Serotonin, first isolated in 1933, is the neurotransmitter that has been identified in multiple psychiatric disorders including depression, obsessive-compulsive disorder, anorexia, bulimia, body dysmorphic disorder (nose doesn't look perfect after ten surgeries), social anxiety, phobias, etc. Serotonin is a major regulator and is involved in bodily processes such as sleep, libido (sexual interest), body temperature, and other areas.
Perhaps the best way to think of Serotonin is again with an automobile example. Most automobiles in the United States are made to cruise at 70 miles per hour, perfect for interstate highways and that summer vacation. If we place that same automobile on a racetrack and drive day-after-day at 130 mph, two things would happen. Parts would fail and we would run the engine so hot as to evaporate or burnout the oil. Serotonin is the brain's "oil".
Like a normal automobile on a race track, when we find ourselves living in a high stress situation for a prolonged period of time, we use more Serotonin than is normally replaced. Imagine a list of your pressures, responsibilities, difficulties and environmental issues (difficult job, bad marriage, poor housing, rough neighborhood, etc.). Prolonged exposure to such a high level of stress gradually lowers our Serotonin level. As we continue to "hang on" we develop symptoms of a severe stress-produced depression.
An automobile can be one, two or three quarts low in oil. Using the automobile as an example, imagine that brain Serotonin can have similar stages, being low (one quart low), moderately low (two quarts low), and severely low (three quarts low). The less Serotonin available in the brain, the more severe our depression and related symptoms.
When Serotonin is low, we experience problems with concentration and attention. We become scatterbrained and poorly organized. Routine responsibilities now seem overwhelming. It takes longer to do things because of poor planning. We lose our car keys and put odd things in the refrigerator. We call people and forget why we called or go to the grocery and forget what we needed. We tell people the same thing two or three times.
As stress continues and our Serotonin level continues to drop, we become more depressed. At this point, moderately low or "two quarts" low, major changes occur in those bodily functions regulated by Serotonin. When Serotonin is moderately low, we have the following symptoms and behaviors:
Individuals can live many years moderately depressed. They develop compensations for the sleep and other symptoms, using sleeping medication or alcohol to get some sleep. While chronically unhappy and pessimistic, they explain their situation with "It's just my life!" They may not fully recognize the depressive component.
Very low levels of Serotonin typically bring people to the attention of their family physician, their employer, or other sources of help. Severe Serotonin loss produces symptoms that are difficult to ignore. Not only are severe symptoms present, but also the brain's ideation/thinking becomes very uncomfortable and even torturing. When Serotonin is severely low, you will experience some if not all of the following:
Clinical Depression is perhaps the most common mental health problem encountered in practice. One in four adults will experience clinical depression within their lifetime. Depression is the "common cold" of mental health practice – very common and much easier to treat today than in the past.
Treatment for depression, as might be expected, involves increasing levels of Serotonin in the brain. Since the mid-eighties, medications have been available that attempt to specifically target and increase Serotonin. Known as Selective Serotonin Reuptake Inhibitors (SSRI's), these medications such as Prozac, Zoloft, and Paxil are felt to work by making more Serotonin available in the brain.
Like all neurotransmitters, we can have too much Serotonin. While elevated levels of Serotonin produce a sense of well-being, bliss, and "oneness with the universe" – too much Serotonin can produce a life-threatening condition known as Serotonin Syndrome (SS).
Likely to occur by accident by combining two Serotonin-increasing medications or substances, Serotonin Syndrome (SS) produces violent trembling, profuse sweating, insomnia, nausea, teeth chattering, chilling, shivering, aggressiveness, over-confidence, agitation, and malignant hyperthermia. Emergency medical treatment is required, utilizing medications that neutralize or block the action of Serotonin as the treatment for Serotonin Syndrome (SS).
Like Dopamine, Serotonin can be accidentally increased or decreased by substances. One method of birth control is known to produce severe depression as it lowers Serotonin levels. A specific medication for acne has also been linked with depression and suicidal ideation. For this reason, always inform your physicians if you are taking any medication for depression. Also avoid combining antidepressants with any herbal substances reported to be of help in Depression such as St. John's Wort.
Joseph M. Carver, Ph.D. is a clinical psychologist in southern Ohio USA. He began his career in 1971, and has practiced in psychiatric and medical hospitals, community mental health centers, and private practice. He is currently in private practice. He also provides expert witness testimony for the Social Security Administration. In May 2007 he became a Consulting Psychologist for Counselling Resource in Great Britain.
Topics - Living With Mental Illness