I’m revisiting this story (originally from April) in honor of #WorldMentalHealthDay. Siddhartha Mukherjee has assembled a master history on how we treat depression, and why, in the New York Times.
From the pre-Prozac Nation era to now, when antidepressants are the third-most prescribed drug in America, how has our understanding of this disease changed? The once prevailing theory of neurotransmitter imbalance, while not wrong, has proven to be an incomplete explanation.
Today, as much attention must be given to treating the provocation of depression as is given to treating the physiology of the condition. More and more studies have questioned how serotonin really influences depression in various brains. Rather than come to any solid conclusions, it appears that it’s not just the neurotransmitter alone, but how serotonin works in the context of the brain that it’s working in. The severity of the depression seems to predict how well an antidepressant will work, and much of the effect itself may be due to placebo.
How do we separate the placebo effect from treating the underlying causes of depression, social and chemical? And just wait until you hear about how the once-dogmatic view that new neurons don’t grow in the adult brain is wrong, and what that might mean for the neurobiology of emotions.
We “grow sorrowful,” but we rarely describe ourselves as “growing joyful.” Imprinted in our language is an instinct that suggests that happiness is a state, while grief is a process. In a scientific sense too, the chemical hypothesis of depression has moved from static to dynamic — from “state” to “process.” An antidepressant like Paxil or Prozac … does not, as previously suspected, simply increase serotonin or send more current down a brain’s mood-maintaining wire. Rather, it appears to change the wiring itself. Neurochemicals like serotonin still remain central to this new theory of depression, but they function differently: as dynamic factors that make nerves grow, perhaps forming new circuits.
We remain closer to the beginning of the journey to cure depression than to the end. And that scientific journey will demand we remind ourselves of many principles, in treatment and in the stigma surrounding it, namely these two:
- The brain is a dynamic organ, a delicately balanced web of morphing, almost cloud-like connections, whose complexity defies our understanding, but whose adaptive nature we must accept and exploit, in both diagnosis and treatment.
- That depression, and mental disorders like it, are not the default state of our brain’s intended chemistry does not make them wrong, bad, hopeless or shameful.
This is an opportunity to use the fruits of the brains of a few to help the brains of many.
The Science and History of Treating Depression ↘
Posted 7 months ago with 471 notes
Reblogged from jtotheizzoe
Originally posted by jtotheizzoe
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