Depression is not caused by a lack of serotonin.

https://healthselfdefense.substack.com/p/depression-is-not-caused-by-a-lack

WHAT IS THE “SEROTONIN HYPOTHESIS”?

The serotonergic hypothesis posits that one of the main causes of depression (depressive responses) is related to a significant deficiency or absence of the neurotransmitter/biomolecule serotonin in the brain. The context of the monoamine hypothesis (dopamine, serotonin, norepinephrine, etc.) emerged in 1963 when Carlsson and Lindqvist discovered that neuroleptic drugs tested for the treatment of schizophrenia increased the turnover and quantity of dopamine in the brains of rodents.

However, despite serotonin being a chemical neurotransmitter traditionally associated with mood regulation in the nervous system, and despite the significant scientific advancements in its research, all efforts to empirically validate the serotonin hypothesis for depression have failed.

THE CONSEQUENCES OF PSYCHOLOGISTS’ LACK OF SELF-CRITICISM
Supporting a disease-centered model, and the biological alteration of serotonin as the cause of “depressive” behaviors, does not help students and professionals critically review the full range of theoretical approaches, while ignoring vast areas of theory and research and contradicting the principles of social work ethics and practice, including the crucial role of families and culture, client strengths and empowerment, and the individualized approach to each case.

The only certainty we have about the “serotonin hypothesis” is that things are always happening in the brain, no matter what we do. Interestingly, in many psychology and psychiatry clinics, they simply use questions and descriptions about our behavior, about whether we have been suffering excessively in recent months, to diagnose “depression,” without performing biological tests that demonstrate brain deficits of serotonin, which is supposedly where “depression” originates and resides. “An explanation is not more scientific simply because it is expressed in neurobiological terms.”

GENETIC STUDIES DISMANTLE THE “SEROTONIN THEORY”
If there truly were a lack of serotonin (or if serotonin receptors were less sensitive), genetic studies of serotonin-related biomolecules should demonstrate an alteration associated with high levels of homovanillic acid in cerebrospinal fluid, which has not been demonstrated in any conclusive study. Similarly, hormonal studies are inconclusive, having shown no abnormalities or differences in growth hormone and prolactin levels in subjects diagnosed with “depression.”

And most importantly, there are no conclusive studies linking an imbalance between serotonin 5-HT1A receptors and SERT (serotonin transporter) levels. As an explanation for these failures, we can say that, at the outset of the hypothesis, it was probably not foreseen that we would currently possess the tools to detect imbalances in the genes involved in serotonin production.

THE PHILOSOPHY OF SCIENCE DISMANTLES THE “SEROTONIN HYPOTHESIS”
According to Popper, the “serotonin hypothesis” has low falsifiability due to its lack of specificity (even abstraction). In this case, if one prediction about serotonin was not confirmed, another easily took its place, making it almost indestructible. According to Kuhn, we can assume that the “serotonin paradigm” has endured because a sufficiently prominent and more successful alternative hypothesis was never developed, so there has never been a real crisis that would incentivize an update and conversion of that paradigm.

According to Lakatos, the “serotonin hypothesis” is more accurately described as a degenerative than a progressive research program, due to its numerous failed predictions and many ad hoc alterations to the main hypothesis, resulting in the hypothesis’s core being excessively distorted.

WHY IS THE “SEROTONIN HYPOTHESIS” STILL SO SUCCESSFUL?
In the 1960s, linking psychiatry with the high prestige of neurochemistry and psychopharmacology fulfilled the medical desire to “bring psychiatry back into the mainstream of medicine.” This desire has persisted due to the simplicity, low cost of professional intervention, and high economic interest behind the “one neurotransmitter, one disease” model—a perfect marketing concept for pharmaceutical companies, and in this case, for selling SSRI drugs.

We routinely assume that the accumulation of studies on a topic is strong evidence supporting its validity, when in reality it indicates the opposite: it indicates that no definitive study on the subject yet exists. This medical view of “depression” reduces therapeutic empathy and increases the stigma surrounding “mental disorders.” Unfortunately, it is very appealing, as it allows for the evasion of responsibility, blaming people for their own problems, and “chronicizing” depression to extract economic benefits for longer.

WHAT WOULD THE “SEROTONIN HYPOTHESIS” HAVE NEEDED TO BE RIGOROUS AND RESPECTED?
For the “serotonin hypothesis” to have been empirically validated during its 60-year history, it would have needed to devise alternative hypotheses. It would have needed to design one or more crucial experiments with possible alternative outcomes, each of which would have ruled out one or more of the hypotheses. It would also have needed to obtain a clean and definitive result, while recycling the procedure, and formulate “sub-hypotheses” or sequential hypotheses, to refine the possibilities that remain to be verified.

