Medical breakthroughs in treating depression/anxiety

[wjfox]

As a part-time futurist, I do extensive research on the latest scientific and technological breakthroughs. There's so much stuff happening in medicine at the moment, it seems to be progressing at an exponential rate, and this includes studies on anxiety-related conditions. It's increasingly clear to me that possible cures might be on the horizon, so I thought I'd create a thread for collating news that might be of interest.

Some of these "cures" might be 5, 10 or 20+ years away - but make no mistake, they are coming, due to our exponentially growing knowledge of genetics, stem cells, brain structures, nanotechnology, biotech and other fields. You may feel that your life will never change, and that you're destined to always feel anxious/sad, but there is definitely hope on the horizon in terms of drugs and other treatments. The impact of computers and information technology, the resulting explosion of the Internet, and the global sharing of knowledge is going to revolutionise medicine in the not-too-distant future.

I'll be updating this thread from time to time, but feel free to post any interesting articles here whenever you find them. I'll start with this -


Cloning scientists create human brain cells

Scientists in Edinburgh who pioneered cloning have made a technological breakthrough that could pave the way for better medical treatment of mental illnesses and nerve diseases

http://www.guardian.co.uk/science/20...mental-illness



I also posted this story a while back -

http://www.social-anxiety-community....ad.php?t=60070



And here's a couple of useful links for news relating to depression/anxiety:

http://www.sciencedaily.com/news/mind_brain/anxiety/

http://www.sciencedaily.com/news/mind_brain/depression/

[951thompson]

very interesting thanx

[Johnni]

Originally Posted by mark101

I can't imagine that cures for mental illness are 5yrs away to be honest,i'd say the 20year option is more likely.We've been hearing for years now how we are on the threshold of massive breakthroughs regarding cancer etc.. but are we really? Scientist's allway's talk these things up to put their feelers out for funding which is entirely understandable.I'd like to believe it's all coming soon tho

Exactly.
Breakthroughs mean only that, one step closer to the goal yet that doesnt mean the goal is close does it?

[wjfox]

Originally Posted by mark101

We've been hearing for years now how we are on the threshold of massive breakthroughs regarding cancer etc.. but are we really?

Yes. Read my blog for 2011 here -

http://futuretimeline.wordpress.com/...k-back-part-1/

(scroll down to "Biology and Medicine")

Stem cells in particular are enabling huge progress to be made.

[AnathemA]

Even if, in 10 years time, there's some wonder drug that gets rid of all your anxiety and avoidance, you're still going to be lacking social and life experience. No drug can give you that.

Sitting around and waiting for some miracle cure is the absolute worst thing you can do.

[Johnni]

Originally Posted by AnathemA

Even if, in 10 years time, there's some wonder drug that gets rid of all your anxiety and avoidance, you're still going to be lacking social and life experience. No drug can give you that.

Thats a good point. SA is not just a mental illness but also is caused/exacerbated by external factors such as lack of interaction with people. If you take the drug that rids you of your anxiety there is still alot of work to do with regards to improving your quality of life.

[Johnni]

Originally Posted by mark101

Well i'd just be happy to be anxiety free,all the rest would come together much easier with a confident/happy demeanour that's for sure

Very true however i dont really like over the top claims from scientists & news of new breakthroughs saying something is when it isn't. A cure for anxiety does not mean a cure for SA, its more complex than that.
The OP is well researched on subjects like this and seems a clever dude however reading articles they have posted on here i try and keep my feet firmly on the ground when reading them however i don't think others do.

[Johnni]

Originally Posted by mark101

So if they cured anxiety it wouldn't include social anxiety? Sorry,i'm a bit slow but i'm not with you.

As i said in reply to Anathama's post if you got rid of anxiety someone may still be socially anxious as they havent had the regular experience or contact with people enough to be comfortable in that sort of environment, that has to be learnt from actually doing it imo.

