Controversial new thoughts on antidepressants and alternative treatments for depression

Depression is the leading cause of disability worldwide, which is a scary thought. It does not discriminate and can affect anyone of any age, race, religion, sexual preference or gender. We know these things about depression, but one thing we might not have known is that the link between serotonin levels and depression is now coming into question – could doctors have been wrong this whole time?

On UK-based Professor of Psychiatry thinks so, and has gone on the record to say that the widely held belief that depression is caused by low levels of serotonin in the brain – and that raising these levels with antidepressant drugs known as SSRIs is an effective treatment – is a myth. This is quite a controversial view; SSRIs are the most widely used treatment for depression in across the world.

Writing for medical journal BMJ this week, David Healy, Professor of Psychiatry at the Hergest psychiatric unit in North Wales, said that there was a misconception that lowered serotonin levels were a large contributing factor to depression – labelling it as “the marketing of a myth”.

Serotonin reuptake inhibiting drugs have been prescribed in droves since the late 1980s. Prior to this, tranquillisers were used, until drug companies marketed SSRIs for depression, “even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety,” Professor Healy explained.

SSRIs were a great success and were able to restore serotonin levels to normal, but that was wrongly translated as the drugs remedying a chemical imbalance. Professor Healy argues that there is and still is no evidence to suggest SSRIs correct anything.

The myth that SSRIs were fixing chemical balances, which weren’t even proven to exist in the first place, won over many, including the complementary health market, psychologists, and journals. And it also won over doctors and patients looking for a quick solution without looking at the root of the problem. “For doctors it provided an easy short hand for communication with patients. For patients, the idea of correcting an abnormality has a moral force that can be expected to overcome the scruples some might have had about taking a tranquilliser, especially when packaged in the appealing form that distress is not a weakness”.

Professor Healy also asked a good question: “Does a plausible (but mythical) account of biology and treatment let everyone put aside clinical trial data that show no evidence of lives saved or restored function?

“Do clinical trial data marketed as evidence of effectiveness make it easier to adopt a mythical account of biology?”

So, if SSRIs aren’t effectively treating the problem, or aren’t solving a real chemical imbalance, what are the other options out there for depression sufferers? beyondblue’s website states, “there is no one proven way that people recover from depression. However, there is a range of effective treatments and health professionals who can help people on the road to recovery.

“There are also many things that people with depression can do for themselves to help them recover and stay well. The important thing is finding the right treatment and the right health professional for the individual’s needs”. Would you agree?

Among the alternative treatment recommendations by beyondblue are cognitive therapy, interpersonal therapy, behaviour therapy, and mindfulness.

Mindfulness-based cognitive therapy (MBCT) could provide an alternative non-drug treatment for people who do not wish to continue long-term antidepressant treatment, suggests new research published in The Lancet.

The first ever large study of 424 adults with recurrent major depression and whom were taking maintenance antidepressant medication was conducted to compare MBCT with medication and see which was able to reduce the risk of relapse.

MBCT is structured training for the mind and body, designed to change the way people think and feel about experiences in their life and the findings showed that while the therapy wasn’t any more effective than maintenance antidepressant treatment in preventing relapse of depression, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.

“Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point,” says Willem Kuyken, lead author and Professor of Clinical Psychology at the University of Oxford in the UK.

Tell us below, do you agree with David Healy? Are SSRIs effective in your opinion? What other methods have you or someone you know tried to treat depression?