Psychiatry needs theories with higher levels of specificity and falsifiability. Science works best when diverse theories with different predictions compete with each other, but in this case, the “serotonin hypothesis” has been defended with a fervor that cannot be justified by the available evidence. Therefore, in conclusion, psychiatry is probably not ready for “grand” unitary theories like the “serotonin hypothesis” as a cause of “depression.”

Decolonizing also means letting go of bioessentialism:

"As I began to see the structural and systemic roots of our distress, I increasingly moved away from “born this way” thinking. The more I prioritized intentional community building and reconnecting to my cultural roots, the more impossible it became to see my pain as separate from other people’s struggles. It’s all interconnected and psychiatric labels simply failed to capture these nuances that collectivist communities are built on.

Decolonizing also means letting go of bioessentialism

Maybe we shouldn’t assume anything of people who do or don’t carry a neurodivergent label. Maybe someone identifying as neurodivergent or NOT won’t help you understand much about them or circumvent the process of getting to know them with care, over time. Maybe we should let people open our world to new worlds. Maybe we shouldn’t covertly or overtly force people to turn to a colonial tool like the DSMV to figure out “what they have” or “who they are”. Maybe we don’t need to push people into categories excessively to make them comprehensible.

If terms under the umbrella of neurodivergence are important to you, then know that I’m not asking you to abandon them, nor am I framing them unilaterally as “bad”. I’m asking you to look beyond them, to be aware of how they can be leveraged for harm and to recognize that there are other ways for communities to make sense of their distress without these labels. I’m asking you to embrace complexity and create space for it. The rest of the world should not have to speak this precise language. The language of colonial psychiatry should never have been forced upon the global south and it shouldn’t be today, including any reclaimed version within the neurodiversity framework."

Psychiatric diagnoses & bioessentialism will not liberate us, Ayesha Khan, Ph.D.

https://wokescientist.substack.com/p/psychiatric-diagnoses-and-bioessentialism

#madpride

Psychiatric diagnoses & bioessentialism will not liberate us, Ayesha Khan, Ph.D.

https://wokescientist.substack.com/p/psychiatric-diagnoses-and-bioessentialism

Some clarifications off the bat
I am writing this from the perspective of communities in the global south who have always had alternative modalities to conceptualize human and planetary distress without pathologizing it. Our communities have been/ are being killed for our cultural traditions including medicine. Many of us in the diaspora are struggling to rediscover, reconnect with, practice, and preserve our traditions.

If terms under the umbrella of neurodivergence are important to you, then know that I’m not asking you to abandon them, nor am I framing them unilaterally as “bad”. I’m asking you to look beyond them, to be aware of how they can be leveraged for harm and to recognize that there are other ways for communities to make sense of their distress without these labels. I’m asking you to embrace complexity and create space for it. The rest of the world should not have to speak this precise language. The language of colonial psychiatry should never have been forced upon the global south and it shouldn’t be today, including any reclaimed version within the neurodiversity framework. Most importantly, if we’re attempting to abolish colonial/ capitalist systems while building collectivist systems of community care then I think everyone has a lot to learn from alternative frameworks created, nurtured & developed by communities who have always been fighting for the health of the planet.

I also urge you to be wary of biological essentialism that sounds like “I was born like this, I’ve always been like this, this is just how my brain works”. The concept of neurodiversity has been heavily co-opted in the global north, watered down, individualized, sanitized and DEPOLITICIZED. People often frame neurodivergence as atypical brain wiring which is the same biological essentialism that gave us race science. Many movements and spaces in the global north have a tendency to turn to bioessentialism (for gender/ sex and sexuality for example). Categories and labels like autism/ ADHD etc, whether they are reclaimed & redefined or not, are all social constructs, not biological realities with clear boundaries, definitions and measurable criteria. Usage of these terms as biological categories can be harmful and prevent revolutionary progress as we try to reimagine community care.

As I began to see the structural and systemic roots of our distress, I increasingly moved away from “born this way” thinking. The more I prioritized intentional community building and reconnecting to my cultural roots, the more impossible it became to see my pain as separate from other people’s struggles. It’s all interconnected and psychiatric labels simply failed to capture these nuances that collectivist communities are built on.