[AnathemA]

I suppose it depends if we're talking about curing just the excessive anxiety suffered by people with anxiety disorders or getting rid of *all* anxiety. The latter could be quite dangerous, to be honest. There are evolutionary reasons why we humans get anxious about certain things.

If it's just the excessive anxiety, we'd still get the natural anxiety from an unfamiliar situation.

[Johnni]

^^ Yeah getting rid of anxiety in a person could be a dangerous thing.

[wjfox]

If you're interested in future trends/predictions, then I thoroughly recommend learning about Ray Kurzweil - arguably the most respected futurist in the world. He has an amazing track record of predictions, correctly forecasting the emergence of the Internet, as well as the completion of the Human Genome Project, the year when a computer would beat a human chess player, and various other milestones. His famous 2005 book, The Singularity is Near, is the most mind-blowing thing I've ever read, and perfectly illustrates the progress being made in science.

If you've heard of Moore's Law - the doubling of computer power every couple of years - that's what's now happening with medicine too, thanks to information technology and the sharing of knowledge. There are numerous trends which clearly show this. So, for example, if you take the cost of DNA sequencing: back in 2000, it cost over £100 million to sequence a complete human genome. Today, it can be done for a few thousand pounds, and by 2015 it could be done for £100 or less. Tests which determine your complete genetic profile, showing its faults and vulnerabilities, and the illnesses you're likely to catch in the future, will become affordable to the average Joe.

That's just one trend, but there are numerous others. See for example some of the graphs on this page:

http://www.singularity.com/charts/page17.html

(already a few years out of date, but interesting nonetheless)

[Drimma]

Originally Posted by mark101

Yeah for sure your gonna have to get out there and do everything for the first time but you wouldn't feel anxious doing it because they cured the anxiety.Would feel strange or weird but it would be great to be doing it all and learning,you would happily tell people your recovering SA coz your guard would be down,that's how i'm imagining it anyways.It's major benefit as with most cures would not be for middle aged people like me but young people who haven't missed out on a huge portion of life.

I agree with this.

I think if we did get less anxious learning/experiencing all these new feelings unaccompanied by mortal fears and self doubt would do a total 180 on how we view social interactions. Cause in themselves social interactions are very enjoyable - so even if there'd be a learning curve - less anxiousness would lead to seeking more of those social highs and we'd be the ones organizing parties rather than dreaming of new ways to avoid them.

but by the time something like that comes along the best of me would have withered infront of a pc long ago

[custom_fusion-lqx]

Kurzweil ingests "250 supplements, eight to 10 glasses of alkaline water and 10 cups of green tea" every day and drinks several glasses of red wine a week in an effort to "reprogram" his biochemistry.[45] Lately, he has cut down the number of supplement pills to 150.


he sounds more supplement mad than me

[AnathemA]

Oh dear. I was wondering how long until Kurzweil showed up. Some of his figures are interesting and others are complete jokes, like his singularity timeline with 'time to next (arbitrarily picked) event (possibly combined with another event)'. Almost hilariously unscientific.

Others are just misleading. Having computing power equivalent to a human brain doesn't mean we will have a working artificial brain. Someone would have to program it, which could potentially take much, much longer. Human intelligence is not increasing exponentially.

At the very least, if you have a single sceptical bone in your body, the 'criticism' section of that Wikipedia article (along with the links in the footnotes) is worth reading.

Guy writes books to sell to people. He's hardly going to predict a humdrum future, now, is he?

[wjfox]

Originally Posted by AnathemA

Having computing power equivalent to a human brain doesn't mean we will have a working artificial brain. Someone would have to program it, which could potentially take much, much longer.

It won't need a complex program - it will just be reverse-engineered, which is what they're doing already, and is happening at an exponential rate.


