Written by Bruce Levine

Welcome to the Twilight Zone of the political landscape of psychiatry, where faux-left liberals are clueless that they have unwittingly become right-wingers, where shameless right-wingers exploit anything in an attempt to hold on to their AR-15s, and where anti-authoritarian left critical thinkers know that if they are not careful—or even if they are—they will find themselves being used politically in a repulsive way.

In January 2022, when British psychiatrist Joanna Moncrieff, co-chairperson of the Critical Psychiatry Network, published “The Political Economy of the Mental Health System: A Marxist Analysis”—an examination of how psychiatry was diverting Western societies from the suffering caused by neoliberal capitalism—she was simply ignored by the mainstream media.

However, in July 2022, after Moncrieff published “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence,” she became public enemy #1 for establishment psychiatry and its apologists in the mainstream media, including Rolling Stone.

On July 30, 2022, Rolling Stone published an article about Moncrieff titled: “Who Is the Psychiatrist Behind the Antidepressant Study Taking Over Right-Wing Media?” However, Moncrieff’s study, published in the journal Molecular Psychiatry, is not an “antidepressant study.” Instead, the study is a systematic review of the empirical evidence for the serotonin theory of depression—what is commonly called the “chemical imbalance theory of depression.”

Specifically, Moncrieff’s article is a comprehensive review of the empirical evidence for the relationship between depression and the neurotransmitter serotonin. Moncrieff and her co-researchers examined hundreds of different types of studies that attempted to detect a relationship between depression and serotonin (including studies of the relationship between depression and plasma serotonin, serotonin metabolites in other bodily fluids, serotonin receptor binding, serotonin depletion experiments, and the serotonin gene).

Moncrieff concluded that there is no evidence of a link between low levels of serotonin and depression, stating: “We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.”

In scientific circles, as I detail in A Profession Without Reason (2022), the discrediting of the serotonin chemical imbalance theory of depression is not news. In fact, I quote leading establishment psychiatrist Ronald Pies, Editor-in-Chief Emeritus of the Psychiatric Timeswho in 2011 stated: “In truth, the ‘chemical imbalance’ notion was always a kind of urban legend—never a theory seriously propounded by well-informed psychiatrists.”

However, what is news about Moncrieff’s “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence” is that this extraordinarily comprehensive examination of virtually all empirical evidence has become the final nail in the coffin for the corpse of the serotonin chemical imbalance theory of depression—resulting in a very public burial that will hopefully usher in a new era in which not only research scientists but also treating physicians and the general public know that this serotonin chemical imbalance theory has been discarded.

Rolling Stone’s Hatchet Job

hatchet job is not necessarily libel or false but is a maliciously destructive critique that routinely includes extraneous and irrelevant points aimed at unfairly casting its victim in a bad light.

For quite some time now, the standard hatchet used by psychiatry apologists in their attacks on any critic of psychiatry is to include the extraneous fact that the Church of Scientology—a pseudoscientific and secretive institution with a reputation for financially exploiting members and retaliating against former members who speak out against the organization—is a critic of psychiatry. This tactic is similar to the one that was routinely used by the right-wing media on anyone opposing the Vietnam War, which in that case was the inclusion of the fact that the war was opposed by the totalitarian Soviet Union and China.

Moncrieff is not a Scientologist, and Rolling Stone avoids a libel suit by—instead of calling her one—stating: “Moncrieff’s work is frequently promoted by an organization called Citizens Commission on Human Rights (CCHR), which touts itself as a ‘mental health industry watchdog’ and was established by the Church of Scientology, which is virulently opposed to psychiatry and medical interventions for mental illness.”

Then, neglecting Moncrieff’s January 2022 Marxist analysis of psychiatry and how it enables neoliberal capitalism, Rolling Stone states: “Yet Moncrieff’s views more clearly align with the right on other matters. For instance, much of her work has focused on the question of preserving personal bodily autonomy over the health and welfare of the general populace, as evidenced by one 2014 paper she wrote on the work of the late Thomas Szasz, a controversial psychiatrist who questioned the institution of psychiatry and eventually co-founded the CCHR. (Szasz himself was not a Scientologist).”

So, Rolling Stone gets Scientology into its Moncrieff article a second time, and then declares Moncrieff’s concern about preserving personal bodily autonomy to be a right-wing concern. Isn’t a woman’s right to choose an abortion about a woman’s right of “preserving personal bodily autonomy”? Somehow the vaccine political landscape has made what was once the left issue of “personal bodily autonomy” into a right one.

