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Is Serotonin Your Brain’s “Happy Chemical”?

Is Serotonin Your Brain’s “Happy Chemical”?

If Serotonin is the “happy chemical” in your brain, then boosting serotonin levels should keep depression at bay. But this is not the reality.

Serotonin is a hormone that marks the end product of digestion. When you finish your meal, this is the hormone in your brain that says “ahh, I feel nice and comfortable now”.  If your serotonin levels are low because you have not eaten for a while, you are edgy and irritable, not depressed. Once you eat something, that uncomfortable feeling goes away because serotonin levels are back up.

The idea that depression was caused by low serotonin levels is based on flimsy evidence dating to the 1950’s.  Pharmaceutical companies discovered drugs like Prozac, Zoloft and Paxil that could affect serotonin levels in the brain and then promoted the low serotonin level theory to market these drugs for depression.

This fallacy has been ingrained into us as much as the belief that lowering cholesterol reduces heart attacks and strokes. Most people believe that increasing our serotonin levels will lift us out of depression and they use wildly popular drugs known as serotonin-selective re-uptake inhibitors, better known as SSRI’s. Current research and most psychiatrists now say that it is very unlikely these drugs treat depression by increasing serotonin levels. They may have another mechanism of action that we don’t know or it is simply a placebo effect.

The consensus is that depression is a complex disorder with hundreds of potential underlying causes, said Dr.Roger McIntyre, head of the mood disorders psychopharmacology unit at the University Health Network in Toronto. “There is really no scientific case to say that people who have depression have a deficiency in body and brain serotonin levels.”

The medical journal BMJ (British Medical Journal) put the spotlight on the low serotonin level in a recent editorial published in March and written by Dr. David Healy, a professor of psychiatry at Bangor University in Wales.

Blockbuster sales of antidepressants such as Prozac, Celexa, Abilify, Effexor and Pristiq are based on the marketing of the serotonin myth, Healy wrote. He added that pharmaceutical companies misled the public into putting too much faith in SSRI’s. So far scientists have not been able to prove whether SSRI’s raise or lower serotonin levels and according to Dr. Healy, they still don’t know.

Most psychiatrists today agree that depression is not a matter of serotonin levels being up or down. However, because of the good feeling that presents itself after a meal, some people continuously eat food to achieve that mellow feeling and become obese. This is more of an addiction to food and using food as a drug. In many cases people who are depressed don’t want to do anything at all, even eat.

Modern antidepressants block the re-absorption of serotonin in the brain. When researchers found that SSRI’s helped depression in some patients, they concluded that low serotonin levels must be the cause of depression.  This assumption is no more scientifically valid than having a headache means your ibuprofen levels are too low.

So without any scientific proof, pharmaceutical companies continue to market their antidepressants as a treatment for low serotonin. If you go to the website for the antidepressant drug Celexa, under the FAQ section you will see the answer, “Celexa helps to restore the brain’s chemical balance by increasing the supply of chemical messenger in the brain called serotonin.” This was such a good sell because the idea of correcting a chemical imbalance reduced the stigma of mental illness.

When these drugs were first introduced they had such promise that they were featured in a New York magazine cover story entitled Bye-Bye Blues: A New Wonder Drug for Depression.

But all this hype did not prepare the patients for the horrific list of side-effects ranging from nausea, insomnia, and sexual dysfunction to suicidal thoughts, or even the strong chance that their SSRI’s might not relieve their suffering.

What always bothered me about anti-depressants was the fact that if you suffered the principal side-effects of insomnia and or sexual dysfunction, how was the drug going to help your depression? I felt it could only make it worse.

In a recent study by the U.S.National Institute of Mental Health just completed in 2015, two out of three patients with depression, either did not respond at all to SSRI’s or received very partial relief. The study was called STAR D and was the largest most comprehensive study done to date on SSRI’s.

Many patients use interferon, a drug prescribed to stimulate your immune system in patients with skin cancer and Hepatitis C. The main side-effect of this drug is depression and studies have shown that preventative treatment with SSRI’s greatly reduces the risk of depression in these patients. It is possible that serotonin drugs may have indirect effects on the immune-inflammatory system but that will have to be determined by more research.

Depression is an illness of the brain, the most complicated organ in the human body. However, it is a very complex illness and a simple pill that treats blood pressure, blood sugar or takes away a headache may never be able to cure this condition.

For now we have natural treatments such as 5-HTP ( hydroxytrytophan), GABA, Relora and of course the old stand-by, St. John’s Wort. Taking natural supplements along with cognitive behaviour treatment and a daily regimen of exercise is the best treatment we have going for us so far until something new comes along.


Antidepressant Marketing

Right now, the top selling drug in the United States is Abilify, a powerful antipsychotic. Sales took off in 2007 when the drug was approved as an add-on for depression for patients who do not get adequate relief from anti-depressants alone. It was approved in Canada in 2013 and By March 2015, annual sales topped $7 billion.

U.S. advertisements for Abilify say that the drug works “like a thermostat to restore balance.” But if you actually read the drug’s product insert which requires a very powerful magnifying glass, it acknowledges that the mechanism of action is “unknown.” Researchers have no idea how Abilify works.

In fact, psychiatrists are just beginning to understand what causes depression, and why some medications work for some patients, and not others.

Some researchers hypothesize that depression is due to a dysfunctional glutamate system. Disruptions in this fast-acting signalling system may alter the brain’s ability to change and adapt in response to stress and other events. This is called neuroplasticity and a reduction may lead to depression.

A second theory, known as the metabolic hypothesis, suggests that insulin, like glutamate, facilitates brain plasticity. Depression may occur when brain regions do not make enough insulin or cannot respond to insulin properly. This means becoming depressed when going for long periods without food or having a blood sugar problem that limits your insulin and causes depression.

Other researchers are testing the immune-inflammatory hypothesis-the idea that depression is caused by inflammation due to an over-worked immune system.

Another theory is the bio-energetic hypothesis which suggests that tiny powerhouses within brain cells may not be producing or disposing of energy and energy by-products properly. This may lead to destruction of brain cells, and consequently depression. It comes from the fact that excessive alcohol acts as a depressant and destroys brain cells.

Someday we will find the answer but so far we know for sure serotonin levels have nothing to do with the mental illness of depression.