Based on a systematic review of 17 medical studies, a recently published paper has raised questions and sparked debate about the chemical imbalance theory of depression. Although the study did not perform additional research, after synthesizing and evaluating evidence in the principal relevant areas, the authors conclude the longstanding theory is unproven.
Serotonin is a monoamine neurotransmitter, a chemical that regulates mood, sleep, appetite, and sexual desire. The chemical imbalancetheory suggests that depression is caused by lowered serotonin levels in the brain.
The paper, published July 20 in the journal Molecular Psychiatryby a multi-national team of researchers, is entitled The serotonin theory of depression: a systematic umbrella review of the evidence. The paper questions the chemical imbalance theory that began in the 1960s, based on the premise that reduced serotonin activity causes depression. This hypothesis was derived from the fact that the first two specifically antidepressant drugs, discovered in the 1950s, were both shown to increase brain levels of serotonin. Therefore, early experiments assumed a causal relationship between serotonin and depression.
Subsequently, a variety of antidepressants often referred to as happy pills were developed, promoted around, and reinforced this theory.
Although many professionals and the public still accept the serotonin theory of depression, the authors of the paper said they found no conclusive evidence that depression is associated with, or caused by, reduced serotonin concentration or activity in the brain. The study also calls into question whether raising serotonin levels via antidepressants is a reliable treatment for depression.
Although clinical experts have determined that antidepressants help in the treatment of severe depression, their mechanism is not entirely understood.
Expert reaction to the study was immediate and vigorous. The day the paper was published, BritainsScience Media Centre published a round-up of various experts and their responses.
Among them was Michael Bloomfield, Ph.D., psychiatrist and researcher at University College, London. While Bloomfield said that the hypothesis that depression was caused by a chemical imbalance in serotonin was a really important step forward in the middle of the 20thcentury, he called the review unsurprising. He noted, I dont think Ive met any serious scientists or psychiatrists who think that all causes of depression are caused by a simple chemical imbalance in serotonin.
Phil Cowen, a professor of psychopharmacology at Oxford University, has studied the effects of serotonin on depressed patients for 30 years. He believes no mental health professional today would support the view that a complex disorder like depression stems from a deficiency in a single neurotransmitter.
Professor Gitte Moos Knudsen, head of the Department of Neurology and Neurobiology Research Unit at Denmarks University Hospital of Copenhagen, said the study is based on a misconception, namely that depression is a single disease with a single biochemical deficit. Today, Knudsen notes, it is largely accepted that depression is a heterogeneous disorder with potentially multiple underlying causes.
Although the July 20 paper did not focus on the pros and cons of using antidepressants, their mechanism of action in treating depression has become the focus of discussion. This is because most of the antidepressants used today have roots in the questionable chemical imbalance theory.
In response to the study, Frederick Sundram, deputy head of psychological medicine at the University of Auckland, New Zealand, wrotethat the mechanism of action for antidepressants is not yet fully understood. He believes there may be other mechanisms at work, such as neuroplasticity. In addition, he wrote, 30 to 40 percent of the efficacy of antidepressants is due to a placebo effect.
Sundram claimed the brain chemical imbalance theory takes a simplified approach to a very complex human condition, an approach that is not shared by most psychiatrists. For example, he said, if someone has a history of personal trauma and lives under the constant stress of social isolation, unemployment, economic problems, leading to depression, antidepressants are unlikely to solve the problem.
In March, the World Health Organization (WHO) published a report that mirrors Sundrams view. The report noted that the global prevalence of anxiety and depression rose 25 percent in 2020, during the COVID-19 pandemic. The WHO said that peoples anxiety and depression were exacerbated by feelings of isolation under lockdowns, financial worries, and fear of illness or death for themselves and their loved ones. All of these are issues for which an antidepressant alone may be insufficient.
The Royal College of Psychiatrists, a British mental health authority, responded to the study by citing its position paper on antidepressants (pdf), which states that although the idea of using antidepressants to correct a chemical imbalance in the brain is too simplistic, they do have early physiological and psychological effects.
The Royal College suggests that antidepressants treat the symptoms of depression but do not directly address any underlying psychosocial causes, so medication is often combined with psychotherapy that can improve the patients ability to cope with difficult life situations.
