A new understanding of depression
The work of psychology is complex. Sometimes, we can identify physical causes for psychological symptoms. (We always look for them in case they’re there!) But sometimes, the connections between mind and body are not as obvious as we’d hope.
For decades, it has been observed that certain chemical levels can vary widely in the brain. Since we know the brain uses these chemicals to regulate itself, the hypothesis has been that dysregulation in these chemicals can lead to negative symptoms like depression, anxiety, etc. Indeed, the medications that we know beyond a doubt have the power to improve depression do so by regulating these chemical levels. And yet, it now appears that’s not the whole story.
New research published in Molecular Psychiatry challenges the long held hypothesis that chemicals like serotonin play the biggest role in causing depression. After reviewing decades of research on the matter, researchers have concluded that there is no consistent evidence that serotonin levels in the brain are a factor in causing depression or influencing its severity. They cite many interesting findings in support of their case. First, many depressed people do not show reduced serotonin levels in the brain. Second, people who are not depressed but who’ve had their serotonin levels forcibly reduced via diet changes are not any more likely to become depressed. And third, many people who are not depressed already have low serotonin levels; they just don’t know it, because they’re not depressed.
These findings suggest that environmental stressors are now the main suspect when it comes to depression, or are at least far more important than chemical factors.
Again, these findings do not suggest that the medications we have developed for depression don’t work or are not worth taking. On the contrary, they absolutely work, we just still aren’t exactly sure how they help. If such medications are helping you function, by all means, please keep taking them! What these findings do suggest is that it is important thar we pair medication with effective behavioral and psychological tools for a complete treatment.
Research shows that two of our most effective behavioral interventions for depression are Behavioral Activation, and Cognitive Behavioral Analysis System of Psychotherapy, or CBASP for short. Both of these techniques teach the client tools designed to help them regain a sense of enjoyment, mastery, and control in their relationships and daily activities, things usually lost in depression. If you’re in talk therapy for depression, feel free to ask about and advocate for these approaches.
Another highly effective non-pharmacological treatment for depression, especially chronic depression that is not responding well to medication, is something called TMS. You must visit an office weekly to receive this treatment, but it is non-invasive and not painful. It uses magnetic stimulation of the brain to regulate its functioning, and I’ve seen it provide long awaited relief to some of my most depressed clients.
As a relatively young science, psychology is constantly growing and changing as we seek to understand our inner world more completely. I hope this research will encourage us all to take better care of each other, realizing that a medication can’t always counteract the stressful forces of modern life. It’s clearer than ever that improving our living conditions and lowering our stress will have a direct impact on our mental health.