For years we’ve been told that depression is caused by low serotonin levels in the brain. Now, a leading professor of psychiatry is warning that belief is little more than a dangerous miscommunication, saying the marketing of selective serotonin reuptake inhibitor (SSRI) drugs is “based on a myth.”
SSRI use began to skyrocket in the early 1990’s. The drugs were seen as a safer alternative to tranquilizers, which were the standard treatment for depression until that time. Despite being weaker than old-style tricyclic antidepressants, they grew in popularity because it was believed they restored serotonin levels back to normal, “a notion that later transmuted into the idea that they remedied a chemical imbalance,” said David Healy, head of psychiatry at the Hergest psychiatric unit in Bangor, North Wales.
Healy wrote in a report published in the journal BMJ that in the 1990s, no one knew if SSRIs raised or lowered serotonin levels, but there was no evidence that the treatment worked as a treatment at all. The drugs have fewer side effects than their predecessors, and are safer in overdose, which contributed to their popularity.
“For doctors it provided an easy short hand for communication with patients,” Healy wrote. ‘For patients, the idea of correcting an abnormality has a moral force that can be expected to overcome the scruples some might have had about taking a tranquilliser, especially when packaged in the appealing form that distress is not a weakness.’
Healy says depression should be reclassified as an infectious disease rather than an emotional disorder, and the professor is not alone in his thinking. Dr. Turhan Canli of Stony Brook University in New York believes depression could be caused by a parasitic, bacterial, or viral infection and argues in favor of further research to test his hypothesis. If this is the case, Canli says scientists could develop a vaccine to protect against depression (a solution we aren’t sure is the right one).
“Instead of conceptualising major depression as an emotional disorder, I suggest to re-conceptualise it as some form of an infectious disease,” Canli wrote in the journal Biology of Mood and Anxiety Disorders. “I propose that future research should conduct a concerted search for parasites, bacteria, or viruses that may play a causal role in the etiology of major depression.”
Top mental health professionals have always known that depression might not be caused by serotonin levels alone, but the public never got the memo. Professor Sir Simon Wessely, President of the Royal College of Psychiatrists, says that SSRIs are indeed helpful in the treatment of depression when combined with psychological treatments, but added that “most researchers have long since moved on from the old serotonin model.” Further, reports say that 70% of people on antidepressants don’t have depression.
Professor David Taylor, Director of Pharmacy and Pathology and Head of Pharmaceutical Sciences Clinical Academic Group, King’s Health Partners, South London and Maudsley NHS Foundation Trust, said:
“‘Professor Healy makes a forceful but poorly supported argument against something which doesn’t and has never really existed: the idea that SSRIs ‘correct’ an ‘imbalance’ of serotonin in the brain.’
Researchers and psychiatrists alike know that SSRIs are effective in a number of disorders but no one is sure exactly how they work. Their readily demonstrable effect is on serotonin but they have many indirect secondary effects in the brain.”
Marcia Angell, former editor-in-chief of the New England Journal of Medicine, explained in a New York Times book review exactly how this theory was set afloat:
“When it was found that psychoactive drugs affect neurotransmitter levels in the brain, as evidenced mainly by the levels of their breakdown products in the spinal fluid, the theory arose that the cause of mental illness is an abnormality in the brain’s concentration of these chemicals that is specifically countered by the appropriate drug …
That was a great leap in logic … It was entirely possible that drugs that affected neurotransmitter levels could relieve symptoms even if neurotransmitters had nothing to do with the illness in the first place (and even possible that they relieved symptoms through some other mode of action entirely).”
With this logic, Angell writes, you “could argue that fevers are caused by too little aspirin!”
Healy warns that regardless of what actually causes depression, the drugs used to “treat” the illness are not improving. In fact, in some cases, the safety and efficacy of new drugs is declining.
“In other areas of life the products we use, from computers to microwaves, improve year on year, but this is not the case for medicines, where this year’s treatments may achieve blockbuster sales despite being less effective and less safe than yesterday’s models,” Healy writes.
Not only may antidepressants not attack the root cause of depression, but they could also be dangerously and permanently altering brain function. According to Mercola, patients are recovering from depression faster, but are relapsing more, or only partially recovering and existing in a state of chronic depression that never goes away.
Only about 15% of clinically depressed people that are treated with an antidepressant go into remission and stay well for a long period of time. The other 85% begin suffering continuing relapses and become chronically depressed.
Medical journalist and Pulitzer Prize nominee Robert Whitaker told Mercola:
“By the 1990s, this change in the long term course of depression was so pronounced that finally it was addressed by researchers,” says Whitaker. “Giovanni Fava from Italy said, “Hey, listen, the course is changing with antidepressants. We’re changing it from an episodic illness to a chronic illness, and we really need to address this.”
Not only that, but the depression is sinking into people [on antidepressants] in a deeper way than before.”
This is likely because psychotropic drugs can actually interfere with neurotransmitters, upsetting the delicate processes within the brain that are vital to maintaining normal biological functions, resulting in side effects that actually mimic mental illness.
“After several weeks on psychoactive drugs, the brain’s compensatory efforts begin to fail, and side effects emerge that reflect the mechanism of action of the drugs. For example, the SSRIs may cause episodes of mania, because of the excess of serotonin. Antipsychotics cause side effects that resemble Parkinson’s disease, because of the depletion of dopamine (which is also depleted in Parkinson’s disease).
As side effects emerge, they are often treated by other drugs, and many patients end up on a cocktail of psychoactive drugs prescribed for a cocktail of diagnoses.”
About the Author
Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.