Depression is not caused by a chemical imbalance. That is the headline of the weekend. Or at least
there's no evidence backing the serotonin hypothesis of depression. So this is what
researchers with the University College London have found after conducting a meta-analysis,
which is a high quality review of dozens of studies, and it was published in a
peer-reviewed journal. So this is the gold standard of psychological research. They
summarized their research by saying there's 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. Now, this is not surprising to the researchers and
scientists who study depression. They've known for decades that depression is a multifaceted disease
without a single cause. But 85 to 90 percent of the public do believe that depression is a
chemical imbalance, and that's one reason why so many people take antidepressant medication. More
than one out of every eight American adults and one in six adults in the UK take an antidepressant
medication. And, you know, that's not the only reason they take an antidepressant medication;
it's because they're depressed and they want some relief from this terrible disease.
And I'll address how medication can be a good treatment option a little bit later in this video.
I made a much longer video about the myth of a chemical imbalance earlier this year, but then I
decided not to publish it because honestly I I was too afraid that people would feel blamed or judged
or misunderstood. And I know that for many people with depression, they hate themselves so much
that the chemical imbalance explanation has been a really important belief for you. It helps you
not blame yourself or beat yourself up for how you feel. And I didn't want to undermine that without
giving you something better, without something to replace it. So I do want to be really clear:
depression is not your fault, and there's something you can do about it. You deserve
good information and good treatments. So if you want to watch my longer video, it's unlisted but
the link is in the description. That being said, the chemical imbalance hypothesis was widely
promoted by pharmaceutical companies and widely accepted by the public since the early 2000s.
Doctors, therapists, news outlets, and many social media channels have widely used this hypothesis to
explain what causes depression and to promote the use of antidepressants as a treatment.
And to be clear, there are biological contributing factors for depression
which researchers don't completely understand. There are correlations to things like nutrient
deficiencies, hypothyroid. Some medications can cause depression. Gender contributes to depression
symptoms. Substance abuse, a genetic interaction with the environment, and possibly things like
food allergies and inflammation and toxins, brain injuries, infections, and your gut microbiome,
right? There are also physical changes in the brain, guts, and bodies of people with depression.
We just aren't good at diagnosing them. And there is no single cause. There is no
physical test for depression. We're much better at diagnosing the psychological and environmental
causes of depression, things like abuse and trauma and stress and social isolation, the loss of a
loved one - these are all more easily identifiable causes than any physiological cause of depression.
Researchers with this study found a much closer correlation between stress and depression
than serotonin and depression. Now, all of that being said, I was speaking to someone this morning
and she basically said, "Well then, why the hell am I taking medication?" Medication is still an
effective treatment for many people. When compared to a placebo it helps about 20 percent more people
reduce their depression symptoms. Medication is also generally cheaper and easier to access than
other treatments, and easy accessibility really matters with a disease like depression that saps
your energy and your motivation. Researchers aren't sure why SSRIs work, but one hypothesis
is that they promote neuroplasticity, which is the ability your brain has to change and heal. Now,
I often recommend to my clients with severe depression that they explore their medication
options with their doctor or psychiatrist, but medication is not the only treatment,
and it's not as effective as we've been led to believe by the pharmaceutical companies.
When you have depression, you deserve as much good information and treatment options as possible.
Therapy, exercise, a nutritious diet, good sleep, and reducing stress usually get better results in
the long term than only medication, and they can be used in conjunction with medication. You can do
both. Depression is a real disease. It has a combination of biological, which is your
brain and your body health; psychological, how you think and act; and environmental causes,
so that includes trauma, stress, and abuse and social issues. Right? And depression is not your
fault. No one wants to be depressed. No one just goes out and chooses one day,
you know, "What I want, I want to be depressed." Right? Blaming yourself, beating yourself up,
believing that you're weak or something is wrong with you because you have depression
is not the most helpful approach. But neither is the single-minded and most likely incorrect belief
that depression is simply caused by a chemical imbalance, and the corresponding belief that
your only option is to take medication. So both of these beliefs - the one side that, oh, that "I'm
bad weak or defective" or that "Brain chemistry is causing my depression and there's nothing I
can do about it" - both of these are two rigid and extreme ways of thinking that can essentially
impair your ability to change the things that you can change to improve your depression. They
make you more helpless. Depression is not your fault, but there are some things you can do about
it. So if we want to treat depression, we need a much more flexible and informed way of thinking
about depression and mental health in general. There is actually so much you can do to improve
your mental health and to treat and resolve depression and anxiety. There are research-backed
treatments that are shown to be as effective or more effective than medication. And again,
there's nothing wrong with medication. It's a fine treatment option when you understand the pros and
cons. When we're dealing with a disease that is so impacted by how we think about it as a society
and as mental health professionals, we have to create a dialogue that empowers people. We
can't reduce stigma by just teaching people that there's nothing they can do except to take meds.
Now, I also have an entire course on the mind and body treatments that have been shown to fight
depression more effectively than medication. So if you'd like to learn more about that just check out
the link in the description. There really are so many options for treating depression. Now,
I I hope that the publicity that this study is getting helps us improve the conversation around
depression and mental health, that it helps people get actually informed about what the research says
about depression and not just the information that the pharmaceutical commercials taught us
20 years ago. And I hope this improves our dialogue so that we can actually help people
get feeling better and get better at feeling. So thank you so much for watching, and take care.