The Theory of Chemical Cause of Depression. Is it Valid?

[Try_Repeat]

I often encounter an opinion of other people, that clinical depression is caused by some chemical reasons, for example, low serotonin levels. These people treat depression like diabetes, but not as a personal problem, thinking there is now way to improve their chemical balance except taking antidepressants.

If it is true, what are the reasons for low serotonin levels? Why so many people suffer depression?

Is this chemical explanation of the nature of depression valid and overall accepted?

I think this theory can be dangerous for people with depression, because it prevents them from seeing the causes of depression in their life, in their way of thinking. It prevents them from being cured, it says: "you have no other choice except being a lifelong customer of pharmaceutical companies."

In my opinion a treatment of depression ONLY with antidepressants is a manifestation of doctor's helplessness in front of depression and his inability to provide a real help for his patients.

What do you think?

[acetone]

It is likely that all emotions are chemical in nature. Otherwise how would we explain chemicals(antidepressants) making people happy. Chemicals only have power to react with other chemicals(the chemical makeup of body). Low serotonin levels can be one of the causes of depression. But it definitely is not the only cause. ADs can boost serotonin levels immediately but their therapeutic effects are not immediate but delayed. This debunks that only low serotonin levels can cause depression. The way I see this is that if drug helps you then take the drug, if not try other things which you think help. There is no hard and fast rule. The job of doctors is to treat patients with meds. If you go to a doc with complains of low mood he will likely prescribe you ADs. This is what he/she was taught at the medical colleges.

[Fourteen14]

I often encounter an opinion of other people, that clinical depression is caused by some chemical reasons, for example, low serotonin levels. These people treat depression like diabetes, but not as a personal problem, thinking there is now way to improve their chemical balance except taking antidepressants. If it is true, what are the reasons for low serotonin levels? Why so many people suffer depression? Is this chemical explanation of the nature of depression valid and overall accepted? I think this theory can be dangerous for people with depression, because it prevents them from seeing the causes of depression in their life, in their way of thinking. It prevents them from being cured, it says: "you have no other choice except being a lifelong customer of pharmaceutical companies." In my opinion a treatment of depression ONLY with antidepressants is a manifestation of doctor's helplessness in front of depression and his inability to provide a real help for his patients. What do you think?

I think if you were to speak to the vast majority of clinicians, most would say that no two patients are the same, often the cause is long term stress/trauma (which is thought to affect bio chemistry, such as serotonin) but we also have to face the fact that even if the root cause of the problem is found, it is still an uphill battle treating the physical effects of mental illness.

There is also substantial research to suggest that a significant amount of patients suffering with recurring depression have a physical reduction in the size of the hippocampus (responsible for long term memory) manifesting in physical change to the structures within the brain.

Some people respond to therapy or medication (the majority a mixture of both). The primary concern initially with depression is timing (the therapeutic effects of SSRI work much faster than therapy) and often in major depression the potential for suicide requires swift intervention. Also some patients are not open to psychological therapy until their mood has stabilised.

In addition those suffering with bipolar (formerly known as manic depression) experience extreme mood swings, which, in the vast amount of cases do require medication for chemical stability.

Other effects of depression/anxiety disorders can also involve psychosis, again often requiring pharmaceutical intervention in the short term.

And there are those who simply do not respond to psychological therapy whatsoever, and have little option but to control their condition through medication.

I agree that there will potentially be many people who would benefit equally from therapy rather than medication alone, but this (in my opinion) is down to both access and available resources available to your healthcare service/provider, and the willingness of the patient.

In regards to a doctor feeling helpless to provide real help for the patient, until a swift "one cure suits all" is found, I would anticipate this reflects the feelings of the vast majority of psych practitioners.

The key is finding what treatment is best and for whom.

[jessed03]

I can imagine it's quite unsettling for most general practitioners to try and treat anxiety and depression, as so many are having to now, given the cut backs and long waiting lists just to see other professionals more experienced in the matter.

How many other conditions do they prescribe powerful, long term medication for, without any hands on testing whatsoever?

