"For decades now, the public has been told that depression is caused by a chemical imbalance in the brain and that antidepressants can help rectify this. In 2022, my team and I published a systematic, umbrella review showing there is no compelling evidence that depression is caused by a deficiency of serotonin, specifically. Leading psychiatrists continue to present depression as a condition that is caused by a biological process, but no other mechanism has been established."
"Previous studies with students and people recruited online suggest that believing that depression is caused by a biological mechanism leads to " prognostic pessimism." People who hold such beliefs are less likely to believe they will recover than those who do not. In a study of patients enrolled in a psychotherapeutic program, those who endorsed a biological explanation for their condition had lower expectations and worse outcomes than those who did not."
Antidepressant prescribing has risen sharply across Western countries, with many users remaining on treatment long-term. The common explanation that depression results from a serotonin deficiency lacks compelling evidence. Endorsing biological causes for depression is associated with prognostic pessimism, lower recovery expectations, poorer psychotherapy outcomes, and reluctance to discontinue medication. A survey of 497 people attending a national psychological therapy program who had used antidepressants asked about perceived causes and beliefs about how antidepressants work. Respondents were classified by endorsement of biological causation and medication mechanisms. Beliefs about biological causation influence expectations of recovery and decisions about continuing or stopping medication.
Read at Psychology Today
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