Artificial brain '10 years away'
http://news.bbc.co.uk/1/hi/technology/8164060.stm

Scientists Create Tiny Artificial Brain That Exhibits 12 Seconds of Short Term Memory
http://www.popsci.com/science/articl...rt-term-memory

IBM Simulates 4.5 percent of the Human Brain, and All of the Cat Brain
http://www.scientificamerican.com/ar...l-of-cat-brain

New computer chip models how neurons communicate with each other at synapses
http://web.mit.edu/newsoffice/2011/brain-chip-1115.html

Blue Brain Project
http://en.wikipedia.org/wiki/Blue_Brain_Project

"A cellular human brain is possible by 2023 equivalent to 1000 rat brains with a total of a hundred billion cells."
http://www.kurzweilai.net/henry-mark...decisive-years

[Duke of Prunes]

There's no single definitive mechanism behind every single case of anxiety or depression. The idea of having a monotherapy that cures every case of every psychiatric symptom is a bit far-fetched.

There are already many well-known molecular/neurological abnormalities that are associated with SA that can be targeted with drugs, but it's impractical to diagnose them in a living patient, and the necessary drugs are illegal or controlled and have issues with tolerance and often long-term neurotoxicity (e.g. amphetamines).

[Moksha]

Originally Posted by wjfox

As a part-time futurist, I do extensive research on the latest scientific and technological breakthroughs. There's so much stuff happening in medicine at the moment, it seems to be progressing at an exponential rate, and this includes studies on anxiety-related conditions. It's increasingly clear to me that possible cures might be on the horizon, so I thought I'd create a thread for collating news that might be of interest.

Some of these "cures" might be 5, 10 or 20+ years away - but make no mistake, they are coming, due to our exponentially growing knowledge of genetics, stem cells, brain structures, nanotechnology, biotech and other fields. You may feel that your life will never change, and that you're destined to always feel anxious/sad, but there is definitely hope on the horizon in terms of drugs and other treatments. The impact of computers and information technology, the resulting explosion of the Internet, and the global sharing of knowledge is going to revolutionise medicine in the not-too-distant future.

I'll be updating this thread from time to time, but feel free to post any interesting articles here whenever you find them. I'll start with this -


Cloning scientists create human brain cells

Scientists in Edinburgh who pioneered cloning have made a technological breakthrough that could pave the way for better medical treatment of mental illnesses and nerve diseases

http://www.guardian.co.uk/science/20...mental-illness



I also posted this story a while back -

http://www.social-anxiety-community....ad.php?t=60070



And here's a couple of useful links for news relating to depression/anxiety:

http://www.sciencedaily.com/news/mind_brain/anxiety/

http://www.sciencedaily.com/news/mind_brain/depression/

Very interesting. I have visited your webpage as well, which I also found fascinating.

I guess the brain is key to so much human misery and evil, not just depression and anxiety. If we could fully understand and map out the brain, down to the last neuron, perhaps we could manipulate it in all sorts of ways. I wouldn't be surprised if we found that the behaviour of psychopaths, paedophiles, sadists, the habitually anti-social, the violent bullies, the religious fundamentalists and so on can all be traced (or a large part of it; I know environment is very influential as well) to parts of the brain not functioning properly. Maybe we will be able to re-wire the brain of a psychopath or violent rapist so that they begin to feel profound empathy and compassion.

What the pessimists seem to forget is that we already have drugs to treat depression and anxiety , even to improve concentration, memory and cognition. It is not a matter of "can we?" but "can we massively improve how effective they are and do away with the side effects?". Then again, once the brain is fully understood (or at least understood much better), we might be able to take control of it using something other than drugs- some as yet undreamt of technologies and techniques.

Imagine if we could effortlessly treble someone's IQ, so that even David Beckham and Jordan could read A Brief History Of Time and Joyce's Ulysses in an afternoon! I guess the whole notion of there being clever, talented, creative people and 'the rest' would go. Then again, if we are able to give people a sense of blissful joy and happiness whenever they want it, would anyone have the motivation to do anything? It is no coincidence that the only legal mind- altering drug (alcohol) is a depressant. If we were able to live our lives in a state of blissful joy there would be little motivation or need to work hard in order to buy a nice house or have the occasional escape to the sun; people would be happy to just sit in a dingy bedsit feeling blissed out. Perhaps our grown up kids, nephews etc will find it hard to imagine what it was like to grow up in a world in which we had virtually no control over such things and just had to make do with the hand nature dealt us- some kids were clever and confident and creative, some weren't. They will find it just as hard to imagine what depression, loneliness, anxiety, low self-esteem etc were like as I found it to imagine what fighting in the war was like for my grandfather.