That's what makes anxiety and depression so hard to treat. Nobody can tell you if your condition is genetic or learned. Nobody can tell you how your levels of dopamine, serotonin, noradrenaline etc, stack up compared to the norm. Nobody can tell you the state of your neuro transmitters, and only recently have brain scans begun to detect how your condition has altered certain areas of your brain. And even a lot of those changes can't be fully realized unless you cut a persons head open.

How ironic really, that treatment for anxiety - a disorder of uncertainty - is one of the most uncertain treatment plans in the medical book.

Maybe God is a comedian playing to an audience too afraid to laugh, as they say!

If you take a look at the meds section of this forum alone, and read the posts of many, many people; 90% of whom have a lot of doubts over their treatment.

Again, how many non-fatal, non-harmful illnesses in the medical book have that ratio of patient anxiety levels when it comes to treatment. There aren't too many.

I wonder sometimes what people's confidence would be like in treatment, if they could see their blood work on a sheet of paper that indicated a deficiency in Serotonin. Or if they could see on a brain scan, that their amygdala had enlarged (or something tangible like that), because of thinking habits, and therapy would rectify that.

I think the levels of patient confidence would inevitably soar. It's a shame we dont have anything like that yet, and the sooner some kind of tangible testing becomes available, the sooner a lot of unnecessary stress will go on the decrease.

The monetary aspect of anxiety is just huge. Collosal. The cost of doctors visits, testing, medications, specialist appointments, therapy sessions, sick leave from work etc.. The list goes on. It just isn't feasible right now to offer more than what doctors offer. I've spent years talking to people, who have gone on journeys to get better, and what that sometimes involves is monumental. It's not possible for an over worked doctor to be a full time part of that. They can only sit on the side and offer bits and pieces here and there.

If you're lucky and you can get subsidised therapy, then your therapist will offer you a little more on top of that, and that can be good enough for a lot of people, but there are still so many who need more on top of that. And sadly the system just isn't really equipped to give the masses that bit extra that they need.

It's not financially feasible to send anxious people to life coaches to figure out their purpose in life. It's not feasible to send them to dietitians to correct their (usually) many unhealthy lifestyle habits. It's not feasible to send everybody to relationship councillers, meditation coaches, financial experts. And that's just to name a few things.

Even if a doctor has the best intentions in the world, and the training to match; so many are still very limited in what they can do for a patient. So they play odds. The NHS states that somewhere near 70% of people respond favourably to therapy and medication combined. So that's what any good doctor offers. Assuming the countries fiscal policy allows those things to be given.

The best thing a patient can do right now, in my honest opinion (and it is just in my opinion), is to throw a lot of mud at the wall and see what sticks.

You can't know what causes your anxiety. If there's a root, you must find that, but just from an average physiological perspective - most aren't going to find out.

So you try all angles, and see what you respond to. You try different meds if need be, in the hope that something will hit the spot and work on possibly faulty neuros. You experiment with diet, to check if digestive health is an issue, which is a big problem for people these days, and an even bigger one considering the gut is known as the second brain. You of course do your therapy, to check if your thinking habits are affecting your chemistry. You engage in nervous system friendly activities, to see if your condition is being prolonged by confused nerve impulses.

And most of the time, if you're aware of your body, you'll begin to uncover a picture of what went wrong, and how to change that. Not all the time, but often you can. It becomes a little like the ending of a movie, when you spot all of these clues, and add them up to solve the mystery.

Though, sadly, people still do fall through the net even after doing all of those things. Although usually those people can at least see improvements. That's better than nothing.

Still all of us wait until more information becomes available, and we can treat mental illness in a person, similar to how we treat a physical one.

[Try_Repeat]

forwells, jessed03, Fourteen14 good points! Thanks!

[Try_Repeat]

Now I understand that I didn't formulate my first statement well. Of course depression is reflection of chemical processes in our brain (including processes with serotonin involved). Our thoughts are chemical.

But I wanted to say, that this imbalance can be a cause, not reason. For example such feeling as fear born in your brain. But it is not effective to treat this problems only by addressing that parts of the brain (wit pills for example) which produce fear chemicals. Maybe an individual has a source of fear in his life? Maybe he needs to fix his nervous system? Maybe he needs to work with his past? Whatever.

