A review of the current data about serotonin metabolism and depression was published in the July, 2022 issue of Systematic Review.

The findings? There is no relationship between depression and any aspect of serotonin metabolism. Depressed people don’t have changes in their serotonin levels, their serotonin receptors, or serotonin transport molecules.

Why are SSRIs (selective serotonin re-uptake inhibitors) so widely used?

Are SSRIs, the mainstay of the chemistry-first approach to the treatment of depression, even effective?

The authors of this paper offered two possible answers to these questions. One is that SSRIs have some other effect on the brain separate from their effect on serotonin. The other explanation is that the value of SSRIs is explainable from the placebo effect.

If SSRIs are of questionable value, what are effective alternatives?

Depression is a serious condition, and no simple answer will prove effective for all people. But we know that each of these strategies has ben shown to be of some benefit:

• Listen to John Philip Sousa and march in place while waving your arms around
• Tell someone you admire them
• Join a club or organization
• Get a massage or visit your chiropractor
• Rewrite your story
• Take some fresh mint, rub it between your hands and take a deep sniff
• Go to the art museum
• Walk in your local park
• Limber your spine
• Drink coffee
• Get a good night’s sleep
• Make an appointment with your therapist
• Hit the gym

Take depression seriously! But taking it seriously doesn’t necessarily mean medicalizing it. There are alternatives.