Depression Forums
Depression - Road to Recovery => Breaking Stories => Topic started by: SteveW on March 01, 2012, 10:18:11 PM
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A little on the serotonin theory of depression pointing out that is a theory not established fact. My feeling is that the truth value of the theory is somewhere between incomplete and frankly wrong.
http://www.psychologytoday.com/blog/charting-the-depths/201007/the-serotonin-theory-depression-is-collapsing
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I started to read the article but I'm tired so I'm going to read it properly in the morning.
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Personally antidepressants work for me so I'm happy to keep taking them however they work - I'd very much like to know if the writer of the article has any vested interests in discrediting the current theories how we get depression and the way we attempt to cure it and more a more substantial article with these new theories before I'll stop believing the serotonin connection.
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So far as I know he is an independent academic-Professor of Psychology at the University of Florida I think. You can't really ignore theory.Development of new anti-depressants depends on it. They aren't developed at random but on the basis of some underlying theory of depression. I'm glad anti-depressants work for you but they don't for a lot of people.I wont go into the details but they are a very inefficient set of drugs. Better drugs require better theory.
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To cover your argument ad hominem I thought I'd supply a second critique. This is more technical, although it still doesn't cover quite a lot of what depression is about.
http://neuroscientificallychallenged.blogspot.com/2008/04/serotonin-hypothesis-and-neurogenesis.html
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I'll have to read it when I get home from work Steve, I would agree that any advance in treating depression would be very welcome.
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I have to say that ssri work for me to an extent, but I'm a lot better with than without.
I think depression is a very complex and little understood illness, as we're not all the same and are exposed to different environmental factors it may be that the serotonin theory applies to some but not all, much in the same way as antibiotics, different ones are needed to treat different types of infection.
Having a statistics degree I am also well aware that statistical results can often be reported in different ways dependent on the desired outcome.
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All I can say is that the anti-depressant I am on Duloxetine (Cymbalta) is helping me. I also believe that medication works only so far, thats why I have counselling to help me understand and deal with my depression.
We are all different and what works for one person does not work for another.
Thats my view anyway.
S x
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Snap! I have a MSc in Statistics as well. I doubt that we need different theories for different people. I think your antibiotic analogy tends to be a bit flawed. That tends to be because GPs tend to treat people blind without establishing which bug and which antibiotics it's susceptible to first . By the way a lot of the evidence that theories need to explain isn't statistical anyway. It tends to come from visual inspection of MRI scans. The sample sizes tend to be a bit small for statistics, MRI scans are pretty pricey.
But the serotonin hypothesis cant explain elementary facts like Reboxetine. This is a drug which has zero effect on serotonin but is just as effective an anti-depressant as the serotonin drugs.There is plenty of real theory about. Try the link below if you want to see a serious theory. I'm using it as an example. I don't necessarily endorse it
http://bmb.oxfordjournals.org/content/65/1/193.full
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Sorry Steve, antibiotic analogy not thought through just of the top of my head.
Will read article a bit later on having concentration probs at the moment.
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Shaz
I'm glad duloxetine is helping you but it doesn't change the facts about anti-depressants based around serotonin. A 70% response rate is about what you can expect from any of the drugs. Half of those are usually reported as cured the other half are reported as improved. The last 30% are completely untouched.
If that was an antibiotic for a chest infection that would be regarded as pathetic. Cure 35%, improve the cough of 35% do nothing at all for the rest. And there is the worst fact of all. 20% of people can take all the anti-depressants in existence, and combinations of two or three and still remain completely untouched ever. That is a lot of people.
That seems the best that serotonin based drugs can manage. Drugs are created around a theory of depression. If your theory is wrong you are almost lost before you start.
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I thought the article was very interesting. I agree that if ADs were antibiotics, we would bin most of them due to their "trial and error" nature
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This is definatly interesting.
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I thought the article was very interesting. I agree that if ADs were antibiotics, we would bin most of them due to their "trial and error" nature
well, you wouldn't have the time to do trial and error, due to death.
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:) Stevie, yep there's a flaw in my argument, the idea that we'd go back to the GP month after month saying "this one doesn't work either" would be a bit difficult given that the infection would have killed us by then....
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I was wondering if why some peoples' depression doesnt respond to antidepressants because there is more than one cause of depression; for instance I believe thyroid deficiency can cause lethargy and depression so if there is an underlying illness causing the depression it should be treated either at the same time or before antidepressants are prescribed.