There is a certain risk, that by providing antidepressant treatment, we eliminate the cause of depression, but not the reason.

I think that the belief that depression is caused primarily by chemical imbalance, which can be fixed by antidepressants is comfortable for doctors, pharmaceutical companies and even patients. Doctors don't have to work with patients, they just prescribe them some meds. Easy work. Companies which produce pills have their money. And patients have a quick solution and they can get rid of responsibility for their condition.

It is more comfortable to think like: "I am not responsible for my depression. It is based only on factors I can't control (serotonin levels). I am poor and sick."

Because of this three factors this belief is so popular. It is comfortable for everybody!

PS. My own experience made me believe the opposite, that depression is more close to personal problem, than to some "disease". I had strong panic attacks and mild depression. First I reacted to these things as to some curse: "why the hell do I have all these!". But during some meditations I realized, that the causes of these problems are in my personal traits. Depression is not always a curse. It shows to a person that there are some mistakes, "bugs" in his personality, in his way of think, in his attitude towards people, in his habits, in his way of life. I had a plenty of bugs! By fixing them, I was able to get rid of my problems with fear.

By prescribing only medical treatment we eliminate a chance that individual will find these "bugs" and change his life for better living.

[Fourteen14]

Hi Try_repeat

I'm still not sure I get the point you are trying to make.

Is it that you feel depression shouldn't be medicated or that it should be done as combo of meds and therapy (this is the majority of treatment in the UK) or just pure therapy? .

The biggest problem as I see it (as I mentioned in my last post) is it's so personal to the individual, and diagnosis is done through well educated guess work.

So what would your solution be? And, how would it be done on a vast scale at an affordable cost to the state and patient ?

[Try_Repeat]

Hi Try_repeat
It should be done as combo of meds and therapy (this is the majority of treatment in the UK).


Yeah maybe, for the severe depression cases. But only as supplementary use. To soften the symptoms to provide some motivation for therapy. Or if nothing else works.


or just pure therapy?

In all other cases yes. I am not a doctor. It is only my opinion. But this advise I would give to anybody who will ask for my personal opinion.

The problem with depressed people that sometimes they overestimate the feeling of sadness, dissatisfaction. I don't deny that they feel real bad. And I felt really bad too. But there is much taken from their reaction towards sadness or fear. And when they take antidepressants they don't feel "mental pain" and think: "oh nice, this is how I want to feel every time!" But when the effect of pills decrease they think: "oh I am said again! It is so bad! I should fix the chemistry of my brain to feel joy again! I will take another pills". And even when they under the effect of new antidepressants, there can be fear that their bad condition will return. Because it doesn't depend on them. From their belief it depends on some chemical balance in the brain.

But I think, that people have to work with their reaction towards "mental pain". If they take pills, how can they work with it? They should feel it and accept it, though it sounds hard.

I made some progress in fighting depression and panic attacks only when my indifference towards sadness and fear began to grow (thanks to meditation). I became less emotional attached to fear or pain. They appeared, but it wasn't so painful for me, because I perceived these feelings another way. I thought: "these are just transient feelings, why should I react to them!" I managed to let them go. And it helped me so much!

This is very easy explanation of my experience. In reality, it was more complex thing, that happened to me because of meditation. I manage to fix some inner "bugs" which caused depression in my case (nervousness, anger, shyness, suppressed thoughts, bad habits, way of thinking, attention problems, laziness, lack of discipline and so on). And I got rid of panic attacks and depression.

So if to ask my opinion, If I was a doctor, I would tell patients, that coping with depression is not an easy task. One have to perform a lot of work to get rid of it. There are no fast and easy solutions for this problem. My solution is therapy (maybe cognitive therapy), meditation (as benign antidepressant, as a kind of self therapy, as a kind of self reprogramming, as a kind of controlling your attention, as a king of calming nervous system, as a kind of self analyses method and a way to know yourself better(before starting meditating I didn't realize that all my shortcomings were the reasons for depression, I thought about chemical imbalance only)), healthy lifestyle, sports, yoga, relaxation techniques, more rest, more quite work, more smiling, less thinking about you condition.

