10 ms·

Is serotonin the happy brain chemical?

72 points by jimsojim 11y ago

rincewind 11y ago
Is the zero bit the computer happy bit?
- amelius 11y ago
  I don't know, but I found this to be the interesting bit: > Depressed and anxious people might simply be too good at learning about bad outcomes > Over the past few decades, researchers have been discussing that mental health issues such as depression and anxiety might fundamentally be disorders of learning, rather than outcomes of a ‘chemical imbalance’ that requires correction by a serotonin boost. Specifically, certain individuals which have atypical function of the serotonin system (which might be caused by genetic factors or stressful lives) may be at risk of developing depression or anxiety because they are too good at learning about negative outcomes, and thus are more likely to feel that the world is a bad place if they experience negative life events. One of the most talked-about studies in the psychiatric literature supports this possibility (6). It found that individuals with a particular genotype affecting the serotonin system were more likely than others to develop depression or anxiety only if they had experienced stressful life events, such as child abuse, unemployment, or loss of a loved one. Clearly, having an atypical serotonin system alone wasn’t enough – it had to be combined with negative experiences.
  - agumonkey 11y ago
    Add paranoid, which mindset is mostly interpreting everything as a source of bad (worst) outcome. It also drives thinking into designing "pure solutions" in which the bad just cannot happen. I applied it unconsciously in software design (recently learned it was a design philosophy too).
  - 0xcde4c3db 11y ago
    This paragraph is rather inconsistent. The first sentence talks about the issue being one disorder rather than another, then supports that with a study finding that both are components. It seems like a lot of people use that study as an argument for ignoring the part they're not interested in, rather than concluding that both components should be treated.
johnw11 11y ago
I would like to point out that there is a whole range of non-SSRI medicines that have significant clinical effects on depression. In particular: Medicines that promote drowsiness (such as sleeping aids and even the antipsychotic quetiapine), as sleep deprivation and depression are highly correlated. The atypical antidepressant wellbutrin/bupropion, which impacts a whole bunch of chemicals in the body but notably does not affect seratonin levels. My personal experience from having taken it is that it makes me more energetic, similar to a weak amphetamine. MAOIs, which again impact a whole bunch of chemicals, including seratonin but notably also melatonin, which is well-known to promote sleep. These are well-known to be highly effective antidepressants, but are rarely used because they require the patient to alter aspects of his lifestyle. The situation is complicated by the fact that the category of depression consists of a bunch of different symptoms that may be comorbid in many people, but are not necessarily.
- johnw11 11y ago
  Also, while I don't personally have experience with a lot of illegal drugs, if you ask anyone who does he will tell you that there are drugs that nearly instantly make you happy without having to wait weeks for the drugs to have a subtle effect on your thought processes. These illegal drugs may or may not be too dangerous to use regularly to treat depression, but it's worth noting the fact that it's clearly not "impossible" to make a true "happy pill"
  - johnchristopher 11y ago
    But don't those happy pills have really high dependence and don't you need to increase the dosage and the intervals to stay on the same plateau ?
    - deleted 11y ago
      [deleted]
    - johnw11 11y ago
      Yes, many do, but is that necessarily inherent to all "happy pills"?
gghh 11y ago
The article presents a possible explaination for why SSRI antidepressants (which increase the amount of serotonine in one's synapsis) are effective: serotonine plays a role in how we learn, and > [people with an] atypical function of the serotonin system may be at risk of developing depression or anxiety because they are too good at learning about negative outcomes > Serotonin changes produced by the drug, combined with appropriate therapy, might work by allowing patients to learn that the world is not such a bad place rather than simply making them happy. The article continues noting that this would explain a few things, like > (1) why treatment with SSRI anti-depressants doesn’t tend to increase happiness until weeks after depressed patients have begun taking medication. Serotonin changes produced by the drug, combined with appropriate therapy, might work by allowing patients to learn that the world is not such a bad place rather than simply making them happy. > (2) why some depressed patients generally do not improve when undergoing SSRI treatment. Consuming pills in the absence of improvement in life conditions or appropriate therapy might in fact make it easier for