I have a problem with anxiety and depression. I think that’s pretty normal for anyone who spends a lot of time thinking about climate change, but a few years back it got to the point where I was worried about my heart. I ended up going on an SSRI(Strategic Serotonin Reuptake Inhibitor). I’m not sure which, but I think it was Wellbutrin. The first couple weeks I was on it were great. For whatever reason, my brain suddenly worked! I had been expecting it to take the edge off my anxiety (which it did), but suddenly my problem with procrastination was just gone. It was like there had been a loose wire in my brain for my entire life, and someone had suddenly fixed the connection. That went away pretty quickly, and I was back to having to fight my brain to do just about anything, but my anxiety was under control, and that made a huge difference in my quality of life. Managing that didn’t fix my depression, but it made it a lot easier to handle.
Since then I’ve been taking them off and on. In the U.S. it was because of money. When I got to the UK, it just took my a while to get around to getting a prescription, because as I’ve mentioned, that part of my brain doesn’t seem to work quite right. I’ve been on fluoxetine (generic Prozac) since March of 2020, and while I did get a productivity kick when I went back on it, that faded as before. My own experience has been that SSRIs work. That’s why it was odd to see headlines saying otherwise. I didn’t bother digging into it much because I’m aware of how inaccurate headlines can be, and I’ve had other things on my mind. I also knew that Rebecca Watson had looked at the issue in the past, and would likely do so again. I was not disappointed.
But before we even get to that, the title should also give away the fact that this was NOT a review to determine whether or not antidepressants work (which, again, they do). This was a review to determine HOW antidepressants work. Because in all fields of science, researchers accept that sometimes we know that something works but we’re not yet sure why, like when James Lind performed a randomized controlled trial that found that citrus fruit cured scurvy in 1753. Vitamin C wasn’t discovered for another 150 years.
The brain is a complicated lump of meat, so it makes sense that how it works remains a big question. In the late 1980s, doctors found that depressed patients could be helped by giving them fluoxetine, more commonly known as Prozac, which is a selective serotonin reuptake inhibitor, or SSRI. SSRIs, to put it very simply, change the way your brain processes serotonin, causing serotonin to stay for a longer period of time in your synapses.
This led some researchers to think, quite understandably, that maybe people are depressed because they need more serotonin. That hypothesis got popular in the years that followed the introduction of Prozac and it certainly became popular amongst the general public, but serious researchers knew that it was always going to be more complicated than that. They already knew that depression has many causes: yes, there’s an imbalance of chemicals in the brain which might include serotonin, but there’s also depression that comes from bad life events, or from physical ailments. Just because it helps a person when you adjust their serotonin levels, doesn’t mean the problem was the serotonin levels. I’ve heard several doctors recently explain it like this: taking Advil may help your headache but it doesn’t mean that your headache was caused by a lack of Advil in the brain.
I will probably die angry about “reporting” like this. While I think the sigma against people with mental health problems has decreased in my lifetime, it is far from gone, and that means there are a lot of people who still have to fight constantly just to get the people in their lives to treat them with respect. Stuff like this makes that a lot harder. It’s irresponsible reporting, and it can do real harm to people.
Watch the video or go to Skepchick for the transcript and sources, and if you see people saying that SSRIs don’t work, please push back, even if it’s just linking them to Watson’s breakdown.