I'm aiming to make this a regular series, so please ask any questions below -- about psychiatry, mental health, or whatever (it does say anything in the title). Until other users add Qs here, I'll continue to add some that are frequently asked to me. Q: Are chemical imbalances a real thing? A: Yes and no. It's quite a bit more complex. The myth of a deficiency of a chemical such as serotonin (SSRIs such as prozac raise serotonin) being the sole cause of depression is definitely incomplete. SSRIs do raise serotonin levels, but that's probably not how they help with depression. Instead after raising serotonin, that causes a drop in serotonin receptors (the things that serotonin attaches to), which changes something else, which changes something else, and eventually gets to something called BDNF. This is a signal that your brain already has that it uses to tell itself to make new brain cells. When someone is depressed (or chronically anxious/stressed), that signal is lower. Antidepressants, regardless of whether they work on serotonin or any number of other mechanisms, leads to increased BDNF. It's like helping the brain rebound from stress. As a note, exercise can also raise BDNF, but much more transiently. Yet even this isn't a complete picture. The brain "state" is just one angle. Everytime we have a thought, or some particularly new experience, or behavior, or probably diet, in some way we're changing our brain state including the chemicals inside. Changing our thoughts affects the chemicals, and changing the chemicals affects our thoughts. Thus therapy is very important.