already depressed individuals to ‘learn’ more about the negative events surrounding them > (3) [why we] have no evidence that [simply] increasing brain serotonin levels actually improves people’s mood. The evidence shown to supports this role of serotonin in the learning process consists of two studies (cited in the article). The first showing that rats grown in the dark developed abnormal sensitivity to non-visual stimuli, and that serotinine played a role in the process. The second found that individuals with a particular genotype affecting the serotonin system were more likely than others to develop depression or anxiety only if they had experienced stressful life events. Betteridge's law of headlines checks out: Is serotonin the happy brain chemical? No, it (probably) plays a complex role in how we learn about bad outcomes.
- digi_owl 11y ago
  Sorry but i have to get this off my chest. This fits me so well. I wonder how many nights i have simply wished i could think less. That is, stop twisting old events hoping to grab some new insights, or ruminate about whats to come given X Y and Z.
  - dustingetz 11y ago
    Maybe you might view that as strength, something about your brain chemistry that lets you achieve deeper insight than your peers, and makes you a better innovator? I say this as someone like you, who replays events in the past or future, over and over to gain deep insights (or maybe confirmation biases), and i also wonder if it is related to my seratonin-dopamine imbalances (i have adhd), as it is very clear that my obsession with understanding the why behind the world is not normal and i wish i could just let it be
cel1ne 11y ago
Serotonine is very old. There are two different genes TPH1 and TPH2 which encode the enzyme information for serotonine-production, which happens at two sites in the body. This split is apparently very old and evolved before vertebrates did. Serotonine controls a multitude of things including wake-night-cycle, blood pressure and temperature. It doesn't even only work as a neurotransmitter, but mechanically as well. Further reading: http://www.ncbi.nlm.nih.gov/pubmed/8768313 http://www.ncbi.nlm.nih.gov/pubmed/8768313
bluedevil2k 11y ago
SSRI's in my opinion are not the future of antidepressants. They work by indiscriminately increasing serotonin levels in the synapse, thereby activating every single serotonin receptor (5-HT). While you get the anti-depressant effect by increasing the activation at the 5-HT1 receptor, you also get the negative side effects of SSRI's since it activates 5-HT2c receptor (weight gain), 5-HT3 receptor (nausea), and sleep issues. The future of the antidepressants lies in chemicals that increase serotonin at the 5-HT1 receptor (lowering depression) without affecting the other receptors. Drugs like mirtazipine and nefazodone attempt to do this by blocking certain 5-HT receptors (mainly the 5-HT2a receptor, which lowers anxiety), and as a result make serotonin levels higher and more available at the 5-HT1 receptor. That's the reason these 2 drugs in particular don't have the nasty side-effects of SSRI's. The future of anti-depressants likely lies in the ability to find a drug that increases activation at the 5-HT1 receptors in certain parts of the brain, while leaving the rest of the brain and receptors untouched.
- ordbajsare 11y ago
  The future of SSRI is the garbage! They are shooting blind! Talk therapy FTW!
- rudolf0 11y ago
  Also keep in mind that depression isn't always caused by serotonin issues or remediated by increasing serotonin (which is somewhat redundant with this article, though I think the article paints serotonin too negatively). For example, if someone has bipolar disorder (or similar issues), they may have fairly standard serotonin concentration and receptor activation, but an SSRI may not help much with their depression.
  - bluedevil2k 11y ago
    True, but the thought is that the feelings of worthlessness, hopelessness, even suicide are seratonin related. There are other types of depression like "don't enjoy things I used to like, lack mental acuity" that may be dopamine related. And "mopey, lack energy" which may be noradrenaline related.
joesmo 11y ago
This is the first honest article I've read on the subject of serotonin and neurotransmitters in years. It basically concludes what very few people seem to be aware of: that we do not know what causes depression or anxiety nor do we know how SSRIs, SSNRIs, or other similar chemicals work. There are, at best, hypothesis, generally untestable. The idea of chemical "imbalances" in the brain is, as it has been since its inception, complete and utter bullshit. The reality is current medical science simply doesn't know, the marketers make the rest up, and for some reason, most doctors play along. That's how you get to the popular and completely wrong idea that serotonin is the "happy" brain chemical. (Of course, if you're aware of the lack of capability in most people to process complex ideas, you could easily guess that such a simplistic idea has to be wrong simply from the number of people who talk about it like it's real.)