[AnathemA]

Originally Posted by wjfox

It won't need a complex program - it will just be reverse-engineered, which is what they're doing already, and is happening at an exponential rate.

No offense, but it doesn't work like that. Of course someone will have to program it. We know how Dijksta's algorithm works, but that doesn't mean we can just magic an implementation of it into existence. Someone has to write the code. (Obviously Dijkstra's algorithm is pretty trivial next to a human brain, but that's not the point.)

And, by the way, the 'cat brain' thing is bunk. It made no attempt to simulate function and was just an exercise in gluing processors together. It was derided at the time for being a publicity stunt.

EDIT: I see Blue Brain is trying to create a computer simulation as they go along. We'll see how they do, then, and whether the completed 'brain' is actually useful for anything.

[wjfox]

Physical Activity Yields Feelings of Excitement, Enthusiasm

ScienceDaily (Feb. 8, 2012) ***8212; People who are more physically active report greater levels of excitement and enthusiasm than people who are less physically active, according to Penn State researchers. People also are more likely to report feelings of excitement and enthusiasm on days when they are more physically active than usual.

"You don't have to be the fittest person who is exercising every day to receive the feel-good benefits of exercise," said David Conroy, professor of kinesiology. "It's a matter of taking it one day at a time, of trying to get your activity in, and then there's this feel-good reward afterwards."

Conroy added that it often is hard for people to commit to an exercise program because they tend to set long-term rather than short-term goals.

Read more: http://www.sciencedaily.com/releases...0208132709.htm

[johnA]

Wjfox - just wanted to say that I've visited your site many times. Thinking about what the future may offer is a subject that I can ponder about for hours. Let***8217;s hope that some of the more advanced predictions hold true.

I do wonder though if it is possible to predict anything in the far distant future. A person living a hundred years ago would have found it impossible to predict the rise of microwave oven. If we are able to increase our intelligence it will make it much harder to predict anything. Superhumans may look at humans the way that we look at ants and an ant today would find it very hard to predict what the future will hold. I***8217;m not convinced that a singularity is the only outcome. I think we are too dumb and there are far too many variables for us to know what happens to advanced races.

[wjfox]

Not exactly a "breakthrough", but this seemed like the best place to post it.

---

Poor Mental Health Linked to Reduced Life Expectancy

ScienceDaily (July 31, 2012) — People with mental health problems have a lower life expectancy, according to a large-scale population based study published July 31 in the British Medical Journal.

Their results reveal that people who experienced symptoms of anxiety or depression had a lower life expectancy than those without any such symptoms.

Even people with minor symptoms of mental health problems seemed to have a higher risk of death from several major causes, including cardiovascular disease.

http://www.sciencedaily.com/releases...0731201257.htm

[wjfox]

Sorry for the negative story - but I hope, at least, it serves as motivation for people to work on improving their mental health.

[WeiJingsheng]

[Brokenx]

Thanks for this, interesting read. I would like to believe a 'cure' is coming but I doubt it wil be here in my lifetime.
I wonder if mental illnesses were more or less common in the olden days? I often wish I'd of been born in a different era, I think this life is too stressful and people don't have any values these days and there's a lack of human decency, when I read I get a different view on the olden days - like people were better. (I know I went a bit of topic there lol)

[WeiJingsheng]

Originally Posted by Charlotte87

Maybe, if there is any truth in the report, is because a lot (not all) of people with mental health issues, can be self destructive in certain ways, eg excessive drinking, smoking, and drug taking.
They may not have jobs and therefore have little money which can effect what type of food they buy. They may not go outdoors much and therefore have very little exercise. They may live in poor housing conditions, which can affect health.
It may not be that having mental health issues, affects a persons whole lifestyle, which then in turn can affect their health.
It would be interesting to have a report on people who are wealthy with mental health issues and people who are poor with them, and see if the same results apply.
Maybe what I am writing is a load of nonsense as well lol

A lot of those factors were taken into account. Exercise, weight, smoking...etc.



