It's important for people to know that the idea that depression results from a "chemical imbalance" is hypothetical. chemical called serotonin. However, our most recent research report shows that the evidence does not support this. Although the serotonin depression theory was first proposed in the 1960s, the pharmaceutical industry got its start in the 1990s in connection with efforts to commercialize a new line of antidepressants known as selective serotonin reuptake inhibitors. or SSRIs. The idea was also supported by official bodies like the American Psychiatric Association, which still tells the public that "differences in certain chemicals in the brain can contribute to symptoms of depression." and in the media. People accepted what they were told. And many started taking antidepressants because they believed there was something wrong with the brain that an antidepressant needed to fix. Over the period of this marketing campaign, the use of antidepressants increased dramatically and they are now prescribed to one in six adults in England, for example. Evidence suggesting that depression is the result of abnormally low or inactive levels of serotonin. Others continue to support the theory. However, until now there has not been a comprehensive review of the research on serotonin and depression that allows firm conclusions to be drawn either way. . SSRIs temporarily increase the availability of serotonin in the brain, but that doesn't necessarily mean depression is caused by the opposite effect. There are other explanations for the effects of antidepressants. In fact, drug tests show that antidepressants are almost indistinguishable from a placebo (fake pill) when it comes to treating depression. In addition, antidepressants appear to have a generalized emotional numbing effect that can affect people's moods, although we don't know how this effect occurs, nor do we know much about it (Raths/Shutterstock). 1990, but not yet systematically collected. We conducted an 'umbrella' review that involved systematically identifying and compiling existing reviews of evidence from each of the major areas of research on serotonin and depression. Although there have been systematic reviews of individual areas in the past, none have combined the evidence from all the different areas with this approach. One area of research that we have included was research comparing the levels of serotonin and its breakdown products in the blood or spinal fluid. Overall, this research showed no difference between people with depression and people without depression. Another area of research has focused on serotonin receptors, which are proteins on nerve endings that serotonin binds to and that can transmit or inhibit the effects of serotonin. Research on the most commonly studied serotonin receptor suggested there was no difference between people with depression and people without depression, or that serotonin activity actually increased in people with depression, the opposite of what theory predicted of serotonin. the protein that helps break down the effects of serotonin (this is the protein that SSRIs act on) also indicates that there was increased serotonin activity in people with depression. However, these results may be explained by the fact that many participants in these studies were taking or taking antidepressants. We also review research examining whether depression can be induced in volunteers by artificially lowering serotonin levels. Two systematic reviews from 2006 and 2007 and a selection of the ten most recent studies (at the time the current research was conducted) found that lowering serotonin levels did not induce depression in hundreds of healthy volunteers. One of the reviews showed very weak evidence of an effect in a small subgroup of people with a family history of depression, but this only involved 75 participants. Very large studies involving tens of thousands of patients have looked at genetic variation, including the gene that contains the instructions for making the serotonin transporter. They found no difference in the frequency of variants of this gene between people with depression and healthy controls.
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July 26, 2022-05:38Updated: Jul 26, 2022 - 5:39 am
It's important for people to know that the idea that depression results from a "chemical imbalance" is hypothetical.
For three decades, people have been inundated with information suggesting that depression is caused by a "chemical imbalance" in the brain, that is, an imbalance of a brain chemical called serotonin. However, our most recent research report shows that the evidence does not support this.
Although the serotonergic theory of depression was first proposed in the 1960s, it was started in the 1990s by the pharmaceutical industry in connection with its efforts to market a new line of antidepressants known as selective serotonin reuptake inhibitors or SSRIs. The idea was also supported by official bodies like the American Psychiatric Association, which still tells the public that "differences in certain chemicals in the brain can contribute to symptoms of depression."
Countless physicians have repeated the message in their private practices and in the media around the world. People accepted what they were told. And many started taking antidepressants because they believed there was something wrong with the brain that an antidepressant needed to fix. Over the period of this marketing campaign, the use of antidepressants increased dramatically and they are now prescribed to one in six adults in England, for example.
Some scientists, including some leading psychiatrists, have long argued that there is no satisfactory evidence that depression results from abnormally low or inactive levels of serotonin. Others continue to support the theory. However, until now there has not been a comprehensive review of the research on serotonin and depression that allows firm conclusions to be drawn either way.
