Blogger Phillip Hickey, PhD, has another great Mad in America post debunking the “chemical imbalance” theory of depression based on an article on Florida State University’s DigiNole Commons. The article is a very easy read and I recommend it highly for anyone who has been diagnosed with “depression” or who has ever taken an anti-depressant medication (or for clinicians).
The lie that depression was caused by a chemical imbalance in serotonin levels in the brain was propagated for decades by psychiatrists and Big Pharma. Please, let’s get the word out that this in NOT TRUE! I am so tired of patients and other clinicians continuing to repeat this urban myth.
To tell patients they have a chemical imbalance when this is not true stigmatizes them, promotes a feeling of helplessness that leads to lack of change, and lowers their already-low self-worth.
The public needs to take action to become aware and reject attempts by PCPs and psychiatrists who keep foisting this serotonin myth on them in an effort to sell drugs.
What is Depression?
Depression is merely an expectable reaction to a situation where a person has many thoughts of self-loathing, which lead to chronic high levels of “stress” (aka threat or fear.) The brain reacts to internal messages of self-criticism as a form of threat, which to the brain are processed in the same way as an external physical threat, such as being mugged. This internally generated “fight-or-flight” response cannot be sustained by the brain and body for long periods of time. The body eventually gives up and shuts down physically and numbs out emotionally, with “symptoms” of lack of motivation, excessive sleep, sadness, worthlessness, helplessness, hopelessness, etc.
Perhaps one day some brain chemical cause of depression might be discovered. But until then, please stop repeating the lie that unhealthy serotonin levels cause depression. Because the above explanation IS actually based on science!
So the chemicals (excess cortisol, deficit of serotonin) are not the cause of depression but a symptom. That makes sense. However, do the chemicals not have a “follow-on” or “compounding” effect (more cortisol = more stress = more cortisol)?
And if one can’t remove one’s self from the situation causing the fear (which causes the production of cortisol and suppresses the production of serotonin), is it necessarily a bad idea to provide artificial serotonin to help break the pattern?
It seems like giving someone serotonin for depression is analogous to giving someone first aid for physical trauma–not a substitute for a visit to a doctor or an ER, but helpful in the short term. Does that make sense?
Excellent questions, but the problem is that Selective Serotonin Reuptake Inhibitors (SSRIs) don’t actually provide excess serotonin. This gets into complicated neurobiology, but as the name implies, they merely block the reuptake of serotonin that should flow from one neuron to another in the brain (times a million…). The theory is the serotonin hangs around in the synaptic cleft between these two neurons and has an effect. The longterm problem is the brain adapts, as the body does, and just grows more components that strive to pick up the serotonin and move it along through the neuron. So the drugs lose their effect, but have many side effects along the way. Again, very complicated and more to be said. And they take 6 weeks to work, so it isn’t really like treating someone in the ER for a trauma.