- lostinny 11y ago
  Indeed! We still don't understand the causes of anxiety and depression, and yet far too many doctors simply went along with the "chemical imbalance" narrative. SSRIs and related medications can be wonderful tools, but that proves nothing re: causality and the best long term treatment. Sadly, this battle was lost a long time ago[1], but it's heartening that people are starting to revisit some of these debates. [1] Here's an article from 1999 arguing essentially the same thing re: how little we understand about mental illness, and how prescribing doctors should be cautious about oversimplifying something so complex: http://www.psychiatrictimes.com/psychotherapy/psychotherapy-perspectives-medication-management http://www.psychiatrictimes.com/psychotherapy/psychotherapy-...
  - tcj_phx 11y ago
    Your link seems to make a case for SSRIs causing learned helplessness. It's been 17 years since this article was written, and the profession is still working on fixing itself. "Hmm." Thanks for the link!
Raphmedia 11y ago
After feeling very down, so much that I didn't felt like myself, I started to experiment with herbal supplements. Valerian to sleep, but my problem wasn't lack of sleep. St John's Wort for mood, but I didn't feel moody. I tried 5-htp, which from my understanding is a precursor to the biosynthesis of Serotonin. The effect was immediate. I felt light headed, buzzed even. I felt as if I had suddenly woken up in a bright new world. I went groceries shopping could barely keep myself from gaping at all the colours, products and people. The next day, those effects were gone but I felt fine. Simply fine. I tried to take more 5-htp, but those strong effects are gone. I am no brain scientist, but to me this is anecdotal evidence that I was very much lacking in Serotonin and that this herbal supplement boosted me right back up. It's not magical, I still feel anxious about deadlines and stressed about hard to deal with clients. However, some kind of dark blurry veil has been lifted from my perception of life. Edit: Since then, I increased my weekly physical activities and improved my overall eating habits. I can't say if it's directly linked with my increase (or rather closer to normal) Serotonin but my instinct says yes.
- carleverett 11y ago
  Relevant part of this comment: "I am no brain scientist." You probably could have had the same effect from a sugar pill.
  - Raphmedia 11y ago
    Why would you claim this? From what I have read 5-Hydroxytryptophan seem like a widely accepted supplement for issues with Serotonin and/or depression and mood. The only articles that I have found that say it might not be of use are studies that simply say that 5-HTP is better than placebo but that we can't say more yet because of lack of researches. Edit: and possible heart valves issues if you do not take it correctly "5-Hydroxytryptophan (5-HTP), also known as oxitriptan (INN), is a naturally occurring amino acid and chemical precursor as well as a metabolic intermediate in the biosynthesis of the neurotransmitters serotonin and melatonin from tryptophan." (https://en.wikipedia.org/wiki/5-Hydroxytryptophan https://en.wikipedia.org/wiki/5-Hydroxytryptophan) "Preliminary studies indicate that 5-HTP may work as well as certain antidepressant drugs to treat people with mild-to-moderate depression. Like the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes fluoxetine (Prozac) and sertraline (Zoloft), 5-HTP increases the levels of serotonin in the brain. One study compared the effects of 5-HTP to fluvoxamine (Luvox) in 63 people and found that those who were given 5-HTP did just as well as those who received Luvox. They also had fewer side effects than the Luvox group. However, these studies were too small to say for sure if 5-HTP works. More research is needed." (https://umm.edu/health/medical/altmed/supplement/5hydroxytryptophan-5htp https://umm.edu/health/medical/altmed/supplement/5hydroxytry...) etc, etc, burden of proof to you... https://scholar.google.ca/scholar?q=5-Hydroxytryptophan&hl=en&as_sdt=0,5 https://scholar.google.ca/scholar?q=5-Hydroxytryptophan&hl=e...
PaulHoule 11y ago
I'm not sure that SSRI's make me happy, but I have never believed the "chemical imbalance" story about them. I have always been kindof anxious, maybe with a touch of GAD or even social anxiety, and I when I knew the rug was about to get pulled out from under me, I started taking an SSRI to increase my resilience. Under the SSRI I am definitely much less anxious, perhaps even to a fault -- the big benefit I see it that I don't get upset about little things, like I don't get upset about being stuck in traffic.
pif 11y ago
By the way, triptans (drugs that increase serotonin level) can be very effective in fighting against migraines. Switching from a splitting head-ache to nothing in 20 minutes, when instead classic analgesics would do nothing, is a step towards happiness. Edit: SSRI -> triptans
NickM 11y ago
