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Irish Times: ‘Serotonin and depression: what are the implications for psychiatry and patients?’
‘There is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity’
George Winter writes for the Irish Times about recent challenges to the serotonin theory of depression and what this means for future approaches to treatment. He spoke with consultant forensic psychiatrist Professor Gautam Gulati to learn more.
Read in full on the Irish Times website here, or read snippets from the discussion with Professor Gautam Gulati below.
Prof Gulati reminds us that depression “is a serious illness which, like certain physical illnesses, can be severe and life-threatening. It would be reductionist to explain this solely through a single neurotransmitter hypothesis.”
Gulati observes that depression has complex underpinnings including, but not limited to, genetics, biology, social adversity, and psychological vulnerabilities. He acknowledges evidence of neurotransmitter abnormalities, “but this is only one piece of an elaborate enigma. As clinicians we aim to formulate causation on an individual basis for each patient, which provides important clues to the treatment approach most appropriate for that person.”
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For patients, Prof Gulati stresses the importance of people with depression seeking help. “Ample evidence shows that antidepressants and talking therapies like Cognitive Behavioural Therapy can treat the illness effectively, particularly in combination with each other, and when the illness is moderate or severe. This can reduce suffering, improve quality of life, and often reduce the risk of suicide. In mild depression, a healthy diet, moderate exercise, and supportive counselling are helpful, and antidepressant medication is usually not prescribed.”