Still, I doubt they could completely cover them.

[wjfox]

http://www.sciencedaily.com/releases...0812151659.htm

How Stress and Depression Can Shrink the Brain

ScienceDaily (Aug. 12, 2012) — Major depression or chronic stress can cause the loss of brain volume, a condition that contributes to both emotional and cognitive impairment. Now a team of researchers led by Yale scientists has discovered one reason why this occurs -- a single genetic switch that triggers loss of brain connections in humans and depression in animal models.

The findings, reported in the Aug. 12 issue of the journal Nature Medicine, show that the genetic switch known as a transcription factor represses the expression of several genes that are necessary for the formation of synaptic connections between brain cells, which in turn could contribute to loss of brain mass in the prefrontal cortex.

"We wanted to test the idea that stress causes a loss of brain synapses in humans," said senior author Ronald Duman, the Elizabeth Mears and House Jameson Professor of Psychiatry and professor of neurobiology and of pharmacology. "We show that circuits normally involved in emotion, as well as cognition, are disrupted when this single transcription factor is activated."

The research team analyzed tissue of depressed and non-depressed patients donated from a brain bank and looked for different patterns of gene activation. The brains of patients who had been depressed exhibited lower levels of expression in genes that are required for the function and structure of brain synapses. Lead author and postdoctoral researcher H.J. Kang discovered that at least five of these genes could be regulated by a single transcription factor called GATA1. When the transcription factor was activated, rodents exhibited depressive-like symptoms, suggesting GATA1 plays a role not only in the loss of connections between neurons but also in symptoms of depression.

Duman theorizes that genetic variations in GATA1 may one day help identify people at high risk for major depression or sensitivity to stress.

"We hope that by enhancing synaptic connections, either with novel medications or behavioral therapy, we can develop more effective antidepressant therapies," Duman said.

[tryinghard]

Excuse me if I'm being stupid, but I don't really get how you could have a 'cure' for anxiety. Firstly, anxiety the emotion/physical symptom is a natural response that we need to feel sometimes, and anxiety the disorder describes people who feel that way excessively due to a difference in the way they perceive the world.

It is not completely understood how neurotransmitters work on emotional wellbeing - and the chemical imbalance theory for depression/anxiety has never been proven - but it is presumably possible to use a chemical that would cause the brain to release more of one hormone and less of another (and don't SSRIs do something like this? Or is that to do with absorption of neurotransmitters or something?)

So unless the 'cure' for anxiety is just a very good antidepressant or electrical brain stimulation technique (like the 'black boxes' that are around today), which don't actually cure any mental health problem but just mask the symptoms or take the edge off them so that the mental health problem can be tackled more easiliy, then I don't really get how there could be a 'cure' per se.

My impression was that non-psychotic mental health problems can be managed or 'cured', if you like (I would prefer to say that emotional and behavioural stability were brought into a healthy range because this is a spectrum, but I'm being pedantic :-p) through a deliberate change in perception and cognition by the patient. It can't be cured from outside.

[WeiJingsheng]

Originally Posted by tryinghard

Excuse me if I'm being stupid, but I don't really get how you could have a 'cure' for anxiety. Firstly, anxiety the emotion/physical symptom is a natural response that we need to feel sometimes, and anxiety the disorder describes people who feel that way excessively due to a difference in the way they perceive the world.