I've noticed a strong pop-psych trend these days of referring to one's own feelings or experiences in terms of neurotransmitters. e.g. "I'm hooked on the dopamine rush of such-and-such activity," "I'm feeling blue today, my serotonin must be low," etc. This drives me crazy. It's pure pseudoscience, and I hear it from people who should know better. Scientifically, we have very little idea what chemicals are actually behind different subjective feelings/moods/whatever. Everyone would love to believe that the brain operates in a simple, intuitive fashion, with one chemical for joy, one chemical for sadness, one chemical for anger, etc., but the reality is way more complex and nuanced. For example, even something well-studied like dopamine, which has been strongly linked with the brain's addiction circuitry, doesn't necessarily stimulate any sort of direct pleasurable feeling as people often infer. It seems to work in a much subtler way, modulating learning, attention, and goal-seeking behavior. A recent study found that it doesn't even necessarily spike when good things happen, but tends to increase in response to unexpected events, good or bad.
- heimatau 11y ago
  > "I'm feeling blue today, my serotonin must be low," etc. This drives me crazy. It's pure pseudoscience, Yeah. I think it's a pseudoscience too. Even though 5HTP and St. John's Wort produce a 'happy feeling' to me and many others. It doesn't last. Even with modern day SSRIs and other depression meds, pill holidays are recommended. Pill holidays shows me that they are an imperfect solution. I would tell a person in a wheelchair to 'try and walk it off' for a few days/weeks. That's unfair to their illness, yet psych does that with their meds. > but the reality is way more complex and nuanced. I couldn't have said it better myself. Hopefully, we'll have a medical breakthrough in psych in the next 20 years. With all the investment, I'm optimistic.
  - DigitalJack 11y ago
    You need to be careful with the pill holiday thing. When I was taking venlafaxine, the withdrawl happened very fast and was miserable... if I missed two days I was in trouble.
    - 11y ago
Nihilartikel 11y ago
There's actually an old, effective-in-studies, and fairly obscure anti-depressant called tianeptine that works by enhancing serotonin reuptake, which lowers the levels. Effectively an Anti SSRI. I hear about it from the nootropics camp from time to time.
- steve-howard 11y ago
  That's very interesting, I've never heard of that. Apparently it's a tricyclic, but doesn't have the same side effects that have caused most tricyclics to fall out of use. Never approved in the US, either, though current research suggests it works in different ways than the most common drugs. I'm hopeful that as drugs unrelated to seratonin, norepinephrine, and dopamine start to show promise with depression, that we'll have a better picture of what's going on in the brain when people get depressed. IMO one of the missing pieces in severe depression treatment is what to do in the weeks it takes medications to take effect, if they even do; the current strategy seems to be "wait it out and if they're at risk of hurting themselves put them in a rubber room." Wiki link for lazy folks: https://en.wikipedia.org/wiki/Tianeptine https://en.wikipedia.org/wiki/Tianeptine
- rudolf0 11y ago
  Unfortunately, tianeptine is not quite the wonder drug people hoped it would be. It does increase serotonin reuptake (thus resulting in lower serotonin concentrations), but this is believed to be unrelated to its anti-depressant and relaxant effects. You can see a debunking here: https://en.wikipedia.org/wiki/Reuptake_enhancer https://en.wikipedia.org/wiki/Reuptake_enhancer Tianeptine was found to simply be an opioid receptor agonist. In other words, it's just a mild opioid, sort of like codeine. Obviously, opioids and opiates can improve mood. But it's a weak agonist, and the opioid receptors it targets are less implicated in the addiction and powerful euphoria associated with morphine or heroin. So, taken in low doses (the standard dose is very low), dependence and tolerance can remain low, and it can effectively improve mood over a long period of time. But increasing the dose will result in typical opioid euphoria, tolerance, and withdrawal effects. Perhaps more importantly, it doesn't treat the root cause of depression in many people; it merely masks it. Sure, SSRIs often don't treat the root cause either, though for people with specific serotonin issues, they can. But an opioid or opiate is always just going to be a "layer" over your depression. It also tends not to help people who struggle with avolition and lack of motivation or energy; it may even do the opposite, as opioids are wont to do. But it will help with your mood. And it not treating the root cause is not necessarily a bad thing if it improves your enjoyment of life and your ability to function. For many people, an SSRI will be more effective than tianeptine. For those who do not have any serotonin imbalance, tianeptine could be better.
CPLX 11y ago
My main takeaway from this article was that someone also wrote an article entitled "Chemicals that activate happiness, and how to gamify them" and somehow thought this was ok.