Dr. Jing-Duan Yang is a psychiatrist and founder of the Yang Institute of Integrative Medicine. In a video presentation on Aug. 20, Yang explained why the chemical imbalance theory has become so prevalent. Yang said that once a theory developed by science becomes tied to a product, its promotion and subsequent researchers tend to exaggerate or embellish the original scientific evidence.
Drawing from his 20 years of clinical experience, Dr. Jing-Duan Yang believes antidepressants do work for some patients. However, it remains to be seen if [they work] in the way that was originally hypothesized, he said.
Dr. Yang believes antidepressant drugs have helped to reduce inflammation in the brain, and some studies suggest depression is related to the inflammatory response in the brain. Therefore these drugs may improve serotonin function but by some other mechanism.
Yang said although antidepressants are clinically proven and effective for many people, most have a variety of side effects, so patients should be cautious when using them.
Yang gave the example of a patient he treated for nearly twenty years. The patient used the common drug Cymbalta for about ten years to improve her serotonin and norepinephrine function against anxiety and depression. The patient reported side effects such as weight gain and increased blood pressure.
After switching the patient to Lexapro, a drug that simply improves serotonin function, her anxiety and depression improved once again. But it wasnt long before she started gaining weight again. She began having other disturbing side effects such as decreased libido, blurred vision, and a feeling that ants and bugs were crawling over her body.
Yang said the most serious concern about this and other common antidepressants is their black box warning, which warns that teens and young adults are prone to more suicidal thoughts and tendencies in the first few weeks of taking the drug. In addition, for some people, anti-depressants increase symptoms of depression.
Dr. Dong Shidao, a traditional Chinese medicine (TCM) doctor living in New Zealand, told The Epoch Times that TCM believes depression is strongly linked to the liver and its response to human emotions.
Chinese medicine believes the liver plays a key role in controlling the flow of qiusually translated as vital energy through the body. When the liver is free of emotional turmoil, qi flows smoothly, and depression is avoided. Depression occurs when negative emotions disrupt the livers functioning, and the flow of qi becomes stagnant or blocked.
Dong believes people become prone to liver qi stagnation when they allow worries and anxiety to remain unchecked. Instead of learning to care for themselves by developing support systems and good relationships, people today spend too much time on their cell phones and computers, says Dong. They dont know how to calm their worries in a healthy way, in order to avoid liver-related depression.
Dong believes the stress of modern society only makes depression worse. To make his point, he uses a famous Chinese saying: If the righteousness exists within, the evil will not enter. He predicts that the more society devolves, the more vulnerable people will be to depression.
Chinese medicine also has medication to treat liver qi stagnation, said Dong. But medication and acupuncture focus on unblocking and adjusting the whole body. TCM frequently uses a botanical formulation called Xiao Chi Hu Tang. The seven-herb formula was developed 1,800 years ago in China by Dr. Zhang Zhongjing and is still relied upon today to treat liver and gastrointestinal disorders.
