Depression Is Not Caused by Chemical Imbalance in the Brain

Upon analyzing 17 previous studies on the subject of depression, scientists have concluded that there might be no link between depression and lower levels of serotonin in the brain. The authors of the review also said that these findings could refute not only theories connecting depression to a chemical imbalance but also the effectiveness of prescribing antidepressants that target serotonin. 

Decades ago, the serotonin hypothesis proposed that depression and a chemical imbalance in the brain—including a deficiency of serotonin—could be closely related. Therefore, the most commonly prescribed antidepressants are those formulated to make serotonin more available in the brain by blocking its reabsorption into the neurons. These are the antidepressants known as serotonin reuptake inhibitors. 

However, in their recent analysis, MD Joanna Moncrieff, a professor of psychiatry at University College London, and her team found that there is no consistent evidence that serotonin is involved at all in depression.

“After a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin,” Moncrieff said in a news release.

“The popularity of the chemical imbalance theory of depression has coincided with a huge increase in the use of antidepressants. Prescriptions for antidepressants have risen dramatically since the 1990s, with one in six adults in England and 2% of teenagers now being prescribed an antidepressant in a given year.”

“Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this new research suggests this belief is not grounded in evidence.”

Research on serotonin and how it breaks down in the blood and brain fluids found that there were similar amounts of these chemicals in people with and without depression.

Research on serotonin receptors and the serotonin transporter, a protein that many antidepressants target, offered inconsistent evidence linking people with depression and their levels of serotonin activity.

Studies in which healthy people’s serotonin levels were artificially lowered through a special diet found that this did not increase their risk of developing depression. In addition, genetic studies found no difference in serotonin-related genes between healthy participants and people with depression.

“Thousands of people suffer from side effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, yet prescription rates continue to rise. We believe this situation has been driven partly by the false belief that depression is due to a chemical imbalance. It is high time to inform the public that this belief is not grounded in science,” said Moncrieff. 

Other researchers are warning against completely ruling out serotonin as an oversimplification of the research. They also caution against making decisions about how to treat depression based on this review, saying antidepressants have been shown to be moderately effective for certain people. SSRI antidepressants can help some patients, just not everyone. 

Other variables, like environmental stress, lifestyle, and anxiety need to be considered. Although the “chemical imbalance” view of depression is not perfect or conclusive, the case of serotonin is not closed yet, and a lot more studies need to be performed. 

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