Large scale study concludes that there is "no support for the hypothesis that depression is caused by lowered serotonin"

NOTE: This is a long post because it's covering a topic that could have dramatic impacts on the mental health of individuals, the mental health industry, and our societal understanding of mental health. I've linked/included some sources at the end and I encourage everyone to read this with care.

*** Before you comment please ensure you've read the whole post and comment mindfully and with consideration for people's wellbeing ***

The Background

For many years the general public, and many professionals, have been presented with the idea that depression is caused by a 'chemical imbalance' in the brain. Often it's specifically placed on a 'low amount of serotonin'.

Despite many professionals in the industry holding skepticism and doubts over this perspective - believing that mental health and wellbeing are far more complex than such a simple and direct cause - many people still believe that if they're experiencing depression it's because there is "something wrong with their brain".

Some surveys have indicated that 85-90% of the public still believes that low serotonin or a chemical imbalance is the primary cause of depression.

This perspective has contributed to a widespread and rampant issue of overdiagnosis, overprescription, and overreliance on pharmaceutical support as a sole solution to people's mental and emotional struggles.

The Study

A large-scale study published this week (linked) has reached the conclusion that there is little to no evidence that depression is primarily caused by chemical imbalances in the brain.

It also concluded that we still do not know exactly what antidepressants are doing to the brain and giving the public the false belief that depression is primarily caused by chemical imbalances prevents them from making informed decisions about their mental health.

One of the important suggestions of the study is that perhaps depression is complex, with a range of contributing factors including social factors (quality of relationships, loneliness etc), economic factors (financial stress), and personal factors (sense of self, emotional intelligence). To say that depression is primarily caused solely by a biological factor appears to not only be misinformed, but it could also be dangerous as the side effects of medication use are well known and can be a terrible thing for people to experience.

What Does This Mean?

This information may be difficult for people to sit with, especially when it goes against the popular narrative. It's also worth highlighting that many people have had, and continue to have, a successful and positive experience with pharmaceutical support for depression. Whether this is some type of placebo effect or some other factor at play, isn't yet clear but the important thing from my perspective is that if it works for you then keep it as part of your toolkit.

My hope is that this study heralds a new approach to mental health care and depression.

One that is more proactive, diverse, and preventative instead of diagnosis, prescriptive, and reactive.

If you are someone who finds that antidepressants help you then please continue to use them. This post is not about rubbishing medication. And please don’t use this study as a way of shaming or guilting people in your life who are using antidepressants - there’s too much stigma around pharmaceutical mental health support as it is.

Whilst I believe that other ‘alternative’ strategies such as Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Acceptance & Commitment Therapy, Mindfulness-Based Stress Reduction, and Positive Psychology interventions are all far more effective and sustainable than relying on antidepressants when it comes to living a happy and fulfilling life I also believe that pharmaceutical support can still play a role.

My hope is that it is used as one tool in a wide toolkit for people and that it is not relied on as a sole source of relief - or relied on as a life sentence.

If you are considering making changes to your mental health and wellbeing plan please make sure you consult your doctor, and ideally a couple of professionals in the space, before making any drastic changes. Feel free to share this study with your doctor and mental health professionals if you feel they’re not yet aware of it.

Sources:

Davis, J. (2014).?Cracked: Why Psychiatry is Doing More Harm Than Good. Icon Books.

Frances, A. (2014).?Saving Normal. William Morrow.

Lane, C. (2022).?A Decisive Blow to the Serotonin Hypothesis of Depression. Psychology Today. Retrieved 22 July 2022, from https://www.psychologytoday.com/us/blog/side-effects/202207/decisive-blow-the-serotonin-hypothesis-depression?fbclid=IwAR2a3Bs178a_YjdypWVzPaAgPDFrZP_ImzDKJQbWVKlTtPLMvjX8b40wOAk.

Moncrieff, J., Cooper, R., Stockmann, T., Amendola, S., Hengartner, M., & Horowitz, M. (2022). The serotonin theory of depression: a systematic umbrella review of the evidence.?Molecular Psychiatry. https://doi.org/10.1038/s41380-022-01661-0

Wise, J. (2022). “No convincing evidence” that depression is caused by low serotonin levels, say study authors.?BMJ, o1808. https://doi.org/10.1136/bmj.o1808