72 points by jimsojim 11y ago

rincewind 11y ago

Is the zero bit the computer happy bit?

amelius 11y ago
I don't know, but I found this to be the interesting bit: > Depressed and anxious people might simply be too good at learning about bad outcomes > Over the past few decades, researchers have been discussing that mental health issues such as depression and anxiety might fundamentally be disorders of learning, rather than outcomes of a ‘chemical imbalance’ that requires correction by a serotonin boost. Specifically, certain individuals which have atypical function of the serotonin system (which might be caused by genetic factors or stressful lives) may be at risk of developing depression or anxiety because they are too good at learning about negative outcomes, and thus are more likely to feel that the world is a bad place if they experience negative life events. One of the most talked-about studies in the psychiatric literature supports this possibility (6). It found that individuals with a particular genotype affecting the serotonin system were more likely than others to develop depression or anxiety only if they had experienced stressful life events, such as child abuse, unemployment, or loss of a loved one. Clearly, having an atypical serotonin system alone wasn’t enough – it had to be combined with negative experiences.
- agumonkey 11y ago
  Add paranoid, which mindset is mostly interpreting everything as a source of bad (worst) outcome. It also drives thinking into designing "pure solutions" in which the bad just cannot happen. I applied it unconsciously in software design (recently learned it was a design philosophy too).
- 0xcde4c3db 11y ago
  This paragraph is rather inconsistent. The first sentence talks about the issue being one disorder rather than another, then supports that with a study finding that both are components. It seems like a lot of people use that study as an argument for ignoring the part they're not interested in, rather than concluding that both components should be treated.

johnw11 11y ago

I would like to point out that there is a whole range of non-SSRI medicines that have significant clinical effects on depression. In particular: Medicines that promote drowsiness (such as sleeping aids and even the antipsychotic quetiapine), as sleep deprivation and depression are highly correlated. The atypical antidepressant wellbutrin/bupropion, which impacts a whole bunch of chemicals in the body but notably does not affect seratonin levels. My personal experience from having taken it is that it makes me more energetic, similar to a weak amphetamine. MAOIs, which again impact a whole bunch of chemicals, including seratonin but notably also melatonin, which is well-known to promote sleep. These are well-known to be highly effective antidepressants, but are rarely used because they require the patient to alter aspects of his lifestyle. The situation is complicated by the fact that the category of depression consists of a bunch of different symptoms that may be comorbid in many people, but are not necessarily.

johnw11 11y ago
Also, while I don't personally have experience with a lot of illegal drugs, if you ask anyone who does he will tell you that there are drugs that nearly instantly make you happy without having to wait weeks for the drugs to have a subtle effect on your thought processes. These illegal drugs may or may not be too dangerous to use regularly to treat depression, but it's worth noting the fact that it's clearly not "impossible" to make a true "happy pill"
- johnchristopher 11y ago
  But don't those happy pills have really high dependence and don't you need to increase the dosage and the intervals to stay on the same plateau ?
  - deleted 11y ago
    [deleted]
  - johnw11 11y ago
    Yes, many do, but is that necessarily inherent to all "happy pills"?

gghh 11y ago

The article presents a possible explaination for why SSRI antidepressants (which increase the amount of serotonine in one's synapsis) are effective: serotonine plays a role in how we learn, and > [people with an] atypical function of the serotonin system may be at risk of developing depression or anxiety because they are too good at learning about negative outcomes > Serotonin changes produced by the drug, combined with appropriate therapy, might work by allowing patients to learn that the world is not such a bad place rather than simply making them happy. The article continues noting that this would explain a few things, like > (1) why treatment with SSRI anti-depressants doesn’t tend to increase happiness until weeks after depressed patients have begun taking medication. Serotonin changes produced by the drug, combined with appropriate therapy, might work by allowing patients to learn that the world is not such a bad place rather than simply making them happy. > (2) why some depressed patients generally do not improve when undergoing SSRI treatment. Consuming pills in the absence of improvement in life conditions or appropriate therapy might in fact make it easier for already depressed individuals to ‘learn’ more about the negative events surrounding them > (3) [why we] have no evidence that [simply] increasing brain serotonin levels actually improves people’s mood. The evidence shown to supports this role of serotonin in the learning process consists of two studies (cited in the article). The first showing that rats grown in the dark developed abnormal sensitivity to non-visual stimuli, and that serotinine played a role in the process. The second found that individuals with a particular genotype affecting the serotonin system were more likely than others to develop depression or anxiety only if they had experienced stressful life events. Betteridge's law of headlines checks out: Is serotonin the happy brain chemical? No, it (probably) plays a complex role in how we learn about bad outcomes.