That is how I see it. Who can say, that he performed all these and he didn't feel better? Most people didn't even try, thinking that imbalance is only the case! Or they tried, didn't get instant results and threw it!

It is good than in UK majority of treatment is done as a complex of medication and therapy. But in Russia some doctors tell: "this if for the rest of your life. You cannot cure it. The only choice for you is to take pills till your death" And many people really believe it! (Not only in Russia) But if the doctor mistakes? Why not to try something else?

[Fourteen14]

I can only go by the UK health service (this is the only one I have ever worked with).

My only real concern with any kind of debate of this nature, is that often it's an unbalanced perspective highly influenced by personal experience and self analysis (on both sides of the argument).

As I mentioned in my original post, everyone is different, and I totally agree that psychological therapy is extremely effective, but the need for pharmaceutical intervention in a large amount of cases is essential (even if it's simply to get the patient to a point of accepting cognitive therapy).

Which ever way you look at it, depression is a result of chemical imbalance (whether temporary or not) but whatever has led to the point of that imbalance, whether biological or environmental (often a combination) the treatment needs to be tailored to the individual assessment of the patient.

It's great if you feel you were able "fix" the areas of your life you felt were contributing to the ill feelings, however care must taken that this is not generalised as possible for everyone.

Otherwise (certainly from the UK perspective) it would save an unnecessary tax payer expense of 8 million prescriptions for AD's every year.

[Try_Repeat]

but the need for pharmaceutical intervention in a large amount of cases is essential (even if it's simply to get the patient to a point of accepting cognitive therapy).


I can't disagree ))


Which ever way you look at it, depression is a result of chemical imbalance (whether temporary or not)

Now I agree with that too! My first statement was incorrect.


It's great if you feel you were able "fix" the areas of your life you felt were contributing to the ill feelings, however care must taken that this is not generalised as possible for everyone.


I agree that my experience of getting out of depression without medicine shouldn't be generalized. Someone needs meds, I suppose...

But I think, one fact can be generalized. Anyone with depression, in order to deal with it should fight with his own personal shortcomings, improve his health, develop mental skills, improve his reaction towards stress, learn to calm down, learn to detach from negative feelings, learn to shift the focus of his attention to something else beside himself and his suffering, learn to find new sources of joy, learn to deal with problems and so on before he gives all his hope to pills.

[Try_Repeat]

forwells

First of all, taking responsibility for you depression, doesn't mean to blame yourself. It means getting the idea that you are able to influence your mood and your reaction somehow. This is the sense of freedom, not guilt.

It is hard to explain, but the idea of such techniques like meditation is not to control some abnormal state, but opposite, you come to find that everything you feel is normal, it is okay, there is nothing really bad in it. You accept it. "What happens, happens." By this you are able to control your mood and get rid of some symptoms. It's a paradox, "control by not controlling", maybe it is hard to understand before you try it.

This is how you feel, and I am not saying that you shall feel guilt and think of yourself like some freak. But you can definitely do something. If you try but can't - it's ok. No one going to blame you.

And as for example with woman. I didn't say that no one need meds. I repeat, someone needs them to act, to live his life, but besides, he should think about something else.

Not all therapies are good. Sometimes doctors try to reveal your past. It doesn't work in every case. And if one kind of therapy didn't work for you, it doesn't mean that your only solution is pills. They cannot be a total solution. They give only temporary fix on situation. Antidepressants, like painkillers, don't provide cure. (I didn't see scientific studies showing that antidepressants can give permanent effect. If you have some links, I will glad to see this info.)

Try something else. Try meditating. These technique will let you to look on yourself in another way, to detach from your feelings and see them clearly. It is impossible to find the solution of your problem, while you stay inside your familiar way of think, in your familiar perception of situation, in your familiar conditions. You have to change the point from where you look at yourself, to see things clearly.

Maybe this statement seems rough, but I think, that almost every man, who don't meditate have a little or big problem. He identifies himself with his feelings and doesn't have a clear understanding about the nature of these feelings. And of course doctor will not tell you about this problem, unless he meditates. Because he himself has the same problem, and he doesn't know that he has it!

Well it's just my opinion. Didn't want to hurt anyone. But I think this is true.