Depression is not a chemical imbalance?

Not according to some new research out there and not according to my own understanding of my depression.

"This review suggests that 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 [21]. We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated." Moncrieff, J., Cooper, R.E., Stockmann, T. et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry (2022).

Read it slowly...."We suggest it is time to acknowledge that the serotonin theory of depression is not empirically substantiated." I cannot tell you how freeing that statement feels to me.

I spent 10 years thinking there was a chemical imbalance in my brain. I even wanted to get a tattoo of the molecular model of serotonin, as a way to honor the missing link in my life. This new research, this article and this statement feel so freeing to me because it helps to validates what I have already come to understand about my depression. That sugar, shame and social media have had far more to do with my depression than serotonin ever has.

I was first diagnosed with depression when I was 30 or 31. The timeline is a little fuzzy from those days, so I don't quite remember. I made an appointment with my doctor at the encouragement of my friend and coworker that, lucky for me, happens to also be a licensed mental health counselor. I saw a fabulous nurse practitioner that sat so patiently with me as I cried telling her I thought I was depressed. After talking and answering some questions, I was prescribed my first anti-depressant.

Me: meds (lexapro) but scared to take. She warned me of potential suicidal thoughts....didnt tell her they have already been there

Friend: Take meds for two weeks..see what happens...check in with me daily about thoughts to monitor them...

I was so grateful for text in this moment, because believe me when I tell you I was UGLY crying, probably even hyperventilating a little bit. I don't remember much from these days, but I remember the panic that set in on my drive home thinking about how the medication prescribed to help me, might make my thoughts worse. Could my thoughts get worse? What would happen if they did?

I did what my friend told me to do. I texted her every day. I took her advice when she told me to "stop eating shit!". I can still hear the stern mom like tone she used when she said it! I took her advice when she told me to exercise. I took her advice when she told me to see a counselor. I took her advice when she told me to do something for myself every single day. And I took her advice when she told me to "Sit with it". A quote I eventually did get tattooed, in her handwriting.

This friend did so much more than just give me the advice that ultimately saved my life. What she did for me in those few weeks went far beyond advice. She held space for me. She made me feel seen and heard and, in that moment, when I admitted to her that I was having suicidal thoughts, I felt a gigantic weight lift off of my soul. She didn't judge. She didn't tell me I was being dramatic. She simply said, check in with me every day. In that one text she lifted the stigma that I was crazy. She acted and treated what I was going through, as any other illness or symptom.

The mental health journey is often described as a roller coaster. When I followed the advice, I felt good. When I felt good, I'd stop following the advice. When I'd stop following the advice the symptoms would come back. It was a cycle I lived in for 10 years.

2020, however, brought me the greatest reset of my life. I say now that I am in remission from depression. I no longer wish to not wake up. I don’t nap for hours to escape the thoughts and I was able to wean myself off all pharmaceutical medications. No Benadryl to sleep. No Lexapro to numb everything inside of me.

I have managed my depression the last two years through counseling, nutrition, meditation, yoga, and by following my passions. By doing things that bring me joy. By connecting with my friends on a deeper, more meaningful way. By playing and coaching the sport that I love. And by journaling through my feelings, the grief, the abandonment, my fears & insecurities.

I still ride the rollercoaster of mental health but it’s a coaster with more highs than lows and my lows are not nearly as low as they used to be.

In my remission, I have been able to reflect on how I came to be near the edge of the Hudson trying to figure out how to end my life. Sobbing and begging for the courage to do it. I have been able to reflect on the 15 years prior to see the buildup to that moment. I can see all the ways in which I set myself up for that moment. How the "food" I ate affected my thoughts, my feelings, and my mood. How shame was the underlying emotion for most of my 20s and certainly in those early suicidal days. The emotion I could never quite name to tame. And I have been able to reflect on how social media affects my thoughts, my feelings, and my mood.

It is time to acknowledge that the serotonin theory of depression is not empirically substantiated and start paying attention to the chemicals we eat and the stress we live in. It’s time we start paying attention to the way we live as a society. It’s time we start paying attention to how the health care system and the food system are woven together to keep us sick. To keep us depressed. To keep us anxious.

I think medication has a very important place in the health care world and I believe medication helped save my life. But I do not think that medication is the end all, be all to health care. Especially mental health care. And can we stop calling it mental health or physical health. It's a whole-body system. Mental health IS physical health! Your mental mess (STRESS) will show up in the body, in some way, at some point. The Body always Keeps the Score!

One of the most influential things I have learned in the last 2 years is that all systems in the body start in the gut. Heal the gut, heal the brain & body! Nutrition is THE most important tool in my toolbox today and I wholeheartedly believe that food is medicine. Real food. Food from a plant not made in a plant, is the real medicine we should be focusing on.


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