Clinical depression and the chemical imbalance theory: social work practice dilemmas

Major Depressive Disorder (MDD) is poorly understood and frequently diagnosed in mental health practice. Qualitative thematic analysis from interviews with 20 licensed clinical social workers (LCSWs) was conducted to evaluate clinicians' perceptions, sources of information, and use of the chemical imbalance theory (CIT) during interactions with clients. Findings revealed that clinicians held nuanced and often critical perceptions of the CIT. When clinicians did incorporate CIT, they did so in highly specific and nuanced ways, often to justify antidepressant treatment. Social workers highlighted a gap in psychopharmacology education and training. Implications for social work education and practice are addressed.