In Chemically Imbalanced, British psychiatrist Joanna Moncrieff takes on one of the most powerful and widely accepted ideas in modern medicine, that depression is caused by a chemical imbalance in the brain, particularly a deficiency of serotonin. For decades, this explanation has shaped how millions of people understand their sadness, anxiety, and emotional suffering. It has also justified the massive global use of antidepressants. Moncrieff’s book is not a casual criticism; it is a carefully researched, historically grounded, and morally serious challenge to this dominant narrative.

The core argument of the book is simple yet unsettling. Moncrieff argues that the “serotonin imbalance” theory was never scientifically proven in the way most people believe. According to her, the Idea was promoted through a combination of hopeful speculation, pharmaceutical marketing, and professional consensus rather than solid biological evidence. Over time, this explanation became so embedded in public consciousness that it began to feel like unquestionable truth.

What makes the book compelling is not just the science but the story behind the science. Moncrieff traces how antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), rose to prominence in the late twentieth century. These drugs were presented as correcting a specific biological defect in the brain. Advertisements, patient leaflets, and even doctors repeated the message: depression is like diabetes; it is caused by a chemical imbalance, and medication restores balance. This comparison gave comfort to many people. It reduced shame. It suggested that depression was not a weakness of character but a medical condition.

Yet Moncrieff asks an uncomfortable question, what if this analogy was oversimplified? What if antidepressants do not “fix” a chemical deficiency but instead act as psychoactive substances that alter mental states, much like alcohol or sedatives? In her “drug-centred” model,........

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