At first glance, the fact that SSRI-type antidepressants act on the serotonergic system seems to support the serotonergic theory of depression. SSRIs temporarily increase the availability of serotonin in the brain, but that doesn't necessarily mean depression is caused by the opposite effect.
There are other explanations for the effects of antidepressants. In fact, drug tests show that antidepressants are almost indistinguishable from a placebo (fake pill) when it comes to treating depression. Also, antidepressants seem to have a generalized emotional numbing effect that can affect people's moods, although we don't know how this effect is produced or much about it.
First comprehensive review
(Alexander Raths/Shutterstock)
The serotonin system has been extensively investigated since the 1990s, but has not yet been systematically recorded. We conducted an 'umbrella' review that involved systematically identifying and compiling existing reviews of evidence from each of the major areas of research on serotonin and depression. Although there have been systematic reviews of individual areas in the past, none have combined the evidence from all the different areas with this approach.
One area of research we included was the comparison of serotonin levels and its breakdown products in blood or brain fluid. Overall, this research showed no difference between people with depression and people without depression.
Another area of research has focused on serotonin receptors, which are proteins on nerve endings that serotonin binds to and that can transmit or inhibit the effects of serotonin. Research on the most commonly studied serotonin receptor suggested there was no difference between people with depression and people without depression, or that serotonin activity actually increased in people with depression, the opposite of what theory predicted of serotonin.
Research on the "transporter" of serotonin i. h the protein that helps break down the effects of serotonin (this is the protein that SSRIs act on) also suggested that there was at least increased serotonin activity in people with depression. However, these results may be explained by the fact that many participants in these studies were taking or taking antidepressants.
We also reviewed research that examined whether depression in volunteers could be induced by artificially lowering serotonin levels. Two systematic reviews from 2006 and 2007 and a selection of the ten most recent studies (at the time the current research was conducted) found that lowering serotonin levels did not induce depression in hundreds of healthy volunteers. One of the reviews showed very weak evidence of an effect in a small subset of people with a family history of depression, but only 75 participants were affected.
Very large studies involving tens of thousands of patients have looked at genetic variation, including the gene that contains the instructions for making the serotonin transporter. They found no difference in the frequency of variants of this gene between people with depression and healthy controls.
Although a famous early study found a link between the serotonin transporter gene and stressful life events, larger and more extensive studies suggest no such link exists. However, stressful life events themselves had a strong impact on the subsequent risk of developing depression.
Some of the studies in our review involving people who are taking or have taken antidepressants showed evidence that antidepressants can actually reduce serotonin levels or activity.
Not supported by evidence
The serotonin theory of depression is one of the most influential and well-researched biological theories of the origins of depression. Our study shows that this opinion is not supported by scientific evidence. It also challenges the basis for the use of antidepressants.
It is believed that most antidepressants in current use work through their effects on serotonin. Some also affect the brain chemical norepinephrine. However, experts agree that the evidence for norepinephrine's role in depression is weaker than that for serotonin.
There is no other accepted pharmacological mechanism for how antidepressants can affect depression. Whether antidepressants work as placebos or by numbing emotions, it's unclear whether they do more good than harm.
While viewing depression as a biological disorder seems to reduce stigma, research has actually shown the opposite and also that people who believe their own depression is due to a chemical imbalance are more pessimistic about their chances of recovery.
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Beat Depression: Using Modern, Traditional and Digital Techniques to Make Us Smile Again
It's important for people to know that the idea that depression results from a "chemical imbalance" is hypothetical. And we don't understand what transient increases in serotonin or other biochemical changes induced by antidepressants do to the brain. We conclude that it is impossible to say that taking SSRI antidepressants is helpful or even completely safe.
If you are taking antidepressants, it is very important that you do not stop taking them without first talking to your doctor. But people need all this information to make informed decisions about whether or not to take these drugs.
By Joanna Moncrieff and Mark Horowitz
Joanna Moncrieff is Senior Clinical Professor of Critical and Social Psychiatry at UCL and co-investigator of a National Institute for Health Research-funded study examining methods of antidepressant withdrawal. She is co-chair of the Critical Psychiatry Network, an informal and unfunded group of psychiatrists, and an unpaid board member of the volunteer group, the Council for Evidence-Based Psychiatry.
