NE LifeCoach asks Depression – have we got it wrong?

My own experience of depression involves the usual discussions that depression is caused by low levels of serotonin; that antidepressants such as Prozac or Sertraline (the selective serotonin re-uptake inhibitors or SSRIs) work because they correct this chemical imbalance.

Yet, this concept of depression being a problem with serotonin is now increasingly being called into question.  Given that 1 in 4 of us will experience this incredibly debilitating and isolating disease at some point in our lives, we really need to get more clarity and agreement on its cause and how to treat it.

Medication risk

In 2016 Danish researchers reported that if healthy people took antidepressants it could elevate the risk of suicide.  Well why would a healthy person take Prozac? Misdiagnoses for one.  Add to this the growing number of doctors who are subscribing to a radical new theory of depression, one which I have resisted for quite some time.  Yet the more I investigate it, the more I track my own experience, the more sense it makes.  The theory is that, at least for some people, depression is in fact the result of inflammation in the body; caused by the body’s immune system and its reaction to either an infection or stress.
So, the idea that depression is a problem of serotonin is now increasingly being called in to question.

Dr David Healy

Then last year I came across a paper called Serotonin and Depression: The Marketing of a Myth in the British Medical Journal, published by Dr David Healy, a professor of psychiatry at Bangor University.  “The lowered serotonin theory took root in the public domain rather than in psychopharmacology….a piece of biobabble.”

According to psychiatrist, Dr Kelly Brogan in her book A Mind of Your Own: “There has never been a human study that successfully links low serotonin levels and depression.”
Just take a moment to read that over again.  “There has never been a human study that successfully links low serotonin levels and depression.”
WOW!  Isn’t it amazing what we just accept? What becomes a kind of consensus reality?

Depression and our Immune system

Dr Brogan and others in the field, believe that depression can be the result of our immune system going into overdrive which then causes inflammation that may manifest in the brain. According to Dr Brogan “Depression is often an inflammatory condition, a manifestation of irregularities in the body that can start far away from the brain and are not associated with the simplistic model of so-called ‘chemical imbalances’.”

So not only does this challenge the idea of chemical imbalance but it also challenges the idea of depression as a genetic illness.  Could our experiences and environments play a much bigger role than we thought?

What is inflammation?

Put simply, it’s part of the body’s natural response when we’re sick. The theory is that high levels of inflammation lead to a decrease in the number of neurons in our brain. This then affects the way they communicate with each other, leading to depression.  It seems that higher levels of inflammation in the brain is a common feature of those who don’t respond to treatment aimed at treating the chemical imbalance of serotonin.

It does make sense if you think of those occasions when you’ve had flu or a cold.  Think of how it affected your mood; we generally become more withdrawn, less sociable, we have less energy and are generally pretty fed up!  What if you aren’t just feeling sorry for yourself?  What if inflammation acting on the brain is causing classic signs of depression?

More evidence

There is more evidence available from the research carried out with people who suffer inflammatory diseases such as Rheumatoid Arthritis (RA).  With a higher level of depression than the average, a study at Glasgow Royal Infirmary showed that when patients with RA were given precise anti-inflammatory drugs to calm the immune system, their mood improved.
Surely this could just be an improvement because the pain level is reduced?  Brain scans showed that this wasn’t the case.  “The brain pathways involved in mediating depression were favourable changed in people who were given immune interventions.” Professor Iain McInnes, consultant rheumatologist running the study.

Ultimately this theory has major implications on how we think about and treat depression.  Whilst SSRIs do provide relief for many people, there is a significant percentage of people who simply do not respond to them.  This is the same group that have high levels of inflammation.  Could this mean that we can say that depression is not always a problem of the mind but a problem of the body as well?  If people start to think about depression in this way then automatically we reduce the stigma attached to mental health.