digi_owl 11y ago
Sorry but i have to get this off my chest. This fits me so well. I wonder how many nights i have simply wished i could think less. That is, stop twisting old events hoping to grab some new insights, or ruminate about whats to come given X Y and Z.
- dustingetz 11y ago
  Maybe you might view that as strength, something about your brain chemistry that lets you achieve deeper insight than your peers, and makes you a better innovator? I say this as someone like you, who replays events in the past or future, over and over to gain deep insights (or maybe confirmation biases), and i also wonder if it is related to my seratonin-dopamine imbalances (i have adhd), as it is very clear that my obsession with understanding the why behind the world is not normal and i wish i could just let it be

cel1ne 11y ago

Serotonine is very old. There are two different genes TPH1 and TPH2 which encode the enzyme information for serotonine-production, which happens at two sites in the body. This split is apparently very old and evolved before vertebrates did. Serotonine controls a multitude of things including wake-night-cycle, blood pressure and temperature. It doesn't even only work as a neurotransmitter, but mechanically as well. Further reading: http://www.ncbi.nlm.nih.gov/pubmed/8768313 http://www.ncbi.nlm.nih.gov/pubmed/8768313

bluedevil2k 11y ago

SSRI's in my opinion are not the future of antidepressants. They work by indiscriminately increasing serotonin levels in the synapse, thereby activating every single serotonin receptor (5-HT). While you get the anti-depressant effect by increasing the activation at the 5-HT1 receptor, you also get the negative side effects of SSRI's since it activates 5-HT2c receptor (weight gain), 5-HT3 receptor (nausea), and sleep issues. The future of the antidepressants lies in chemicals that increase serotonin at the 5-HT1 receptor (lowering depression) without affecting the other receptors. Drugs like mirtazipine and nefazodone attempt to do this by blocking certain 5-HT receptors (mainly the 5-HT2a receptor, which lowers anxiety), and as a result make serotonin levels higher and more available at the 5-HT1 receptor. That's the reason these 2 drugs in particular don't have the nasty side-effects of SSRI's. The future of anti-depressants likely lies in the ability to find a drug that increases activation at the 5-HT1 receptors in certain parts of the brain, while leaving the rest of the brain and receptors untouched.

ordbajsare 11y ago
The future of SSRI is the garbage! They are shooting blind! Talk therapy FTW!
rudolf0 11y ago
Also keep in mind that depression isn't always caused by serotonin issues or remediated by increasing serotonin (which is somewhat redundant with this article, though I think the article paints serotonin too negatively). For example, if someone has bipolar disorder (or similar issues), they may have fairly standard serotonin concentration and receptor activation, but an SSRI may not help much with their depression.
- bluedevil2k 11y ago
  True, but the thought is that the feelings of worthlessness, hopelessness, even suicide are seratonin related. There are other types of depression like "don't enjoy things I used to like, lack mental acuity" that may be dopamine related. And "mopey, lack energy" which may be noradrenaline related.

joesmo 11y ago

This is the first honest article I've read on the subject of serotonin and neurotransmitters in years. It basically concludes what very few people seem to be aware of: that we do not know what causes depression or anxiety nor do we know how SSRIs, SSNRIs, or other similar chemicals work. There are, at best, hypothesis, generally untestable. The idea of chemical "imbalances" in the brain is, as it has been since its inception, complete and utter bullshit. The reality is current medical science simply doesn't know, the marketers make the rest up, and for some reason, most doctors play along. That's how you get to the popular and completely wrong idea that serotonin is the "happy" brain chemical. (Of course, if you're aware of the lack of capability in most people to process complex ideas, you could easily guess that such a simplistic idea has to be wrong simply from the number of people who talk about it like it's real.)

lostinny 11y ago
Indeed! We still don't understand the causes of anxiety and depression, and yet far too many doctors simply went along with the "chemical imbalance" narrative. SSRIs and related medications can be wonderful tools, but that proves nothing re: causality and the best long term treatment. Sadly, this battle was lost a long time ago[1], but it's heartening that people are starting to revisit some of these debates. [1] Here's an article from 1999 arguing essentially the same thing re: how little we understand about mental illness, and how prescribing doctors should be cautious about oversimplifying something so complex: http://www.psychiatrictimes.com/psychotherapy/psychotherapy-perspectives-medication-management http://www.psychiatrictimes.com/psychotherapy/psychotherapy-...
- tcj_phx 11y ago
  Your link seems to make a case for SSRIs causing learned helplessness. It's been 17 years since this article was written, and the profession is still working on fixing itself. "Hmm." Thanks for the link!