Mark Horowitz is a clinical research fellow in psychiatry at UCL and co-founder of a company dedicated to helping people safely wean off unnecessary antidepressants in Canada. He is an Associate Member (unpaid) of the International Institute on Psychiatric Drug Withdrawal (IIPDW) and a member of the Critical Psychiatry Network.
FAQs
Is depression probably not caused by chemical imbalance in the brain? ›
9, 2022 (HealthDay News) -- The notion that depression is caused by a chemical imbalance in the brain has become widespread among the general public. But there's actually no hard evidence that the brain chemical serotonin – the main suspect in this theory – is linked in any way to depression, a major new review finds.
Was depression caused by a chemical imbalance? ›In short, no. Depression isn't caused solely by a chemical imbalance and the involvement of dopamine, norepinephrine and serotonin in depression still isn't 100% clear. For example, the medication tianeptine is an effective antidepressant for some people and it actually lowers serotonin levels.
Is depression probably not caused by a serotonin imbalance in the brain? ›They found no convincing evidence that lower levels of serotonin caused or were even associated with depression. People with depression didn't reliably seem to have less serotonin activity than people without the disorder.
How much of depression is chemical imbalance? ›Depression is likely not caused by a chemical imbalance in the brain, study says. “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.”
What is caused by chemical imbalance in the brain? ›Symptoms of Chemical Imbalances
Studies show that brain chemicals play a role in the development of anxiety and depression. Lower levels of neurotransmitters can cause symptoms, such as feelings of emptiness, worthlessness, sadness, or helplessness. These symptoms can lead to various mental conditions.
Depression may result from injury to the areas of the brain that control emotions. Changes in the levels of certain natural chemicals in the brain, called neurotransmitters, can cause depression.
What is the real cause of depression? ›There's no single cause of depression. It can occur for a variety of reasons and it has many different triggers. For some people, an upsetting or stressful life event, such as bereavement, divorce, illness, redundancy and job or money worries, can be the cause. Different causes can often combine to trigger depression.
What are the 4 main causes of depression? ›- Family history. Though there are no specific genes that we can look at and trace to depression, if your family members have had depression, you are more likely also to experience depression. ...
- Illness and health issues. ...
- Medication, drugs, and alcohol. ...
- Personality.
Today, millions of Americans take serotonin-based antidepressants, such as Prozac, Celexa and Lexapro. But a recent new study from University College London, in which researchers looked at serotonin levels in the blood, finds no link between low serotonin, or a chemical imbalance, and depression.
Is depression a lack of serotonin or dopamine? ›A dopamine imbalance can cause depression symptoms, such as apathy and feelings of hopelessness, while a serotonin imbalance can affect the processing of emotions.
What is the meaning of chemical imbalance? ›
(KEH-mih-kul im-BA-lunts) Too much or too little of any substance that helps the body work the way it should.
How can I balance my brain chemicals naturally? ›Getting enough sleep, exercising, listening to music, meditating, and spending time in the sun can all boost dopamine levels. Overall, a balanced diet and lifestyle can go a long way in increasing your body's natural production of dopamine and helping your brain function at its best.
How can I increase serotonin and dopamine naturally? ›- Exercise. Regular exercise for at least 30 minutes each day improves one's overall mood. ...
- Spend Time in Nature. In previous generations, humans spent most of their time outdoors. ...
- Nutrition. ...
- Meditation. ...
- Gratitude. ...
- Essential Oils. ...
- Goal Achievement. ...
- Happy Memories.
There are no reliable tests to diagnose a chemical imbalance in the brain. Doctors can perform tests to assess the levels of serotonin and other chemicals in your blood. However, this is not an accurate representation of the amount of these present in your brain.
Can a chemical imbalance in the brain be reversed? ›Can a Chemical Imbalance Be Cured? Yes, a chemical imbalance can be restored or cured, but addiction cannot be cured. It takes time to restore a person's chemical imbalance. The individual may experience a dopamine withdrawal and other symptoms of withdrawal related to the specific substance.
How do you restore a chemical imbalance in the brain? ›There are also natural activities that may help increase the levels of serotonin in your brain, such as taking regular walks, meditating, and exercising or practicing yoga. Individuals experiencing chemical imbalances could also benefit from counseling, therapy, and support meetings.
