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September 2022

Serotonin Theory of Depression – a review of the evidence

By UncategorizedNo Comments

Authors: Joanna MoncrieffRuth E. CooperTom StockmannSimone AmendolaMichael P. Hengartner & Mark A. Horowitz

Publication: Molecular Psychiatry (2022)Cite this article Date: 20 July 2022

This article is clear summary of the scientific facts regarding the serotonin theory of depression, and how this theory no longer holds up to current evidence.

It is science rich, lots of statistics, medical terms and microbiology. The message does not change however.

The summary of their findings: “The main areas of serotonin research provide 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. Some evidence was consistent with the possibility that long-term antidepressant use reduces serotonin concentration.”

This review also suggests that the “huge research effort based on the serotonin hypothesis has not produced convincing evidence of a biochemical basis to depression. This is consistent with research on many other biological markers. We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.”

The idea that depression is the result of abnormalities in brain chemicals, particularly serotonin (5-hydroxytryptamine or 5-HT), has been influential for decades. What is more concerning is 80% or more of the general public now believe it is an established fact that depression is caused by a ‘chemical imbalance’.

Many general practitioners also subscribe to this view and popular websites commonly cite the theory . This means for Hypnotherapists treating depression, that we have:

  1. A responsibility to our clients to share this research and discuss it if need be
  2. A responsibility to share this research with our referring GP and doctors, who are really too busy to necessarily have been able to see and consider the latest research coming out of the studies.

Of course it also means we need to become very good at our craft of treating depression with hypnotherapy and strategic psychotherapy so we can create an every greater pool of clients who have had a successful outcome from depression without medication.

What do you think this might mean for us as hypnotherapists treating depression?

Depression is not caused by a chemical imbalance

By Depression, Research studiesNo Comments
 Professor Joanna Moncrieff and Dr Mark Horowitz (both UCL Psychiatry)

Writing in The Conversation, Professor Joanna Moncrieff and Dr Mark Horowitz (both UCL Psychiatry) report on their new research showing no clear evidence that serotonin levels or serotonin activity are responsible for depression.

This article is a clear and concise summary of the “old” thinking regarding serotonin, compared to the current research findings. A very good read.

“Although first proposed in the 1960s, the serotonin theory of depression started to be widely promoted by the pharmaceutical industry in the 1990s in association with its efforts to market a new range of antidepressants, known as selective serotonin-reuptake inhibitors or SSRIs. The idea was also endorsed by official institutions such as the American Psychiatric Association, which still tells the public that “differences in certain chemicals in the brain may contribute to symptoms of depression”.

“People accepted what they were told. And many started taking antidepressants because they believed they had something wrong with their brain that required an antidepressant to put right. In the period of this marketing push, antidepressant use climbed dramatically, and they are now prescribed to one in six of the adult population in England, for example.”

They refer to studies of depression allegedly due to chemical imbalances, transporter genes, gene variations ( study involved tens of thousands of subjects), placebos.

Their final paragraph says ” It is important that people know that the idea that depression results from a “chemical imbalance” is hypothetical. And we do not understand what temporarily elevating serotonin or other biochemical changes produced by antidepressants do to the brain. We conclude that it is impossible to say that taking SSRI antidepressants is worthwhile, or even completely safe. People need all this information to make informed decisions about whether or not to take antidepressants.”

This article originally appeared in The Conversation on 20 July 2022. To read the full article – click here

Depression and Older Adults

By DepressionNo Comments
Depression in our Older Adults presents differently to young adults

I recently read this article on the experience our older adults have with depression. It is a well written article detailing the differences older adults experience with depression.

The publishes, National Institute of Aging, shares “Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings. “

Research is showing intervention early on after the onset of some of these symptoms prevents serious deterioration later on, even suicidal thoughts. This could be as simple as regularly asking how they are, and truly listening to their answer.

A challenge with the article is their reference to using different treatment for depression in older adults always has a medical base ie anti depressants. Current research – ie 2022 publications, is clearly showing anti-depressants on their own are not effective in treating depression in younger adults vs older adults. The author has not included these findings in their article. Hypnotherapy is well evidenced in its efficacy in treating depression.

To read the full article – click here

Low Serotonin Levels and Depression: Debunking the Myth

By Depression, EmotionsNo Comments

Myth of Course. Been  Scientifically Debunked  in Aug 2022.

Author of this copy: Dr Michael Yapko

Researchers for the original article: Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, and Horowitz, MA.

For more than three decades, the depression story has been all about “too low levels of the neurotransmitter serotonin.” The newer antidepressants in the SSRI category (such as Prozac, Paxil, Celexa, and Lexapro) were said to raise serotonin levels and thereby reduce the severity and duration of depressive symptoms.

From the time Prozac as the first SSRI was released, the pharmaceutical industry has continued to push the serotonin story as its advertising mantra. With virtually no evidence at all, the drug companies made it seem as if there was good science behind their antidepressants.

Through relentless advertising as well as cleverly misleading articles placed in leading medical journals, the serotonin mantra became widely accepted by professionals as well as the general public. The belief was widely held that these drugs were safe and effective.

Anticipating astonishingly huge profits in the billions, the drug industry’s advertising strategy in the U.S. shifted away from physicians only to a direct-to-consumer approach: “Ask your doctor if Prozac is right for you!” The “shortage of serotonin” was an almost irresistible rationale for getting medicated and the promise that “you’ll be made better than well” struck a nerve in anyone and everyone who hoped that would be true.

Antidepressants continue to be the number one form of treatment for depression in the US, Australia, Iceland, Portugal, and many other countries around the world. Surveys indicate that 85-90% of the public believe that depression is the consequence of too low a level of serotonin or a “chemical imbalance” in the brain. The advertising of the myth has been exceptionally successful.

Now a major new study, “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence” published just a few days ago (July 20th) in the journal Molecular Psychiatry has dealt a serious blow to the serotonin myth. Through a most comprehensive review of the evidence regarding serotonin receptors and the presumed serotonin transporter molecules, the research team led by University College London psychiatry professor Joanna Moncrieff (author of The Myth of the Chemical Cure ) firmly concluded “there is no evidence of a connection between reduced serotonin levels or activity and depression.”

As most students of Dr Michael Yapko may know, he has been highly critical of promoting  drug solutions for depression for many reasons. His primary and one major one: Depression is more a social than medical problem (see his  books Depression is Contagious and Keys to Unlocking Depression ). Ignoring the many social and psychological factors that contribute to depression relegates antidepressants to the category of a one-dimensional under-treatment of a multi-dimensional disorder.

Michael Yapko has spent his whole professional life researching, treating, and writing about depression, a most serious and debilitating disorder. If antidepressants were completely safe and highly effective, he says he would gladly say “take them!” But…they’re not. And now, finally, the advertising myth that has given rise to a non-critical widespread acceptance of questionable drugs has been challenged and possibly seriously damaged. Let’s see what the fallout will be.

Source: Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, and Horowitz, MA. (7.20.2022). “The Serotonin Theory of Depression: A Systematic Umbrella Review of the Evidence.” Molecular Psychiatry. DOI 10.1038/s41380-022-01661-0.

Read the original article here
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