Raphmedia 11y ago

After feeling very down, so much that I didn't felt like myself, I started to experiment with herbal supplements. Valerian to sleep, but my problem wasn't lack of sleep. St John's Wort for mood, but I didn't feel moody. I tried 5-htp, which from my understanding is a precursor to the biosynthesis of Serotonin. The effect was immediate. I felt light headed, buzzed even. I felt as if I had suddenly woken up in a bright new world. I went groceries shopping could barely keep myself from gaping at all the colours, products and people. The next day, those effects were gone but I felt fine. Simply fine. I tried to take more 5-htp, but those strong effects are gone. I am no brain scientist, but to me this is anecdotal evidence that I was very much lacking in Serotonin and that this herbal supplement boosted me right back up. It's not magical, I still feel anxious about deadlines and stressed about hard to deal with clients. However, some kind of dark blurry veil has been lifted from my perception of life. Edit: Since then, I increased my weekly physical activities and improved my overall eating habits. I can't say if it's directly linked with my increase (or rather closer to normal) Serotonin but my instinct says yes.

carleverett 11y ago
Relevant part of this comment: "I am no brain scientist." You probably could have had the same effect from a sugar pill.
- Raphmedia 11y ago
  Why would you claim this? From what I have read 5-Hydroxytryptophan seem like a widely accepted supplement for issues with Serotonin and/or depression and mood. The only articles that I have found that say it might not be of use are studies that simply say that 5-HTP is better than placebo but that we can't say more yet because of lack of researches. Edit: and possible heart valves issues if you do not take it correctly "5-Hydroxytryptophan (5-HTP), also known as oxitriptan (INN), is a naturally occurring amino acid and chemical precursor as well as a metabolic intermediate in the biosynthesis of the neurotransmitters serotonin and melatonin from tryptophan." (https://en.wikipedia.org/wiki/5-Hydroxytryptophan https://en.wikipedia.org/wiki/5-Hydroxytryptophan) "Preliminary studies indicate that 5-HTP may work as well as certain antidepressant drugs to treat people with mild-to-moderate depression. Like the class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs), which includes fluoxetine (Prozac) and sertraline (Zoloft), 5-HTP increases the levels of serotonin in the brain. One study compared the effects of 5-HTP to fluvoxamine (Luvox) in 63 people and found that those who were given 5-HTP did just as well as those who received Luvox. They also had fewer side effects than the Luvox group. However, these studies were too small to say for sure if 5-HTP works. More research is needed." (https://umm.edu/health/medical/altmed/supplement/5hydroxytryptophan-5htp https://umm.edu/health/medical/altmed/supplement/5hydroxytry...) etc, etc, burden of proof to you... https://scholar.google.ca/scholar?q=5-Hydroxytryptophan&hl=en&as_sdt=0,5 https://scholar.google.ca/scholar?q=5-Hydroxytryptophan&hl=e...

PaulHoule 11y ago

I'm not sure that SSRI's make me happy, but I have never believed the "chemical imbalance" story about them. I have always been kindof anxious, maybe with a touch of GAD or even social anxiety, and I when I knew the rug was about to get pulled out from under me, I started taking an SSRI to increase my resilience. Under the SSRI I am definitely much less anxious, perhaps even to a fault -- the big benefit I see it that I don't get upset about little things, like I don't get upset about being stuck in traffic.

pif 11y ago

By the way, triptans (drugs that increase serotonin level) can be very effective in fighting against migraines. Switching from a splitting head-ache to nothing in 20 minutes, when instead classic analgesics would do nothing, is a step towards happiness. Edit: SSRI -> triptans