The more I anchored into the collective, the less attached I was to even the redefined, radical derivates of these labels. The diagnoses that were always foreign to my community, imposed on us by our colonizers, were again feeling foreign to me. Though I see the power in reclaiming some things that have been used to oppress you, I don’t see the utility in everyone reforming and repackaging every aspect of colonialism. If anything, I see the global north’s obsession with spreading colonial models of mental health, including psychiatric diagnoses, to the the global south as being one wing of modern day colonialism.

Psychiatric labels AND the neurodiversity framework do not speak to majority of the people in my community or to majority of people in the world.
This does not mean that I think it is bad if someone is empowered by these labels. But folks in neurodivergent spaces in the global north need to think about the fact that they may have a lot to learn from collectivist communities who have always had all-encompassing, transformative, land-preserving, care systems. These life-sustaining approaches to medicine were violently destroyed or are currently undergoing colonial erasure. Colonized people are criminalized, punished and killed for attempting to continue their traditions.

Decolonizing also means letting go of bioessentialism

Maybe we shouldn’t assume anything of people who do or don’t carry a neurodivergent label. Maybe someone identifying as neurodivergent or NOT won’t help you understand much about them or circumvent the process of getting to know them with care, over time. Maybe we should let people open our world to new worlds.

Colonialism brainwashes people into thinking they are “individuals” or atomized beings separate from everything, separate from each other, the land, the trees, the birds and the rest of our kin. These systems have concocted ridiculous bioessentialist boxes and categories to convince us that we are alone, separate, distinct, and unrelated.

#madpride #healthselfdefense

Depression is not caused by a lack of serotonin.
The lie of the serotonin hypothesis and how decolonizing also means letting go of bioessentialism

https://healthselfdefense.substack.com/p/depression-is-not-caused-by-a-lack

Over the last century, the disease-centered model for addressing “depressive behaviors” has become just another problem to solve, rather than the appealing solution it appears to be for the general population. We say appealing because for many people, evading responsibility by claiming that “it’s not me, or our circumstances, the problem is your brain” is a huge relief for protecting our short-term self-esteem.

It seems that asserting, without any evidence, that the problem of our excessive sadness and anhedonia lies in the brain poses no problem for anyone. Students have to make less effort to understand the phenomenon, professionals must treat most patients the same way, without considering their life context, and for the general population, it’s a great way to easily explain problems they are likely partly responsible for.

WHAT IS THE “SEROTONIN HYPOTHESIS”?

The serotonergic hypothesis posits that one of the main causes of depression (depressive responses) is related to a significant deficiency or absence of the neurotransmitter/biomolecule serotonin in the brain. The context of the monoamine hypothesis (dopamine, serotonin, norepinephrine, etc.) emerged in 1963 when Carlsson and Lindqvist discovered that neuroleptic drugs tested for the treatment of schizophrenia increased the turnover and quantity of dopamine in the brains of rodents.

However, despite serotonin being a chemical neurotransmitter traditionally associated with mood regulation in the nervous system, and despite the significant scientific advancements in its research, all efforts to empirically validate the serotonin hypothesis for depression have failed.

THE CONSEQUENCES OF PSYCHOLOGISTS’ LACK OF SELF-CRITICISM
Supporting a disease-centered model, and the biological alteration of serotonin as the cause of “depressive” behaviors, does not help students and professionals critically review the full range of theoretical approaches, while ignoring vast areas of theory and research and contradicting the principles of social work ethics and practice, including the crucial role of families and culture, client strengths and empowerment, and the individualized approach to each case.

The only certainty we have about the “serotonin hypothesis” is that things are always happening in the brain, no matter what we do. Interestingly, in many psychology and psychiatry clinics, they simply use questions and descriptions about our behavior, about whether we have been suffering excessively in recent months, to diagnose “depression,” without performing biological tests that demonstrate brain deficits of serotonin, which is supposedly where “depression” originates and resides. “An explanation is not more scientific simply because it is expressed in neurobiological terms.”

GENETIC STUDIES DISMANTLE THE “SEROTONIN THEORY”
If there truly were a lack of serotonin (or if serotonin receptors were less sensitive), genetic studies of serotonin-related biomolecules should demonstrate an alteration associated with high levels of homovanillic acid in cerebrospinal fluid, which has not been demonstrated in any conclusive study. Similarly, hormonal studies are inconclusive, having shown no abnormalities or differences in growth hormone and prolactin levels in subjects diagnosed with “depression.”

And most importantly, there are no conclusive studies linking an imbalance between serotonin 5-HT1A receptors and SERT (serotonin transporter) levels. As an explanation for these failures, we can say that, at the outset of the hypothesis, it was probably not foreseen that we would currently possess the tools to detect imbalances in the genes involved in serotonin production.

