two more points: (1) When information processing and mapping reaches a certain level of complexity, we seem to experience that as thinking. Thoughts are thus energy flow that points beyond itself, called information flow; what it is pointing to is the content or meaning of the thought. (2) This whole complex process of metamapping acquires the quality of awareness. All in all, the way we experience these relationships between different levels of information processing by the brain is called mind. In short (and admittedly too short to be entirely accurate), while the pancreas produces Insulin, the brain ‘produces’ mind, and mind, unlike Insulin, ‘has a mind of its own’ that is not reducible to the brain, and that in fact can change the wiring and structure of the brain, because the brain is neuroplastic (can rewire itself).

Insulin and mind could therefore not be more different in their relationship to their organ of origin. What’s special about mind is that it contains the ‘you’ who can be in charge by directing attention, and directing attention in certain ways wires the brain. You can use your mind to rewire the brain, and you cannot tell what is primary, the mind or the brain. Objective neurofirings (brain) cause subjective experience (mind), and vice versa. Sometimes neurofirings cause subjective experience, sometimes the other way round, and most times it is impossible to separate the chicken from the egg. Biology causes psychology and vice versa. The brain is minded and the mind embodied. Applied to our notion of chemical imbalance, when you cry for example, there is bound to be a chemical imbalance – the question is where its cause lies: Is a brain-altering substance or physical impingement causing sadness and crying, or is the mind in pain causing alterations in chemical brain functioning expressed as sadness and crying? This shows you how relative the notion of a chemical imbalance is, and that addressing this question is central to the development of a sound treatment approach. To simplify and clarify our discourse, let’s call a chemical imbalance due to a brain alteration a biological chemical imbalance (BCI), one due to a mind alteration a psychological one (PCI).

The way the body and the brain are built and function is partly transmitted from generation to generation through genes – we all know that. What does not get enough attention in the medical community is that the mind also gets transmitted from generation to generation, and the entity of transmission is called the meme. Don’t worry too much about the meme, but this is just to say that if your dad is constantly angry and taking it out on you as a child, your dad’s angry mind will be passed on to your mind, which gets structured by the anger in certain ways that will cause your mind to be dysfunctional. Because of the inextricable interaction between mind and brain, your dysfunctional mind will cause changes in your neurofiring patterns and even your brain structure to cause a dysfunctional brain with a chemical imbalance. No genes involved whatsoever!

Practically speaking this has huge implications for how psychiatrists need to counsel their patients. To deliberately oversimplify in order to make a point, a patient with a psychological chemical imbalance requires primarily psychotherapy and meditation, since mind is the cause of symptoms and needs to be treated in order to fix the imbalance. A patient with a biological chemical imbalance requires primarily medication, since the cause of symptoms is in the brain. The reason this is far too simplistic lies in the fact that the mind can rewire the brain and the brain can change the mind, which means physical brain problems can sometimes be addressed through the mind and mind problems through the brain with medication. At other times the combination of both medication and psychological interventions are the most efficient. Therefore all kinds of subtleties of treatment combinations have to be considered that are too complex to elaborate on in this context. However, an important point emerges from all this: Mind is to a large extent unconscious, and as Voltaire already said long time ago, ‘the heart has its reasons that reason does not know’. Just because we may not understand why we feel a certain way, does not mean there is no hidden reason in the recesses of the mind (in fact there almost always is!). Just because we cannot make sense of our own mind does not mean the cause must be in the genes! Once we acknowledge that, we can also rest in the knowledge that the mind methods we have to help the mind are designed to get at precisely those hidden themes in our lives that cause havoc without us knowing that they do or even exist.

In my practice, in which I do not deal with illnesses such as schizophrenia, where primary brain dysfunction is likely the norm, I mostly see people who suffer from mind problems, not brain problems, and yet so many of my patients are previously treated by other professionals as if they had no mind, as if the mind could not rewire the brain, and as if they had a dysfunctional brain that requires medication. Immediately reaching for the prescription pad when a depressed patient enters the office has two ‘advantages’: It is the kind of quick fix we all tend to crave, and it absolves the patient from months and years of hard mind work. Patients are institutionally encouraged to feel that they have nothing to do with ‘their depression’, and that the doctor can fix it. This attitude may be appealing in theory, but it is akin to treating pneumonia with Tylenol. It does not get at the cause of the problem, even if it alleviates the symptoms, and therefore the medication-induced improvements are more often than not unsatisfactory, incomplete or outright ineffective in the long run. To be told you have a BCI, when in fact you suffer from a PCI, is counterproductive and at best yields unsatisfactory results, at worst can make patients much worse.

Never forget, therefore, no matter what kind of illness you struggle with, that as a human being you are minded. You have a mind, and your mind is simultaneously very subtle and powerful. One way or another, whether your ailment is physical, psychological or spiritual, the skill and proficiency, with which you know how to use your mind, will be the single most determining factor in how well you will navigate life’s complexities. As Buddha said, ‘your untrained mind is your worst enemy, your trained mind your best friend’. If you ignore your mind, you will keep creating untold suffering for yourself.

Copyright © 2017 by Dr. Stéphane Treyvaud. All rights reserved.

Categories: Blog.