In any regard, both the Scientology and “bodily autonomy” issues are completely extraneous and unrelated to Moncrieff’s “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence.” Why the attempt to associate Moncrieff with the right-wing to discredit her for Rolling Stone readers?

One answer lies in the fact that criticism of psychiatry and the psychiatric-pharmaceutical industrial complex—while still a concern of the shrinking anti-authoritarian left—is taboo for faux-left liberals, who now dutifully defend psychiatry at all cost from the right-wing.

The landmine Moncrieff stepped on was that her study—one that definitively debunked the serotonin chemical imbalance theory—was taken up by the right-wing media to attack selective serotonin reuptake inhibitor (SSRI) antidepressant use.

The right-wing media is fully aware that the U.S. general public is getting increasingly enraged by mass shootings, and that the political tide has turned in favor of more meaningful gun control. Thus, the right-wing is looking for anything that it can blame for these mass shootings other than guns and bullets. And for the right, psychiatry’s chemical imbalance falsehoods along with the SSRI drugs that this now discarded theory ushered in are a great distraction to this reality.

The first paragraph lede of the Rolling Stone piece tells us that a paper was “widely picked up by media outlets in the United Kingdom, with some citing the study as evidence that SSRIs don’t work.” Then Rolling Stone tells us Moncrieff’s study was “promoted extensively by far-right commentator and professional transphobe Matt Walsh, who tweeted, ‘Big Pharma has made billions prescribing wonder drugs to treat depression but there was never any solid scientific evidence that the drugs would work. Now we know that the whole thing was built on a myth.’” And Rolling Stone adds that Tucker Carlson characterized the study as a rejoinder against taking SSRIs, “First we were told that SSRIs would save lives. Now we learn they don’t actually work as intended. In fact, the whole idea behind the drug was completely wrong.’” While Carlson is obviously exploiting a fact for his FOX agenda, he happens to be correct that the theory is invalid.

What is also correct is that this invalid serotonin chemical imbalance theory propelled the explosion of SSRI drugs. Prior to the public’s acceptance of the serotonin chemical imbalance cause of depression, many people were reluctant to take antidepressants—or to give them to their children. But the idea that depression is caused by a chemical imbalance that can be corrected with Prozac, Paxil, Zoloft or some other SSRI sounded similar to taking insulin for diabetes—a common analogy used by prescribing physicians to encourage SSRI use. So, as I document in A Profession Without Reason, the use of antidepressants skyrocketed following the entry of SSRIs into the marketplace in the late 1980s, with the rate of antidepressant use in the United States increasing nearly 400 percent between 1988 and 2008.

We Should All Care About What Moncrieff Cares About

“Being from the U.K.,” Moncrieff told Rolling Stone, “I am very much in favor of gun control, so I don’t like people using anything as an argument against that.” However, what seems to really irk faux-left liberals is that Moncrieff refuses to be intimidated by the Twilight Zone politics of psychiatry into keeping quiet about her findings, adding, “Although I am concerned about our findings being used to argue against gun control, I do not think this means that we should not be talking about them.”

Buried deep into the Rolling Stone article is another Moncrieff quote, one that if Rolling Stone was truly leftist publication would be its lede: “I am perplexed at why this story has been taken up by the right-wing media more than the left.” She then points out that psychiatry has been guilty of “inappropriately medicalizing distress and thereby obscuring the effects of social injustice, poverty, inequality, racism, child abuse etc, [which] should be a major concern for the left.”

Once upon a time, “medicalizing distress and thereby obscuring the effects of social injustice, poverty, inequality, racism, child abuse etc” along with the emotional suffering caused by the alienating and dehumanizing effects of neoliberal capitalism were major concerns for many on the left. But today, faux-left liberals are apparently mostly concerned with other matters, such as defending psychiatry; and critical thinkers on the anti-authoritarian left, such as Moncrieff, who remain concerned are pushed by faux-left liberals to the margins and, if they cannot be ignored, are pushed off cliffs.

Bruce E. Levine, a practicing clinical psychologist, writes and speaks about how society, culture, politics, and psychology intersect. His most recent book is A Profession Without Reason: The Crisis of Contemporary Psychiatry—Untangled and Solved by Spinoza, Freethinking, and Radical Enlightenment (2022). His Web site is brucelevine.net