“Common Knowledge” that was Accepted as truth about Depression
For decades, the dominant explanation for depression has centered around a “chemical imbalance” in the brain—most notably, a deficiency in serotonin. This theory shaped how millions of people understood their mental health, influenced public awareness campaigns, and supported widespread prescribing of antidepressants like SSRIs (Selective Serotonin Reuptake Inhibitors).
But in 2022, a landmark scientific review published in Molecular Psychiatry challenged this long-held belief—and opened the door to a broader, more holistic conversation about what truly causes depression and how best to treat it.
Common knowledge had no basis. It’s really common assumption.
What the Study Found
The study, led by psychiatrist Dr. Joanna Moncrieff and colleagues, is titled: “The serotonin theory of depression: a systematic umbrella review of the evidence” (Moncrieff et al., 2022, Molecular Psychiatry).
You can access the full article here: https://doi.org/10.1038/s41380-022-01661-0
This umbrella review analyzed findings from dozens of studies across multiple areas of serotonin research, including:
- Serotonin levels in the blood and brain
- Serotonin receptors and transporters
- Genetic variations affecting serotonin activity
- The impact of tryptophan depletion (a precursor to serotonin)
The conclusion? There is no consistent or convincing evidence that low serotonin levels cause depression.
This doesn’t mean serotonin plays no role at all in mood—but the idea that depression is simply a chemical imbalance has been scientifically unsupported for some time. What this study did was bring that reality to public attention in a major way.
Why This Matters
Many people have been told—often in good faith—that their depression is caused by a chemical imbalance, much like a diabetic might be told they lack insulin. That explanation, while reassuring for some, may oversimplify the truth and obscure other important causes of depression such as:
- Trauma and early life stress
- Chronic pain or illness
- Loneliness and lack of support
- Grief, loss, or unresolved life experiences
- Systemic oppression, poverty, or inequality
Framing depression solely as a biological glitch can also lead to:
- Over-reliance on medication without exploring other necessary treatment options
- Stigma or confusion when antidepressants don’t work as expected
- Dismissal of the emotional, relational, and social roots of suffering
What Does This Mean for Antidepressants?
The review does not claim that antidepressants are useless. In fact, many people still find relief from them—though often through mechanisms not fully understood. Antidepressants can affect emotional reactivity and pain processing, and some individuals report meaningful improvement.
But the idea that they are “correcting a serotonin imbalance” is not supported by current evidence.
This shift in understanding calls for greater transparency and informed consent in how depression and its treatments are discussed. People deserve to know that:
- Depression is complex and multifaceted.
- Recovery is possible—and likely will involve more than just medication.
- Therapy, lifestyle support, connection, and trauma healing are often essential parts of the path forward.
A More Holistic, Trauma-Informed Approach
As a trauma-informed mental health practice, it’s time we embrace a more honest and compassionate model of care—one that sees depression not as a brain defect, but as a signal of unmet needs, unresolved pain, or deep emotional overwhelm. This is best done with the guidance of a therapist skilled in treating depression. To learn more, TADAS counseling for depression.
That might mean:
- Exploring the roots of emotional distress in a safe, supportive therapeutic space
- Reconnecting with your body through somatic or grounding practices
- Building meaningful relationships and supportive community
- Healing trauma through evidence-based approaches like EMDR, IFS, or parts work
- Making gradual lifestyle shifts that honor your nervous system, energy, and needs
And not mentioned is Neurofeedback, highly effective in treating and long overlooked by the American medical system.
There is no one-size-fits-all path to healing, but there is always hope—and always more to the story than a serotonin imbalance. Ongoing stress and anxiety can sometimes lead to depression over time — you can read more about our approach to Depression Counseling here.
Final Thoughts
Science is always evolving, and with it, our understanding of mental health must evolve too. The Moncrieff et al. study reminds us that depression is not just biological—it’s personal, social, and psychological. When we recognize that, we can offer care that is not only more accurate, but more empowering, human, and healing.
Citation:
Moncrieff, J., Cooper, R. E., Stockmann, T., Amendola, S., Hengartner, M. P., & Horowitz, M. A. (2022). The serotonin theory of depression: a systematic umbrella review of the evidence. Molecular Psychiatry, 27(10), 2401–2413. https://doi.org/10.1038/s41380-022-01661-0
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