How do I reset my chemical brain balance? ›- Create exciting daily routines. Incorporate fun activities into your daily routine, even if they are mindless activities. ...
- Focus on perfecting your sleep schedule. ...
- Improve your diet. ...
- Exercise. ...
- Practice mindfulness. ...
- Listen to music.
The main subcortical limbic brain regions implicated in depression are the amygdala, hippocampus, and the dorsomedial thalamus. Both structural and functional abnormalities in these areas have been found in depression.
Does your brain go back to normal after antidepressants? ›If the symptoms develop later or gradually, they may constitute a relapse of the depression. Ultimately, these withdrawal symptoms will improve with time, but they can be unpleasant for days and possibly even weeks. In time, the brain readjusts and people should experience a return to their normal state.
Is depression damage reversible? ›Depression and mood disorders are characterized by structural as well as neurochemical alterations in the brain. However, these changes are not permanent, and can be blocked or reversed with behavioral and pharmacological treatments.
What are the 3 main causes of depression? ›
Sleep, diet and exercise. A poor diet and lack of sleep and exercise can affect your mood, and make it harder for you to cope with difficult things going on in your life. Although a poor diet, or not getting enough sleep or exercise, cannot directly cause depression, they can make you more vulnerable to developing it.
Is drinking water good for depression? ›Drinking plain water is associated with decreased risk of depression and anxiety in adults: Results from a large cross-sectional study.
Is there a true cure for depression? ›There's no cure for depression, but there are lots of effective treatments. People can recover from depression and live long and healthy lives.
How long does it take for brain chemicals to rebalance? ›A minimum of 3-6 months is required to restore neurotransmitter levels to normal. However, it takes longer to restore the body's total store of neurotransmitters. If a patient stops the neurotransmitter therapy too quickly, they may experience a return of their original symptoms.
What vitamins help with serotonin levels? ›...
Vitamins and Minerals That Increase Serotonin
- Vitamin B6 (pyridoxine) ...
- Folic Acid (vitamin B9) ...
- Vitamin C. ...
- Vitamin D. ...
- Magnesium. ...
- Zinc.
If you have anxiety you can also develop chemical imbalances that were not previously present, because anxiety affects your brain chemicals.
Can a person be born depressed? ›Heritability is probably 40-50%, and might be higher for severe depression. This could mean that in most cases of depression, around 50% of the cause is genetic, and around 50% is unrelated to genes (psychological or physical factors).
What is the most common way to treat depression? ›Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
What are the 5 levels of depression? ›Types of major depression include melancholia, psychotic and antenatal or postnatal. You may be diagnosed with mild, moderate or severe depression. Your mental health professional may diagnose you with depression if these symptoms: happen most days.
What supplements boost dopamine? ›Along with eating a balanced diet, many possible supplements may help boost dopamine levels, including probiotics, fish oil, vitamin D, magnesium, ginkgo and ginseng. This, in turn, could help improve brain function and mental health.
What foods contain serotonin? ›
Serotonin does not occur in the foods we eat, however it is synthesized from tryptophan, an amino acid. Tryptophan is mostly found in high protein foods, like meat, fish and poultry.
How can I increase my dopamine naturally? ›Engage in activities that make you happy or feel relaxed. This is thought to increase dopamine levels. Some examples include exercise, meditation, yoga, massage, playing with a pet, walking in nature or reading a book.
Does serotonin syndrome cause depression? ›It has long been suggested that over-activity of the serotonin system may relate to mood disorders such as depression and anxiety, as these seem characterized by too much withdrawal and avoidance.
What happens if serotonin is out of balance in the brain? ›Serotonin plays several roles in your body, including influencing learning, memory, happiness as well as regulating body temperature, sleep, sexual behavior and hunger. Lack of enough serotonin is thought to play a role in depression, anxiety, mania and other health conditions.
Does serotonin play a role in depression? ›Serotonin is linked to mood regulation and is known to be a key factor in overall mental health. Low levels of serotonin can cause depression, anxiety, insomnia, and other mental health conditions.
What causes serotonin imbalance? ›Prolonged periods of stress can deplete serotonin levels. Our fast-paced, fast food society greatly contributes to these imbalances. Genetic factors, faulty metabolism, and digestive issues can impair the absorption and breakdown of our food which reduces our ability to build serotonin.