How to take the news that depression has not been shown to be caused by a chemical imbalance

Joanna Moncrieff

Summary TL;DR

For decades people have been told that depression is caused by a serotonin deficiency. This was the rationale behind the introduction of the SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants in the 1990s, which were thought to work by boosting low levels of serotonin. Our research shows no evidence of low serotonin in depression, which suggests that antidepressants do not work in the way they were originally thought to work.

There are other explanations for how antidepressants affect people, and why they can be helpful that are not to do with reversing underlying brain abnormalities and have different implications. Drugs like antidepressants change normal brain chemistry and this affects people’s moods and behaviour. SSRI’s blunt both negative and positive emotions, for example, and this may provide relief for people who are acutely distressed or unhappy. Antidepressants also act through inducing hope and optimism (the placebo effect). In the long-term…

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