FTT: Depression and Serotonin

Happy Free Thoughts Thursday, people.

I had an entire newsletter written on this topic sitting in my drafts for months before deleting it because I was afraid of how people would respond.

Then, about two weeks ago, research was published that supported my stance but for some reason it's not getting the traction I feel it deserves.

Let's chat about it.

1 Thought From Me:

Depression:

a mood disorder characterized by sadness and loss of interest which affects how we think, feel and behave.

Serotonin:

a neurotransmitter that plays a variety of important roles in our body like regulating sleep, mood, sexual function, bone health, nausea, and more.

Background

The Myth

There's a longstanding belief that depression is caused by a chemical imbalance in the brain.

Specifically, the belief is that depression is caused by our brain's inability to produce a sufficient amount of serotonin.

The Origin

The serotonin theory of depression was first introduced in the 1960s but was popularized in the 1990s when the pharmaceutical industry began promoting it in an effort to market its newly developed "antidepressants" known as selective serotonin-reuptake inhibitors (SSRIs).

As is the case when big pharma markets drugs, official institutions such as the American Psychiatric Association also provided support for the serotonin theory of depression, stating even to this day that “differences in certain chemicals in the brain may contribute to symptoms of depression."

Impact

Belief

The first problem with the serotonin theory of depression is that it causes people to feel as though there is something wrong with them.

If someone is struggling with depression and then they're told the cause of their depression is a chemical imbalance in their brain, this can reinforce their already existing feelings of inferiority and hopelessness.

If they were simply born this way, what reason do they have to believe they can change?

Behavior

Compounded with their lack of interest, energy, appetite and motivation, when people believe they're depressed because they were born with the wrong chemical makeup in their brain, they're much more likely to discount the benefits of natural remedies.

Despite the extensive research highlighting the benefits of exercise, sleep, sunlight, hydration, diet, socialization, meaningful work and so much more on our overall level of happiness and well-being, people who subscribe to the serotonin theory of depression are more likely to rely on SSRIs than they are to take matters into their own hands.

SSRIs

Just as people begin to feel like they're doomed, they're told there's a solution—and it comes in the form of a pill.

As the name suggests, selective serotonin-reuptake inhibitors temporarily block the reabsorption of serotonin into neurons therefore making more of it available for use in the body.

People are told SSRIs are the cure for the chemical imbalance in their brain.

During 2015-2018, the CDC found that approximately 1 in 7 people in the U.S. took an SSRI within 30 days of their study, and I can only imagine that number has increased over the last four years.

There are a number of serious problems with SSRIs:

  1. Depression isn't caused by a lack of serotonin (more on that in the next section).
  2. Side effects like agitation, indigestion, headaches, lowered sex drive, nausea, loss of appetite, insomnia, dizziness, dry mouth and excessive sweating, to name a few.
  3. Their impact is barely distinguishable from a placebo.
  4. They've been shown to numb all emotions, including the good ones.
  5. Prolonged use may lower the natural availability of serotonin in the body.

What's more is that people who subscribe to the serotonin theory of depression are less likely to discontinue their use of SSRIs because they fear the consequences of doing so.

Truth

The Data

There has been controversy around the serotonin theory of depression since its inception.

Many researchers and psychiatrists have noted the lack of evidence supporting its validity over the years, but until recently there has been no significant review of the research to refute it.

That was until Joanna Moncrieff published the results of an umbrella study on July 20th of this year which found that "the main areas of serotonin research provide no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations.”

The Change

There is a serious lack of accountability when it comes to the topic of depression, and how could there not be?

When we're convinced that our emotional struggles can be traced back to a chemical imbalance in our very own brains which can only be fixed by a pill sold by an industry whose marketing not only appears everywhere we look but also appeals to our emotional core, why wouldn't we buy the solution they're selling?

We've had a belief forced upon us which takes control of our well-being directly out of our hands and puts it into the hands of another: the belief that something is inherently wrong with us.

That belief came from the serotonin theory of depression, but now that we know depression is not caused by a lack of serotonin and just because we're struggling it doesn't mean we were born with a chemical imbalance in our brain, we can begin to take control back into our own hands.

Rather than outsourcing accountability to our doctors and pharmaceutical companies we can begin to look at how we're living our lives.

Are we exercising? Are we drinking water? Are we eating a healthy diet?

How often do we connect with others? How often do we get outside? How often do we do meaningful work?

Are we getting enough sleep? Are we talking about our problems? Are we giving to others?

We have the evidence that our well-being is, in fact, within our control, and that simple things (for must of us) like those addressed in the questions above can have a positive impact.

Now it's up to us to change the stigma around what truly causes depression—and that starts with taking responsibility of our own health, both mental and physical.

Conclusion

The Reality

The reason I was afraid to touch this topic in the past is because it's a sensitive one.

People don't want to hear that they have control because that would mean taking responsibility. And that's difficult.

I've had to confront this reality myself and I'm just as susceptible to these struggles as anyone else. That's precisely why I write these newsletters.

I don't ever want people to feel as though I'm preaching to them like I have it all figured out. Especially with a topic as serious as this one.

But I do want people to realize how strong they are and how much of a difference they can make for themselves and others when they decide to take life into their own hands.

Life is hard. That's the truth.

We all deal with failure and loss and financial troubles and relationship problems and health emergencies and more.

There are a lot of things we can't control.

That's precisely why it's so important to take care of the things we can.

Live your life to the fullest,

Chris

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Resources:

https://neurosciencenews.com/depression-chemical-imballance-21105/

https://www.nature.com/articles/s41380-022-01661-0

http://theconversation.com/depression-is-probably-not-caused-by-a-chemical-imbalance-in-the-brain-new-study-186672

https://www.cdc.gov/nchs/products/databriefs/db377.htm

https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/side-effects/

https://www.psychologytoday.com/us/blog/insight-therapy/202207/depression-is-not-caused-chemical-imbalance-in-the-brain