Read more:
Study Reignites Debate on the Chemical Imbalance Theory of Depression - The Epoch Times
- How Integrative Medicine is helping a teen battle Sickle Cell Disease - News 5 Cleveland WEWS - February 8th, 2024
- Overview of Integrative, Complementary, and Alternative Medicine - January 14th, 2024
- Integration of Traditional, Complementary, and Integrative Medicine (TCIM) in the Institutionalization of Evidence ... - World Health Organization - January 14th, 2024
- A holistic approach to integrative medicine - Mayo Clinic Press - November 16th, 2023
- Integrative Medicine: What Is It, Types & Benefits | Fullscript - October 16th, 2023
- What is Integrative Medicine? - Andrew Weil, M.D. - DrWeil.com - October 16th, 2023
- Integrative Medicine - UF Health - October 16th, 2023
- What is integrative medicine (IM)? - Medical News Today - May 17th, 2023
- Houston Integrative Medicine - May 17th, 2023
- Journal of Integrative Medicine | ScienceDirect.com by Elsevier - April 23rd, 2023
- ScienceDirect.com | Science, health and medical journals, full text ... - December 27th, 2022
- Highlighted Efforts by Tata Memorial Centre and Centre for Integrative Medicine and ... - Latest Tweet by - LatestLY - December 27th, 2022
- Integrative Medicine Research | Journal | ScienceDirect.com by Elsevier - November 24th, 2022
- About Herbs, Botanicals & Other Products | Memorial Sloan Kettering ... - November 16th, 2022
- Integrative Medicine Board Certification | ABPS - American Board of ... - October 21st, 2022
- Fellowship: Andrew Weil Center for Integrative Medicine - October 13th, 2022
- UCHealth Integrative Medicine Center - Central Park - October 13th, 2022
- New Guideline on Integrative Medicine for Pain Management in Oncology - Cancer Therapy Advisor - October 13th, 2022
- 'What the Duck' display lands in Downtown Middletown and beyond - FOX61 Hartford - October 13th, 2022
- AIHM Annual Conference Features More than 50 International Leaders in Integrative Health and Medicine - Benzinga - October 13th, 2022
- Gaia Herbs celebrates 35 year legacy with coveted sustainability certification and Gaia PRO launch - EurekAlert - October 13th, 2022
- The Chopra Foundation and its Never Alone Initiative, partner with the tech-based social impact start-up, Seva.Love, and The Girl Generation to Launch... - October 13th, 2022
- Are Tomatoes Bad For Arthritis? Here's What An MD Has To Say - Women's Health - October 4th, 2022
- At Columbia, Integrative Therapy for Children with Cancer Is Mainstream - Columbia University Irving Medical Center - October 4th, 2022
- Integrative Health or Complementary and Alternative Medicine Market Size and Forecast to 2029 -Arab Yoga Found - openPR - October 4th, 2022
- Potential Health Benefits of Lion's Mane Mushroom - Everyday Health - October 4th, 2022
- How I Finally Found A Way To Manage My Anxiety - Women's Health - October 4th, 2022
- What Is Psoriasis And Can It Be Treated? - Forbes - October 4th, 2022
- Regent candidates discuss their ideas at Faculty Senate forum | The University Record - The University Record - October 4th, 2022
- The Administration Announced Ending Hunger, Improving Nutrition and Physical Activity, and Reducing Diet- - Benzinga - October 4th, 2022
- VOC Port will be transformed into transhipment hub: Union Minister Sonowal - The New Indian Express - October 4th, 2022
- Choose integrative medicine for health and wellness - Technique - September 25th, 2022
- Integrating the Best from All Medical Disciplines and Fighting Medical Fascism - The Douglass Update Launches Fully Integrated Med-Sciences Education... - September 25th, 2022
- I'm An M.D. & This Is The Supplement I Trust For Consistently Deep Sleep - mindbodygreen - September 25th, 2022
- NMC bats for integration of modern medicine with Ayush - The Hindu - September 25th, 2022
- They Hold The Third Meeting Of Traditional And Complementary Medicine - World Nation News - September 25th, 2022
- Deepak Chopra & Seva.Love Announce "ChopraVerse: House of Enlightenment," the Metaverse for Wellbeing in Collaboration with Utopia - PR... - September 25th, 2022
- The effectiveness of pharmacopuncture in patients with LSS | JPR - Dove Medical Press - September 25th, 2022
- Allergic to the world: can medicine help people with severe intolerance to chemicals? - The Guardian - September 25th, 2022
- Integrative Medicine - September 16th, 2022
- Jacksonville nurse practitioner writes book on how to use integrative medicine in your daily life - FirstCoastNews.com WTLV-WJXX - September 16th, 2022
