A common misconception that I hear all the time is that being diagnosed with “clinical depression” means that your brain isn’t producing the right neurotransmitters. We’ve all seen the shirts, mugs, and cutesy posters with the slogan:

If you can’t make your own neurotransmitters store bought is fine!

But here’s a hot take: your diagnosis of depression says basically nothing about what’s going on in your brain.

Just because a mental health professional or a doctor diagnosed you with depression, doesn’t mean that your brain doesn’t make enough neurotransmitters. This is a story that has been sold to us by the medical model of mental health.

The story goes that depression happens because your brain is broken and antidepressants are the solution. And this story is POPULAR. So popular, in fact, that it’s become almost general knowledge and “The general public widely believes that depression has been convincingly demonstrated to be the result of serotonin or other chemical abnormalities.”

But a new peer-reviewed systematic review published in Molecular Psychiatry in July 2022 concludes,

the huge research effort based on the serotonin hypothesis has not produced convincing evidence of a biochemical basis to depression. This is consistent with research on many other biological markers . We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated.

Translation? The updated science suggests that the belief that depression is about a neurochemical imbalance is outdated and not backed up by evidence.

 

So what does cause depression?

Depression is characterized by feelings of sadness, hopelessness, exhaustion, lethargy, difficulty concentrating, and unexplained physical symptoms (among others). It’s a diverse collection of symptoms that has a diverse array of causes.

The causes of depressive symptoms can include any of the following:

• Trauma

• Grief and loss

• Lack of access to needed resources

• Being overworked and burned out

• Vitamin D deficiency

• Loneliness and disconnection

• Existential dread

• Feeling hopeless within late stage capitalism

The takeaway? The cause of your depression is likely unique and not easily explained away by faulty neurochemistry.

All of this doesn’t mean that there’s no place for medication in mental health treatment, but that we need to have is a more nuanced and holistic conversations about what mental health symptoms mean.

Antidepressants and other psychotropic medications are helpful for many folks in their recovery. They save lives and help people come out of the darkness and back into life.

But too often psychotropic medications are miscategorized as a “cure” for mental health conditions, leading folks to believe that the only thing they need to do is take their meds and stay the course, and their depression will be well-managed.

I talk to my clients about using medication to support their recovery by helping them to feel more calm, grounded, motivated, or present. We discuss what medication can, and cannot, offer and how it can be integrated into a holistic approach to their recovery. We talk about how to know if your meds are working, how to know if they’re not, and how to advocate with your psychiatrist or doctor for the help you deserve.

You deserve a therapist or provider who will conduct a thorough assessment and help you identify the root cause of your symptoms, rather than slapping on a label and jumping straight to medication. You deserve a care team that sees you as a full person with a full range of experiences and a life story that contributes to who you are today.

I challenge you to replace the phrase “I have clinical depression” with “I am experiencing despair, hopelessness, lethargy, exhaustion,” or whatever else fits for you. Let’s be clear with our language and clear with our approach to recovery.

What do you think about this? I’d love to know how this lands or what questions come up for you in the comments!

With love to you all,

 

Summer