In July of 2022, a review of existing research was published “debunking” the serotonin theory of depression. Many of us know that over the years, this theory has been, for the most part, already abandoned. Most clinicians subscribe to a biopsychosocial model, which recognizes any of the following may be increasing symptoms depression: brain chemistry, genetics, physical health, systemic injustices, impact of systemic oppression on marginalized individuals, trauma (acute trauma or chronic trauma), substance use, compassion fatigue, or just being a human in the era of COVID-19.
So, if we as professionals have already acknowledged that the serotonin/chemical imbalance theory is outdated, why did the review make such a splash?
The writers, Joanna Moncrieff, et. al., have been known critics of the effectiveness of antidepressant medications, and it seems they are using the paper to affirm their narrative. The paper was published shortly after Republican politicians and news stations blamed SSRIs (among other things) for mass shootings.
If you have not heard any of this, here are the headlines:
On July 5, while covering the horrific Highland Park mass shooting, Tucker Carlson, on live TV, said that young men are becoming angrier and more violent as a result of the following:
Women holding men accountable for their male privilege was making “young men go nuts”
Social media, video games, porn (none of which have been linked to mass violence)
Getting “high on government-endorsed weed”
Last but not least… that these men are “numbed by the endless psychotropic drugs that are handed out at every school in the country by crackpots posing as counselors”.
So, when the study was published later that month, it was quickly used to prop up this dangerous narrative for political gain. As we all know, when politics are involved, nuance is smothered. The result has moved the narrative around SSRIs from healthy medical skepticism…to misinformation, fearmongering, and stigmatization.
This is extremely dangerous.
The reality is that SSRIs are proven to be effective treatment for many people with depression, and for millions, they have been literally life-saving. Scientifically, we do not understand the mechanism of action behind the effectiveness of these medications - but this is extremely common (we don’t actually know why Tylenol works, but its still the gold standard).
The reason I wanted to bring this to your attention is that it directly impacts our clients that do take these medications. The biggest concern is ensuring clients are not suddenly taking themselves off of SSRIs without medical supervision because this can be lethal. Additionally, many feel ashamed, alienated, confused, and afraid as a result of the narrative being promoted. We need to show up for them, and help them understand the nuance and complexity of mental health. They need to know that if their chosen route of treatment involves SSRIs, we will support and stand by them.