NickM 11y ago

I've noticed a strong pop-psych trend these days of referring to one's own feelings or experiences in terms of neurotransmitters. e.g. "I'm hooked on the dopamine rush of such-and-such activity," "I'm feeling blue today, my serotonin must be low," etc. This drives me crazy. It's pure pseudoscience, and I hear it from people who should know better. Scientifically, we have very little idea what chemicals are actually behind different subjective feelings/moods/whatever. Everyone would love to believe that the brain operates in a simple, intuitive fashion, with one chemical for joy, one chemical for sadness, one chemical for anger, etc., but the reality is way more complex and nuanced. For example, even something well-studied like dopamine, which has been strongly linked with the brain's addiction circuitry, doesn't necessarily stimulate any sort of direct pleasurable feeling as people often infer. It seems to work in a much subtler way, modulating learning, attention, and goal-seeking behavior. A recent study found that it doesn't even necessarily spike when good things happen, but tends to increase in response to unexpected events, good or bad.

heimatau 11y ago
> "I'm feeling blue today, my serotonin must be low," etc. This drives me crazy. It's pure pseudoscience, Yeah. I think it's a pseudoscience too. Even though 5HTP and St. John's Wort produce a 'happy feeling' to me and many others. It doesn't last. Even with modern day SSRIs and other depression meds, pill holidays are recommended. Pill holidays shows me that they are an imperfect solution. I would tell a person in a wheelchair to 'try and walk it off' for a few days/weeks. That's unfair to their illness, yet psych does that with their meds. > but the reality is way more complex and nuanced. I couldn't have said it better myself. Hopefully, we'll have a medical breakthrough in psych in the next 20 years. With all the investment, I'm optimistic.
- DigitalJack 11y ago
  You need to be careful with the pill holiday thing. When I was taking venlafaxine, the withdrawl happened very fast and was miserable... if I missed two days I was in trouble.
  - 11y ago

Nihilartikel 11y ago

There's actually an old, effective-in-studies, and fairly obscure anti-depressant called tianeptine that works by enhancing serotonin reuptake, which lowers the levels. Effectively an Anti SSRI. I hear about it from the nootropics camp from time to time.

steve-howard 11y ago
That's very interesting, I've never heard of that. Apparently it's a tricyclic, but doesn't have the same side effects that have caused most tricyclics to fall out of use. Never approved in the US, either, though current research suggests it works in different ways than the most common drugs. I'm hopeful that as drugs unrelated to seratonin, norepinephrine, and dopamine start to show promise with depression, that we'll have a better picture of what's going on in the brain when people get depressed. IMO one of the missing pieces in severe depression treatment is what to do in the weeks it takes medications to take effect, if they even do; the current strategy seems to be "wait it out and if they're at risk of hurting themselves put them in a rubber room." Wiki link for lazy folks: https://en.wikipedia.org/wiki/Tianeptine https://en.wikipedia.org/wiki/Tianeptine
rudolf0 11y ago
Unfortunately, tianeptine is not quite the wonder drug people hoped it would be. It does increase serotonin reuptake (thus resulting in lower serotonin concentrations), but this is believed to be unrelated to its anti-depressant and relaxant effects. You can see a debunking here: https://en.wikipedia.org/wiki/Reuptake_enhancer https://en.wikipedia.org/wiki/Reuptake_enhancer Tianeptine was found to simply be an opioid receptor agonist. In other words, it's just a mild opioid, sort of like codeine. Obviously, opioids and opiates can improve mood. But it's a weak agonist, and the opioid receptors it targets are less implicated in the addiction and powerful euphoria associated with morphine or heroin. So, taken in low doses (the standard dose is very low), dependence and tolerance can remain low, and it can effectively improve mood over a long period of time. But increasing the dose will result in typical opioid euphoria, tolerance, and withdrawal effects. Perhaps more importantly, it doesn't treat the root cause of depression in many people; it merely masks it. Sure, SSRIs often don't treat the root cause either, though for people with specific serotonin issues, they can. But an opioid or opiate is always just going to be a "layer" over your depression. It also tends not to help people who struggle with avolition and lack of motivation or energy; it may even do the opposite, as opioids are wont to do. But it will help with your mood. And it not treating the root cause is not necessarily a bad thing if it improves your enjoyment of life and your ability to function. For many people, an SSRI will be more effective than tianeptine. For those who do not have any serotonin imbalance, tianeptine could be better.

CPLX 11y ago

My main takeaway from this article was that someone also wrote an article entitled "Chemicals that activate happiness, and how to gamify them" and somehow thought this was ok.