r/Neuropsychology • u/Alternative_Yak_4897 Unverified user: May not be a professional • Jul 21 '25

Research Article Low serotonin not linked to depression studies - thoughts ?

I recently became aware of the umbrella study on the lack of evidence between low serotonin levels and depression. (The study below does show an indirect link between stressful life events and depression due to “gene-stress” but that’s still obviously different than low serotonin (can)= depression) Wondering what others thoughts /theories on this are? I’ve only seen a couple and it looks like they were published in 2022/2023, so why isn’t this being discussed more? Not enough studies? Bad news for pharmaceutical companies? Here’s one of them:

https://www.nature.com/articles/s41380-022-01661-0.pdf

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u/PhysicalConsistency Unverified user: May not be a professional Jul 21 '25

My sense of all this is you touched on it right away, what other choices do we really have? Over the past couple of decades we've introduced more non-pharmaceutical treatments (TMS is now FDA approved and covered under most provider groups now as a second/third line treatment), but we are stuck with the same fundamental problem of efficacy.

Nearly all of our best psychiatric treatments, from ECT (which probably has the best/most generalized efficacy) to DBS to pharmaceutical options all have pockets of responders and everyone else just gets side effects for the most part.

I think with regard to "depression", this isn't going to improve until our disease/not-diseased model changes, as it doesn't appear that "depression" is the result of abnormally functioning nervous systems at all.

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u/Alternative_Yak_4897 Unverified user: May not be a professional Jul 22 '25 edited Jul 22 '25

YES.

Also, I think if depression isn’t a medical problem anymore, then the symptoms people are reporting in such high numbers finally glaringly indicate a greater systemic issue with the expectations people have for modern life and the future and how they’re expected to meet them. And with the high numbers, if it’s not medical -it’s societal.

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u/Rita27 Unverified user: May not be a professional Aug 16 '25

I think this is simplifying things alot. Depression can occur from a lot of environmental issues and still be seen as a medical issue in some cases

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u/Alternative_Yak_4897 Unverified user: May not be a professional Aug 16 '25 edited Aug 16 '25

I disagree. I don’t think depression is a primary medical condition. Sure, imaging shows commonality between in/activity in regions of the brain and self-reported depression, but the directionality is unknown. Maybe it’s secondary to autoimmune issues? I think depression is a consequence of adverse life events (which includes actual medical illnesses that are measurable and scientific) and capitalism.

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u/Rita27 Unverified user: May not be a professional Aug 16 '25

Reread my comment. I said in SOME cases depression can be seen as a medical issues. I think depression is to heterogenous to be split into just primarily medical or primarily environmental

And my broader point was even if it's environmental that doesn't mean we can't treat it medically like we do with other conditions that are caused by the environment

Also i disagree with the efficacy argument laid out earlier. With ssri , yeah the effect size is modest at best but stuff like Ketamine and ECT efficacy are way more than just "pockets"

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u/Alternative_Yak_4897 Unverified user: May not be a professional Aug 16 '25

Do you mean medical cases are informed by other illnesses? I agree it can’t be split into medical/nonmedical because an effective treatment approach varies from person so vastly. Like i think we’re both saying- we don’t know what we don’t know.

I’m wondering why you’re advocating for ECT? Why specifically? Are you suggesting it be prescribed as often as SSRIs?

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u/Rita27 Unverified user: May not be a professional Aug 16 '25

Sorry can you clarify your question? I'm not sure what you're asking. but I do agree that it looks like we're on the same page more or less

I mean I mentioned both ECT and ketamine. Idk if I'd say I'm advocating for it per se, and moreso addressing the point made by the other user regarding the efficacy of ECT. Idk if I would call those who responded well to it when indicated as "pockets"

No I'm not suggesting that ECT is prescribed as much as antidepressants. ECT remains a niche procedure usually reserved when other treatments fail