【Mingpao News】You may have heard that mood disorders are related to the transmission of substances in the brain. One of the well-known transmitter substances is serotonin, but there are others such as norepinephrine, dopamine, and others. Patients will ask, am I depressed because of a lack of serotonin? In fact, this is a complex issue.
Low serotonin levels don’t equal depression, mood illness is stress response
First of all, in daily clinical application, we cannot diagnose whether a patient suffers from a mood disorder due to low serotonin by measuring the level of serotonin in the blood, because the level of serotonin in the blood cannot reflect the level in the brain; even if we measure The level of serotonin in brain fluid does not reflect the level of serotonin activity in nerve endings. Therefore, except at the research level, we do not measure serotonin levels in the diagnosis and treatment of mood disorders.
The relationship between serotonin, the transmitter substance, and mood disorders is not fully understood by the medical community today. In the past few decades, the medical community has always believed that the level of serotonin activity in the brain is related to depression and other emotional diseases, and then developed serotonin drugs to treat depression. These drugs have been clinically proven to be effective, and we believe that these drugs achieve their curative effect by regulating serotonin in the brain. However, we have not yet fully understood the relationship between serotonin and mood disorders. We have not yet fully understood whether there are other mechanisms behind it that can make mood disorders better.
It is even more important for us to understand that mood illness is a stress response. A concept like “vitamin deficiency” cannot be used to understand that lack of serotonin will lead to mood disorders. Among them, the disorder of these transfer substances may only be one manifestation of the stress response. When medications help regulate the transmitter substances, the symptoms of mood disorders can be relieved, but if the underlying source of stress is not found, the mood disorders may reappear.
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Take medication to deal with emotional symptoms before looking for causes of stress
It’s worth mentioning that when we’re in a bad mood, we’re not equipped to handle stress. Because dealing with stress takes mental effort, the process is not easy. Therefore, when emotions make us feel exhausted, we can get twice the result with half the effort if we first use drugs to deal with the emotional symptoms, and then discuss the underlying causes of stress.
Remember, the source of stress is not only external pressure, thoughts and values also affect the pressure we feel. The most famous example is half a glass of water: Some people feel relieved when they see half a glass of water and can drink it slowly; others feel worried that they will die of thirst after drinking the half glass. Why are some people more pessimistic and others more optimistic? It has something to do with our growth and our past. Our past experiences all affect our values, which in turn subtly affect our reactions to people and choices about things, which are important factors in the source of stress.
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Drugs can balance the delivery of substances in the brain to help restore the state
In simple terms, mood illness is not just a disorder of biological delivery of substances, it is actually a stress response. Symptoms of mood disorders appear when the stress is too great or persistent and the body cannot bear it. Drugs can improve symptoms and restore us to the state by balancing the transmission substances in the brain, but it is also important to explore the causes of stress.
Text: Ho Ho Yin (Psychiatrist)