Understanding Anxiety and Depression (part 2): Antidepressants

“Despite the exponential use of antidepressant medications … We still have no clue about levels of serotonin, or any other neurotransmitter, before or after treatment, or if this correlates with improvement in symptoms. More to the point, as a society, we don’t seem to be much happier …”

This 21 minute podcast is part of a series from Dr. William Bostock (Cambridge Progressive Medicine).

You can listen to the podcast itself. Or you can read a transcript, which begins:

“In the last episode I suggested that depression and anxiety are symptoms rather than diseases, and that for the majority of us they are a symptom of the negative thoughts we are thinking, rather than a symptom of an underlying disease.

When I discuss this alternative approach patients often ask me about serotonin levels. Many people have heard about the serotonin or ‘neurotransmitter’ theory of depression. Namely that feelings of low mood, anxiety and irritability are the direct result of abnormally low levels of serotonin in the brain. It is how I learnt about depression in medical school, and subsequently how I, and many of my medical colleagues, explained these symptoms to patients. If the symptoms are the result of a chemical imbalance in the brain, then only doctors and scientists will have the tools to correct the problem. Surely you can’t just ‘think your way out’ of a chemical imbalance?

A neurotransmitter is a chemical that carries signals between brain cells, allowing the different parts of the brain to communicate with each other. Many of the medications we use to treat depression are aimed at boosting the levels of these chemical messengers in the brain. There are lots of them, adrenaline, noradrenaline dopamine and serotonin to name a few. The most common class of drugs are called Selective Serotonin Reuptake Inhibitors or SSRIs. Examples are Fluoxetine (which is Prozac), Citalopram and Sertraline. These act to boost Serotonin levels in the brain.

However, in truth we have absolutely no idea whether people who are suffering with symptoms of depression and anxiety have lower levels of Serotonin or other neurotransmitters than anyone else. We have no way to measure the levels of serotonin in people’s heads, so we simple don’t know. The only reason the theory of low neurotransmitter levels exists is because we were already using medications that increased neurotransmitter levels to treat depression. It is upside down. We developed the drug, and then invented or imagined a theory to explain its effect …”

You can read (or listen to) more from here.

Any reply would be very welcome

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