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You are quite right about thyroid deficiency. There are other physical causes too - Addisons Disease,Late Stage Syphilis,Brain Tumors. Doctors tend not to test for these immediately because they are relatively rare compared to uncomplicated depression. There is little doubt that there are multiple causes of depression,on the social,interpersonal,psychological,and genetic levels.
As to why the drugs don't work for some that is complicated. Part of it is no doubt that they weren't deficient in the neurotransmitter being targeted and that the roots of their depression simply lay else where. Maybe they have been depressed for long enough for various physical changes in the brain to occur-the Amygdala tends to grow, the hippocampus tends to shrink. I've never understood what the current anti depressants could do about something like that. But above all you have to take into account the fact that the drugs simply aren't as powerful as the drug companies would have us believe.
Then there's expectation. A woman with five children who is depressed because she lives in overcrowded sub standard accommodation may well find her depression unaffected by Prozac. Anti-depressants don't compensate for society.Age comes into it. Older people tend to respond more poorly than younger ones. I could go on and on.
It's a complicated business.
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It certainly does sound complicated Steve, and I certainly would agree that expectation must have some bearing. I am fairly certain what brings on my episodes of depression and with counselling realise that I need to alter a lot in my life and the way I look at things to keep down my stress levels but its obviously not the answer for everyone.
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Apparently I need to find a totally stress free job, struggling to think of one !!!!
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Good grief, is any job stress free?!
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If there is one I'd like to know! But imagine how many people would apply for it :D
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I'd be fighting to be first in the queue!
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Nicely written little article on the relationship between SSRI's and neurogenesis. Should the Serotonin Theory of Depression prove to be totally wrong an explanation for the apparent efficacy of SSRI's will be needed.Neurogenesis is one such possible explanation. The research discussed was done on mice, but so is a lot of basic research.
http://neurospeculation.blogspot.com/2008/08/different-mechanisms-behind.html
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thanks Steve, the links you are posting are most interesting and informative
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Thank you Steve, I enjoy reading your links :)
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Thanks Buttercup. I'm glad you found the links interesting. Studying depression is a fascinating thing. I've been studying it for years and still have loads to learn.
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And I'm just beginning
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If you're in the middle of an episode of depression now I hope it proves to be your last and you lack the incentive to learn which my multiple episodes gave me.
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Thank you Steve. I am in a middle of a severe depression and severe anxiety spell. I have sought help this time but know I've suffered in the past. My doctor has just referred me to a psychiatrist so I fear this will not be my last.
Have been doing a lot of reading of late.
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Just read the neurogenesis article and found it very interesting, need to read it through again my concentration for reading isn't terrific at the moment, which I am finding very frustrating!
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This post adds weight to my theory that medication cannot cure my depression. I have multiple reasons to be depressed as far as I am concerned and medication wont touch them. I dont accept the past, and dont accpet the present and I dont accept the future. I am incapable, with drugs or without.
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Just wondering if you could recommend any other research articles ( links)
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Certainly can. Try this one. It takes a totally different approach to neurogenesis and neurotransmitter theories of depression . Its all about Circadian hypotheses of depression though there is a fair amount at the start about circadian rhythms in general. I've always thought early morning wakening and 24 hour variations in mood suggested the biological clock was involved in some way.See what you think.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612129/
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Thank you, will have a read
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If you want an introduction to the whole field, causes and treatment,drugs and otherwise.This book is £16.20. I bought the first edition back in the 70's. It has taken 40 odd years to produce the second edition.
Depression: Causes and Treatment Aaron T. Beck and Brad A. Alford
Also good is:
Depression: Theories and Treatments - Psychological, Biological and Social Perspectives by Arthur Schwartz
It is ridiculously expensive new but Amazon lists second hand copies for a few pounds.
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Buttercup
Knowing I was at less than my best I emailed a friend for suggestions for you. She wasn't all that much help, her approach was-what do I know that you don't. She did however recommend one book very highly. I have already bought a copy and it is in my pile of books to be read if my reading ability ever returns.It looks interesting from my browsing through it. It operates on a completely different level of analysis from anything I have recommended- the social. It is
Understanding Depression: Feminist Social Constructionist Approaches by Janet Stoppard
The incidence of depression in women is far higher than that in men, which makes it of feminist interest. Hope you find time to read it.
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Thank you Steve, I will have a look on Amazon. :)