It is not completely understood how neurotransmitters work on emotional wellbeing - and the chemical imbalance theory for depression/anxiety has never been proven - but it is presumably possible to use a chemical that would cause the brain to release more of one hormone and less of another (and don't SSRIs do something like this? Or is that to do with absorption of neurotransmitters or something?)

So unless the 'cure' for anxiety is just a very good antidepressant or electrical brain stimulation technique (like the 'black boxes' that are around today), which don't actually cure any mental health problem but just mask the symptoms or take the edge off them so that the mental health problem can be tackled more easiliy, then I don't really get how there could be a 'cure' per se.

My impression was that non-psychotic mental health problems can be managed or 'cured', if you like (I would prefer to say that emotional and behavioural stability were brought into a healthy range because this is a spectrum, but I'm being pedantic :-p) through a deliberate change in perception and cognition by the patient. It can't be cured from outside.

There is still a big gap in knowledge on how genes and molecular biology translate to behaviour. We know in general terms that certain regions, sets of genes and neurotransmitters are involved but not much more. I do think that will come though, anti-depressants are certainly not the solution though...

[tryinghard]

Originally Posted by WeiJingsheng

There is still a big gap in knowledge on how genes and molecular biology translate to behaviour. We know in general terms that certain regions, sets of genes and neurotransmitters are involved but not much more. I do think that will come though, anti-depressants are certainly not the solution though...

Indeed, molecular biology is bound to have an effect, but I thought the mind and body work mostly work in tandem, rather than one presiding over the other? So lets say it is found for definite that a drop in serotonin is strongly associated with feelings of depression. Unless I have misunderstood, I think this means that a) lower serotonin levels reduce happiness and b) unhappiness reduces serotonin levels, rather than low serotonin levels producing unhappiness, if you see what I mean. Whatever we think, do or feel there is an expression of this in the brain, since the brain is the 'hardware' that runs the 'software' of our minds. It means that low serotonin levels (or whatever cocktail of neurotransmitters is implicated) equals unhappiness, rather than causing unhappiness. It is the physical manifestation of unhappiness itself. < Again, that was my understanding of it!

When it comes to genes, it seems likely some predisposition will be found towards neurotic disorders, and I think it's pretty certain something will be found for psychotic disorders like schizophrenia and bipolar, but this surely only helps us to understand the physical side of it again? No matter what we do with our brain chemicals, it is presumably a risk that our lives, or more specifically our reaction to events in our lives and our thoughts, will simply 'right' the chemicals back to their original state as we continue to tell ourselves we are unhappy or have reason to be unhappy?

This is coming from my poor understanding of neuro-psychology though, which is basically zero as you can probably tell! It's very interesting stuff though, I wish I knew more about it.

What I think would be fantastic research would be to see how psycho-social triggers affect mental health prognosis, such as whether the use of medical terms and increased medicalisation around common mental illness (the further categorisation and sub-categorisation of emotional and cognitive discomfort, such as with the ever-expanding DSM) helps or hinders prognosis - or indeed does nothing at all. Basically, I wonder whether being told you are ill with a medical disorder/disease in the case of unipolar depression or anxiety makes you worse, improves your chances of getting better or makes no difference.

So maybe you would have two groups of patients not previously diagnosed with depression or anxiety (but who would be diagnosable with one of these). Both groups are treated with the same talking therapy - say CBT - but the difference is one group is told their experiences are normal and common without any reference to medicine or any diagnosis made, while the others are told their experiences are normal and common and medical references and diagnoses are made.

Of course this is totally impossible to actually conduct because the internet exists and if you are anxious and search your symptoms you will soon find out you fit the categorisation of an anxiety disorder. But maybe there's a different way of doing it, I don't know.

Sorry went on a stupid rant.....this is procrastination at its best....

