Add & Subtract - Depression

Oct 14, 2023


A team at University College London has reviewed all published research on depression and serotonin from the last few decades, and found no convincing evidence that low or abnormal serotonin levels cause depression. While antidepressants can have serious side-effects, they have minimal therapeutic effect on depression.

In contrast, many studies have proven the effectiveness of other treatment options, such as psychotherapy, exercise, mindfulness and other self-care practices. Regular physical exercise comes out consistently as the most beneficial medicine of all.

As for the persistence of the prevailing myth that depression is merely a chemical imbalance, fixed with SSRIs? Consider the fact that antidepressants rank third in pharmaceutical sales worldwide, a market projected to reach over $18 billion US annually by 2027.


Professor of Psychiatry and lead author of the UCL study, Joanna Moncrieff:

“Our view is that patients should not to be told that depression is caused by low serotonin or by a chemical imbalance, and they should not be led to believe that antidepressants work by targeting these unproven abnormalities. We do not understand what antidepressants are doing to the brain exactly, and giving people this sort of misinformation prevents them from making an informed decision about whether to take antidepressants or not”

Peer review published in Molecular Psychiatry: The serotonin theory of depression: a systematic umbrella review of evidence


Many studies have found that external life events, such as poverty, stress and loneliness, increase the likelihood of depressive symptoms. It makes sense that we might suffer lower moods when dealing with difficult circumstances. Lower frequency feelings are part of the experience we are going through, focusing our attention on what isn’t working and prompting us towards change.

Rather than taking a magic pill that targets one chemical in the brain, we need to help ourselves and others to resolve stressful situations holistically. For example, in Finland they deal with homelessness by firstly putting people into their own accomodation, and then address other mental health and substance issues.

I look forward to a world where we ensure all people have access to basic human needs, including peace and stability, social contact and meaningful work.

Study co-author Dr. Mark Horowitz:

“One interesting aspect in the studies we examined was how strong an effect life events played in depression, suggesting low mood is a response to people’s lives, and cannot be boiled down to a simple chemical equation. We believe the situation has been driven partly by the false belief that depression is due to a chemical imbalance”

Acknowledgements to journalist Paul Bennett for bringing this material to my attention.

Such an important topic today. If you have any feedback, comments or questions, feel free to get in touch.

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