PSYCHOTROPIC MEDICATIONS ARE NOT PROOF OF ANYTHING
In general, any psychological and psychiatric treatment should always begin with the assumption that psychotropic medications are only a “complementary treatment” for people’s suffering, and not a sole and definitive treatment. However, the irresponsible and widespread use of “antidepressant” psychotropic medications has been justified by the idea that they act by correcting underlying biological abnormalities that produce suffering and behavioral problems. Although, as we have already seen, there is no evidence of such biological abnormalities in the brain of a person labeled with “depression.”

Unfortunately, therapeutic manipulation, a lack of information about the side effects of psychotropic drugs, censored accounts of lives ruined by SSRIs, and the prescription of “drug cocktails” are commonplace. Despite the fact that, in most cases, after taking an “antidepressant,” what is observed is simply the effect of the drug, and not relief or a change in the psychological root of the patient’s problem. “Antidepressants don’t solve your problems, they put them on ‘pause.’”

THE PHILOSOPHY OF SCIENCE DISMANTLES THE “SEROTONIN HYPOTHESIS”
According to Popper, the “serotonin hypothesis” has low falsifiability due to its lack of specificity (even abstraction). In this case, if one prediction about serotonin was not confirmed, another easily took its place, making it almost indestructible. According to Kuhn, we can assume that the “serotonin paradigm” has endured because a sufficiently prominent and more successful alternative hypothesis was never developed, so there has never been a real crisis that would incentivize an update and conversion of that paradigm.

According to Lakatos, the “serotonin hypothesis” is more accurately described as a degenerative than a progressive research program, due to its numerous failed predictions and many ad hoc alterations to the main hypothesis, resulting in the hypothesis’s core being excessively distorted.

#madpride

Decolonizing also means letting go of bioessentialism

https://wokescientist.substack.com/p/psychiatric-diagnoses-and-bioessentialism

“As I began to see the structural and systemic roots of our distress, I increasingly moved away from “born this way” thinking. The more I prioritized intentional community building and reconnecting to my cultural roots, the more impossible it became to see my pain as separate from other people’s struggles. It’s all interconnected and psychiatric labels simply failed to capture these nuances that collectivist communities are built on.

The more I anchored into the collective, the less attached I was to even the redefined, radical derivates of these labels. The diagnoses that were always foreign to my community, imposed on us by our colonizers, were again feeling foreign to me. Though I see the power in reclaiming some things that have been used to oppress you, I don’t see the utility in everyone reforming and repackaging every aspect of colonialism. If anything, I see the global north’s obsession with spreading colonial models of mental health, including psychiatric diagnoses, to the the global south as being one wing of modern day colonialism.

Psychiatric labels AND the neurodiversity framework do not speak to majority of the people in my community or to majority of people in the world.

This does not mean that I think it is bad if someone is empowered by these labels. But folks in neurodivergent spaces in the global north need to think about the fact that they may have a lot to learn from collectivist communities who have always had all-encompassing, transformative, land-preserving, care systems. These life-sustaining approaches to medicine were violently destroyed or are currently undergoing colonial erasure. Colonized people are criminalized, punished and killed for attempting to continue their traditions.

Decolonizing also means letting go of bioessentialism

Maybe we shouldn’t assume anything of people who do or don’t carry a neurodivergent label. Maybe someone identifying as neurodivergent or NOT won’t help you understand much about them or circumvent the process of getting to know them with care, over time. Maybe we should let people open our world to new worlds.

Colonialism brainwashes people into thinking they are “individuals” or atomized beings separate from everything, separate from each other, the land, the trees, the birds and the rest of our kin. These systems have concocted ridiculous bioessentialist boxes and categories to convince us that we are alone, separate, distinct, and unrelated.

If terms under the umbrella of neurodivergence are important to you, then know that I’m not asking you to abandon them, nor am I framing them unilaterally as “bad”. I’m asking you to look beyond them, to be aware of how they can be leveraged for harm and to recognize that there are other ways for communities to make sense of their distress without these labels. I’m asking you to embrace complexity and create space for it. The rest of the world should not have to speak this precise language. The language of colonial psychiatry should never have been forced upon the global south and it shouldn’t be today, including any reclaimed version within the neurodiversity framework.” Psychiatric diagnoses & bioessentialism will not liberate us

#madpride

Après la Mad Pride Autonome 2025, Wow Une Dinguerie (WUD) : Podcast politique en cours de production qui lance un appel à témoignages : https://wowunedinguerie.wixsite.com/accueil

https://www.youtube.com/watch?v=25G9h8ZmgpM
#antipsychiatrie #Madpride