[WeiJingsheng]

Originally Posted by tryinghard

Indeed, molecular biology is bound to have an effect, but I thought the mind and body work mostly work in tandem, rather than one presiding over the other? So lets say it is found for definite that a drop in serotonin is strongly associated with feelings of depression. Unless I have misunderstood, I think this means that a) lower serotonin levels reduce happiness and b) unhappiness reduces serotonin levels, rather than low serotonin levels producing unhappiness, if you see what I mean. Whatever we think, do or feel there is an expression of this in the brain, since the brain is the 'hardware' that runs the 'software' of our minds. It means that low serotonin levels (or whatever cocktail of neurotransmitters is implicated) equals unhappiness, rather than causing unhappiness. It is the physical manifestation of unhappiness itself. < Again, that was my understanding of it!

When it comes to genes, it seems likely some predisposition will be found towards neurotic disorders, and I think it's pretty certain something will be found for psychotic disorders like schizophrenia and bipolar, but this surely only helps us to understand the physical side of it again? No matter what we do with our brain chemicals, it is presumably a risk that our lives, or more specifically our reaction to events in our lives and our thoughts, will simply 'right' the chemicals back to their original state as we continue to tell ourselves we are unhappy or have reason to be unhappy?

This is coming from my poor understanding of neuro-psychology though, which is basically zero as you can probably tell! It's very interesting stuff though, I wish I knew more about it.

What I think would be fantastic research would be to see how psycho-social triggers affect mental health prognosis, such as whether the use of medical terms and increased medicalisation around common mental illness (the further categorisation and sub-categorisation of emotional and cognitive discomfort, such as with the ever-expanding DSM) helps or hinders prognosis - or indeed does nothing at all. Basically, I wonder whether being told you are ill with a medical disorder/disease in the case of unipolar depression or anxiety makes you worse, improves your chances of getting better or makes no difference.

So maybe you would have two groups of patients not previously diagnosed with depression or anxiety (but who would be diagnosable with one of these). Both groups are treated with the same talking therapy - say CBT - but the difference is one group is told their experiences are normal and common without any reference to medicine or any diagnosis made, while the others are told their experiences are normal and common and medical references and diagnoses are made.

Of course this is totally impossible to actually conduct because the internet exists and if you are anxious and search your symptoms you will soon find out you fit the categorisation of an anxiety disorder. But maybe there's a different way of doing it, I don't know.

Sorry went on a stupid rant.....this is procrastination at its best....

Yeah, it's hugely complicated. The chemical imbalance theory is a bit pathetic for many reasons. The level of a neurotransmitter in the brain is fairly insignificant in explaining mental disorders. One, you have counter systems where receptivity will actively reduce when there is more 'noise', so the body will counter the drug. You also have autoreceptors which 'turn off' activity, so the same neurotransmitter in different parts of the brain will reduce the level. Also, a single transmitter has many different functions. Most importantly, you have interactions between different systems, neurotransmitters and genes which differ between every individual. Probably best leaving that there...

As for the causal thing, that makes it even more complicated. To simplify, it has to all be physical. Genes shape our development, the environment alters our epigenome. Our brain develops in a way where we have a stimulus (environment), which causes a multitude of processes to take place. Anxiety is most likely predisposed through genetics and shaped by the environment so that the brain reacts a certain way.

So for example, anxiety, you learn to 'fear' certain things (bad experiences in the past), the amygdala and other parts of the brain are far more reactive than for a normal individual when you experience feared stimulus. Your frontal cortex gets fed this information, and tries to work out what the danger is (negative thoughts, irrational fear). That experience then feeds back onto memory and affects future behaviour. Very simplified, but the point would be that you can't seperate thought from molecular biology, we just have a massive gap in knowledge. Though, we are quite a way off being able to prove it and say how and why beyond certain 'trends' and 'patterns'. You seem to know quite a lot btw, do you study Psych or something similar? Really interesting area, Neuroscience. I would love to work in that field.

It may be worth having a look if they have done any research on that, I'm sure there will be something. Just been accepted on a course for 'Health Psychology', Psycho-social factors are a crucial part of that. How politics, the economy, the community...etc effect individual health. It's more interesting than it sounds...