- Integrative health podcast and video series Word of Mouth, season two released! - PR Newswire - September 16th, 2022
- Where Will the Massage Industry Be in Five Years? - Institute for Integrative Healthcare Studies - September 16th, 2022
- The Plogging Habits That Slow Aging, Science Reveals Eat This Not That - Eat This, Not That - September 16th, 2022
- These are the First Signs of an Autoimmune Disease Eat This Not That - Eat This, Not That - September 16th, 2022
- Study: Dark berry blend linked to improved sleep, stress, physical health - NutraIngredients-usa.com - September 16th, 2022
- Signs There is Something Wrong With Your Gut Eat This Not That - Eat This, Not That - September 16th, 2022
- Can your brain improve? Modern medicine says yes, if you get proper testing and treatment - Billy Penn - September 16th, 2022
- CU Anschutz Researchers Part of National Effort to Rapidly Boost AI in Medical Research - University of Colorado Anschutz Medical Campus - September 16th, 2022
- Ingenious Ideas to Add Coconut Oil Into Your Beauty and Health Routine - News18 - September 16th, 2022
- Carlos III, the lover of homeopathy - Gearrice - September 16th, 2022
- Elevating Practitioner Skills and Enhancing Patient Experience: The Institute for Functional Medicine and Rupa Heath Announce New Partnership -... - September 8th, 2022
- Thailand heightens its healthcare hub ambition with integrative medicine - PR Newswire - September 8th, 2022
- What Is Dirty Energy In Your Home And What Can You Do About It? - House Digest - September 8th, 2022
- 5 Ways to Add Years to Your Life Eat This Not That - Eat This, Not That - September 8th, 2022
- I Went Bald After My First PregnancyHeres What It Taught Me About Hair Loss - Well+Good - September 8th, 2022
- Little-Known Habits That Decrease Your Deadly Cancer Risk Eat This Not That - Eat This, Not That - September 8th, 2022
- Cultivating a Culture of Wellness in the Higher Ed Workplace - UNLV NewsCenter - September 8th, 2022
- Q&A: Before St. Pete show, Alec Benjamin talks John Mayer, his fascination with Mandarin Chinese, and more - Creative Loafing Tampa - September 8th, 2022
- tHE association between LAF-AGEs and osteopenia | MDER - Dove Medical Press - September 8th, 2022
- UNCA and Asheville clinics priortize inclusive healthcare The Blue Banner - The Blue Banner - September 8th, 2022
- Salutogenesis institute launched in Puducherry - The Hindu - August 30th, 2022
- Signs You May Have COVID in Your Gut After Infection Eat This Not That - Eat This, Not That - August 30th, 2022
- With Expanded Outdoor Features, Lifestyle Healing Institute Integrates Traditional and Holistic Medicine - GlobeNewswire - August 30th, 2022
- Sure Signs Your Immune System Isn't as Strong as it Should Be Eat This Not That - Eat This, Not That - August 22nd, 2022
- Jefferson doctors publish new book, 'Tapestry of Health,' with tips on wellness - On top of Philly news - Billy Penn - August 22nd, 2022
- Qualities Clinicians Need to Have to Deliver Integrative Care - HealthLeaders Media - August 22nd, 2022
- Can You Really Drink Too Much Water? We Investigated - mindbodygreen - August 22nd, 2022
- The Breathing Trick That Could Help You Fall Asleep Almost Instantly - Newsweek - August 22nd, 2022
- The Global Nutrigenomics Market is expected to grow by $ 690.14 mn during 2022-2026, accelerating at a CAGR of 12.4% during the forecast period -... - August 22nd, 2022
- The Relationship Between the Blood-Brain-Barrier and the Central Effec | DMSO - Dove Medical Press - August 22nd, 2022
- Zinc side effects: Signs of overdose and how to treat it - Insider - August 22nd, 2022
- IICT to be involved in anti-virus mission & public, private partnerships for developing APIs - The Hindu - August 22nd, 2022
- Study of more than 150,000 people identifies - EurekAlert - August 22nd, 2022
- Detection Of Rare Genetic Mutation In A Family Could Lead To Better Diabetes Treatment - Nation World News - August 22nd, 2022
- 6 Worst Eating Habits Causing Inflammation and Aging You Faster - Eat This, Not That - August 22nd, 2022
- How to End the Mass Formation (VIDEO) - The Epoch Times - August 22nd, 2022
- New UCI-led research reveals the circadian clock influences cell growth, metabolism and tumor progression - Newswise - August 14th, 2022
- Winged Scapula - A Body Builders Woe: Causes, Signs And Treatment - Boldsky - August 14th, 2022
- Cannabis Increasingly Used for Menopause Symptom Relief. Is It Safe? - Healthline - August 14th, 2022