Could drug treatment for depression be a myth?

Could drug treatment for depression be a myth?

A recent study found that low levels of serotonin do not cause depression. But was the research misinterpreted?

One study that found depression not caused by low levels of serotonin, the “happy hormone,” has become one of the most talked about and shared medical articles in recent months.

This finding sparked a wave of misinformation about antidepressant medications, many of which increase the amount of serotonin in the brain. However, the research does not indicate that these medications are not effective or fail to help patients. On the other hand, it has also raised some real questions about how people are treated for mental illness.

After Britain’s Sarah suffered her first major psychiatric problem in her early twenties, doctors told her that her prescribed medication was like “insulin for diabetics”.

For them, it was essential: They said the drug would correct a chemical problem in their brain and would need to be used for life.

Her mother had type 1 diabetes, so she took it very seriously. Sarah continued to use the drugs, even though it made her feel worse. Eventually, she “heard threatening voices” urging her to kill herself. She also underwent electroconvulsive therapy (ECT).

However, the claim that Sarah needed medication as much as diabetics needed insulin was not based on any scientific evidence.

“I felt betrayed by the people I trusted,” she says.

His negative reaction to the drugs has been extreme, but the argument for a “chemical imbalance” as a cause of depression is not uncommon.

Many psychiatrists said they have long known that low serotonin levels are not the main cause of depression. Therefore, the last article will not bring anything new.

However, the large implications of the research suggest that it was new to many people.

The problem is that using the article to say antidepressants don’t work is an inaccurate leap.

In confusion, doctors fear people will stop taking their medication suddenly and risk dangerous withdrawal effects.

The British National Institute for Health and Care Excellence (NICE) says that the use of these medicines should not be stopped suddenly, except in a medical emergency. She says reducing the dose slowly can reduce withdrawal symptoms.

What did the search show?

This latest research looked at 17 studies and found that depressed patients do not have different levels of serotonin in their brains compared to people who are not depressed.

This finding helps rule out the way the drugs might work, and correct the deficiency.

London psychiatrist Michael Bloomfield compares:

He notes, “Many of us know that taking acetaminophen can be helpful for headaches, but I don’t think anyone thinks headaches are caused by not enough acetaminophen in the brain.”

So, do antidepressants work?

Research shows that antidepressants work slightly better than placebos. There are debates among researchers about how important this difference is.

Within this average is a group of people who experience significantly better outcomes with antidepressants. The problem is that doctors simply have no way of knowing if their patient is one of those people.

Some people who take antidepressants say that the medication helps a lot with a mental health crisis or allows them to better manage depression symptoms in everyday life.

Prof Linda Jask, of the Royal College of Psychiatrists (a professional body of psychiatrists in the UK), says antidepressants are “something that helps a lot of people feel better quickly”, especially in times of crisis.

However, one of the authors of the article on serotonin, Professor Joanna Moncrieff, points out that most of the research by pharmaceutical companies is short-lived. Therefore, according to her, little is known about the performance of patients after the first months of using the drug.

“You have to analyze the results of the treatment and not make the patient use the drug for longer than they need to, which is not often the case,” Jask says.

While there are risks to not treating depression, some people will experience serious side effects from antidepressants — the serotonin study authors say these harms need to be communicated more clearly by industry.

Effects can include suicidal thoughts and attempts, impotence, emotional numbness and restlessness, according to Nice.

A few months ago, UK doctors were asked to prescribe therapy, exercise and meditation for patients with less severe depression.

What was said about the search?

Feedback on the study about the relationship between serotonin and depression said the research proved that prescribing antidepressants was “based on a myth.”

But this is not true.

The problem with this argument is that the study did not look at the use of antidepressants.

Serotonin plays a role in mood, so modulating it can make people feel happy, at least in the short term, even if they don’t have abnormally low levels of the hormone. It can also help the brain make new connections.

Others have claimed that research shows depression was never a disease in people’s brains, but a reaction to the environment.

“Of course they are both,” says Mark Horowitz, one of the research authors. “Your genetic factors influence your sensitivity and stress, for example.”

But some people may be better treated with “relationship counseling, financial advice, or a job change” than with therapy.

However, Zoe, who lives in southeastern Australia and suffers from both severe depression and psychosis, says that redefining depression as “distress that will go away if we just fix all the social problems” is also oversimplifying.

For her, this concept neglects people with more serious problems than mental illness.

Psychosis runs in her family, but her episodes are often the result of stressful events.

Zoe says she has found medications, including antidepressants, that have changed her life.

For her, “it’s worth facing the side effects of the medications,” because they prevent dangerous seizures.

And that’s a consensus among the experts who spoke to BBC News: Patients need more information so they can make the decision that works for them.

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