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The Depression? It is not a question of biochemistry (and therefore of serotonin)

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The Depression?  It is not a question of biochemistry (and therefore of serotonin)

It would not be the happiness hormone that triggers the depression. In fact, there would be no ‘tight’ link between the levels of serotonin present in the blood and the disease. This is supported by extensive research just published in Nature which overturns previous studies on the subject.

But let’s try to understand what has been called ‘the good mood hormone’ and then clarify the search for Nature. Serotonin acts as a neurotransmitter and hormone and is present in many tissues including: the brain, gastrointestinal tract, lungs, kidneys and platelets. First isolated in 1935 in the intestinal mucosa by Vittorio Espamer, it owes its name to Maurice Rapport and Irvine Page who in 1948 identified its vasoconstrictive properties and defined it with the fusion of the Latin word “serum” with the Greek “tonic” .

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Levels in the brain

95% of this molecule is synthesized in the gastrointestinal wall and 5% in the brain serotonergic neurons. And for a long time it has earned a reputation as a hormone of good mood, capable of giving serenity, also because its brain levels are involved in the regulation of important functions such as sleep, appetite, emotions and mood.

For years, numerous studies have tried to point out the inconsistency of the theory, given for decades as established, that depression was caused by an imbalance in brain biochemistry, mainly due to serotonin. And now, the research just published on Naturegoes in this same direction and signals once again that serotonin would not have “a relevant role” in depression.

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I study

“This is a very large study in which recent research on the subject was reviewed. It was seen, for example, that there is no genetics of depression and that blood serotonin levels were not related to depression. elements have emerged from studies on neuroimaging. Furthermore, it has been shown that not even the combination of genetic profile and stress was associated with depression. This is not surprising to experienced psychiatrists, since drugs that act on serotonin are not true antidepressants, they serve modulate painful emotions, “he explains Giancarlo Dimaggio, psychiatrist and psychotherapist and co-founder of the Interpersonal Metacognitive Therapy Center in Rome. The research overcomes the argument that depression is just “a product of the biochemistry of the brain” that has generated the idea that a chemical (the drug) is needed to cure it.

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Serotonin levels

There would therefore be no cause-and-effect relationship between serotonin levels and depression. If it is true that the deficiency of some substances affects the functioning of our brain, it cannot be said that they are ‘guilty’ in all respects of mental discomfort “The point of the study is not so much whether the deficiency of a substance is connected to the depression, but if it is the cause. It is natural that every form of psychic suffering is linked to alterations in the brain, but precisely, it is the cause-effect relationship that must be established. If I switch off because I was left, the cause is the sensitivity to abandonment combined with the real event. And this concerns the dimension of the search for meaning. Then surely there will be reactive imbalances in my brain “, adds Dimaggio.

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The sadness

For a long time, however, serotonin was considered to be directly responsible for depression. “This has led psychiatrists, and even more non-psychiatric doctors, to resort to the administration of serotonergic drugs. In itself it is not wrong a priori, but came at the expense of a reasoned clinical decision, after a diagnosis. It is important – explains the expert – to explain above all that it is the diagnosis of depression itself that is a confusing category. Only a minimal percentage of patients diagnosed as such really have depression as a disease in itself. It is endogenous depression or melancholy, made up of pervasive sadness that does not depend on events “.

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In these cases, pessimism, distrust and paralysis are present in the patient, which can be accompanied by feelings of guilt and even delusional ruin. “In the overwhelming majority, depression is not a disease but a set of symptoms, in the same way that the combination of fever and body aches can be. No doctor would make a diagnosis of:” Fever and body aches “, explains the expert.

Anxiety and fear

Let’s talk about the symptoms, manifestations and effects of different diseases. There are those who get depressed because they have spent a long time in anxiety and fear. In these cases, we withdraw, become wary and lose the possibility of having a complete life.

“We can get depressed because we spend our lives aspiring to perfection and a series of two failures brings us down, the mood lowers and we go out. Depression can occur in those who, dedicating their lives to trying to be appreciated and loved, faces a sentimental abandonment. They are life trajectories, completely different personality styles that result in something that manifests the same symptoms. of the anti-inflammatory, relieves the symptoms but the causes must be treated “, explains Dimaggio.

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The therapies

It remains to be seen how this research will change the way patients are treated. “The study does not suggest not using drugs, which remain a valuable and often indispensable tool. What I would expect is that it leads to less use of the label ‘depression’ and more attention to personality problems. And to consider psychotherapy. as the first option for the treatment of those with depressive symptoms, perhaps in combination with drugs if needed “.

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